Establishing causality in pediatric adverse drug reactions: use of the Naranjo probability scale.
Carbamazepine hypersensitivity syndrome is a rare, life-threatening condition. Its diagnosis is critical to avoid future exposure to aromatic anticonvulsants. Pediatricians rarely use a systematic approach to establish the cause of drug reactions in the clinical setting. We describe the use of the Naranjo adverse drug reaction probability scale to establish causality in three cases of suspected anticonvulsant hypersensitivity syndrome with the aim of introducing clinicians to this effective tool. Our analysis reveals that this method is useful, but also highlights potential areas for its improvement.
Avner
Marina
M
Division of Clinical Pharmacology/Toxicology, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.
Finkelstein
Yaron
Y
Hackam
Dan
D
Koren
Gideon
G
D000927:Anticonvulsants / Q000009:adverse effects*; D002220:Carbamazepine / Q000009:adverse effects*; D015984:Causality; D002648:Child; D002675:Child, Preschool; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D010818:Practice Patterns, Physicians'; D011336:Probability; D012640:Seizures / Q000188:drug therapy; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013577:Syndrome
D000927:Anticonvulsants; D002220:Carbamazepine
Semin Cutan Med Surg. 1996 Dec;15(4):217-27
9069589
Crit Care Clin. 1997 Oct;13(4):727-39
9330838
Drug Saf. 1999 Dec;21(6):489-501
10612272
Biol Neonate. 1995;67(4):223-9
7647145
Neurology. 1979 Nov;29(11):1480-5
574201
Arch Intern Med. 1995 Nov 27;155(21):2285-90
7487252
Adverse Drug React Acute Poisoning Rev. 1987 Spring;6(1):1-35
3303863
J Clin Invest. 1988 Dec;82(6):1826-32
3198757
Clin Pharmacol Ther. 1981 Aug;30(2):239-45
7249508
Clin Pharmacol Ther. 1995 Dec;58(6):692-8
8529335
Chest. 1978 Oct;74(4):463-4
151618