Lamotrigine-induced toxic epidermal necrolysis confirmed by in vitro granulysin and cytokine assays.
Lamotrigine is a recent medication which is prescribed for various neuropsychiatric conditions. It is generally well-tolerated, but recent pharmacoepidemiological evidence suggests that lamotrigine is associated with risks of developing severe cutaneous drug reactions like toxic epidermal necrolysis (TEN). However, there still remains the diagnostic challenge regarding how to confirm the drug causality in suspected cases. In most cases so far, lamotrigine causality has not been objectively demonstrated, which was possibly due to high risk of oral challenge tests or the lack of useful in vitro drug assays. Here we report a case of lamotrigine-induced TEN, of which the drug causality was confirmed by in vitro granulysin and cytokine assays.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul 110-799, Korea. ; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 110-799, Korea.
Ha-Kyeong
HK
Won
Department of Internal Medicine, Seoul National University College of Medicine, Seoul 110-799, Korea. ; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 110-799, Korea.
Ji-Won
JW
Lee
Department of Internal Medicine, Seoul National University College of Medicine, Seoul 110-799, Korea. ; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 110-799, Korea.
Woo-Jung
WJ
Song
Division of Allergy and Clinical Immunology, Department of Medicine, Faculty of Medicine, Allergy and Clinical Immunology Research Group, Chulalongkorn University, Bangkok 10330, Thailand.
Jettanong
J
Klaewsongkram
Department of Internal Medicine, Seoul National University College of Medicine, Seoul 110-799, Korea. ; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 110-799, Korea. ; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam 463-707, Korea.
Min-Gyu
MG
Kang
Department of Internal Medicine, Seoul National University College of Medicine, Seoul 110-799, Korea. ; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 110-799, Korea.
Han-Ki
HK
Park
Department of Internal Medicine, Seoul National University College of Medicine, Seoul 110-799, Korea. ; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 110-799, Korea.
Hyun-Seung
HS
Lee
Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu 800-842, Korea.
Min-Hye
MH
Kim
Department of Internal Medicine, Seoul National University College of Medicine, Seoul 110-799, Korea. ; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 110-799, Korea. ; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam 463-707, Korea.
Yoon-Seok
YS
Chang
Department of Internal Medicine, Seoul National University College of Medicine, Seoul 110-799, Korea. ; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 110-799, Korea.
Sang-Heon
SH
Cho
Department of Internal Medicine, Seoul National University College of Medicine, Seoul 110-799, Korea. ; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 110-799, Korea.
Kyung-Up
KU
Min
Cyclosporine; Granulysin; Lamotrigine; Natural killer cells; Toxic epidermal necrolysis