title: Lamotrigine induced DIHS/DRESS: Manifestations, treatment, and outcome in 57 patients.
abstract: OBJECTIVE
  To evaluate the clinical features, course, response to treatment, and outcome of lamotrigine induced drug-induced hypersensitivity syndrome (DIHS) or drug reaction with eosinophilia and systemic symptoms (DRESS).
  
  
  METHODS
  A comprehensive PubMed and Scopus search (covering the period from January 1999 through April 2014) of the English and non-English literature (with English abstract) was conducted to identify published reports of severe cutaneous adverse reactions (SCARs) associated with lamotrigine therapy.
  
  
  RESULTS
  This study population included 57 patients, of whom 38 (66.67%) were female and 19 (33.33%) were male. The latency period varied from 9 days to 120 days, with a mean of 27.58 ± 20.65 days. Multisystem involvement was present in 97.37% (37/38) patients. Systemic corticosteroids were administered to (61.29%) 19/31 patients. 35/38 (92.11%) patients recovered completely, one patient developed liver failure and needed liver transplant, one died from septic shock and one died from multiple organ failure.
  
  
  CONCLUSIONS
  We found a greater predominance of women with LTG-DIHS/DRESS, and 68.42% patients were >18 years of age. The presenting symptoms in most of patients were fever, skin rash, liver involvement, hypereosinophilia, and lymphadenopathy. Lamotrigine is associated to a rather high risk of severe cutaneous adverse reactions and to the risk of dying from such reactions, likes many other anticonvulsants. Early recognition and withdrawal of the suspected agent may avoid irreversible damage to the organs will be life saving.
authors.affiliation: Department of Neurology, The Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing 100853, China. Electronic address: bjxqwang13@163.com.
authors.forename: Xiang-qing
authors.initials: XQ
authors.lastname: Wang
authors.affiliation: Department of Neurology, The Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing 100853, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Lv
authors.affiliation: Department of Neurology, The Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing 100853, China.
authors.forename: Hong-fen
authors.initials: HF
authors.lastname: Wang
authors.affiliation: Department of Neurology, The Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing 100853, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Neurology, The Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing 100853, China.
authors.forename: Sheng-yuan
authors.initials: SY
authors.lastname: Yu
authors.affiliation: Department of Neurology, The Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing 100853, China.
authors.forename: Xu-sheng
authors.initials: XS
authors.lastname: Huang
authors.affiliation: Department of Neurology, The Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing 100853, China.
authors.forename: Jia-tang
authors.initials: JT
authors.lastname: Zhang
authors.affiliation: Department of Neurology, The Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing 100853, China.
authors.forename: Cheng-lin
authors.initials: CL
authors.lastname: Tian
authors.affiliation: Department of Neurology, The Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing 100853, China. Electronic address: lansy@263.net.
authors.forename: Sen-yang
authors.initials: SY
authors.lastname: Lang
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000927:Anticonvulsants / Q000009:adverse effects*; D063926:Drug Hypersensitivity Syndrome / Q000209:etiology* / Q000401:mortality; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D014227:Triazines / Q000009:adverse effects*
chemical_list: D000305:Adrenal Cortex Hormones; D000927:Anticonvulsants; D014227:Triazines; D000077213:Lamotrigine
keywords: Anticonvulsant hypersensitivity syndrome; Antiepileptic drugs; Drug reaction with eosinophilia and systemic symptoms; Drug-induced hypersensitivity syndrome; Lamotrigine