Eslicarbazepine acetate as a therapeutic option in a patient with carbamazepine-induced rash and HLA-A*31:01.
Eslicarbazepine acetate (ESL) is an anticonvulsant drug approved for the treatment of focal epilepsies, and related to oxcarbazepine and carbamazepine (CBZ), which are also derivatives of the dibenzazepine family. ESL is contraindicated in patients with hypersensitivity reactions to CBZ.We report a patient with frontal lobe epilepsy responding to treatment with ESL without any serious adverse effects after developing a severe skin rash following treatment with CBZ. HLA testing revealed an HLA-A*31:01 haplotype, that increases the risk of CBZ-induced cutaneous reactions.This case study shows that, in clinical practice, ESL may be considered in a patient with the HLA-A*31:01 haplotype and a hypersensitivity reaction to CBZ.
Goethe University Frankfurt, Epilepsy Center Frankfurt Rhine-Main, Frankfurt am Main, Germany; Philipps-University Marburg, Epilepsy Center Hessen, Marburg, Germany.
Lara
L
Kay
Goethe University Frankfurt, Epilepsy Center Frankfurt Rhine-Main, Frankfurt am Main, Germany.
Laurent M
LM
Willems
Goethe University Frankfurt, Epilepsy Center Frankfurt Rhine-Main, Frankfurt am Main, Germany.
Johann Philipp
JP
Zöllner
Goethe University Frankfurt, Epilepsy Center Frankfurt Rhine-Main, Frankfurt am Main, Germany.
Philipp S
PS
Reif
Goethe University Frankfurt, Epilepsy Center Frankfurt Rhine-Main, Frankfurt am Main, Germany; Philipps-University Marburg, Epilepsy Center Hessen, Marburg, Germany.
Karl Martin
KM
Klein
Goethe University Frankfurt, Epilepsy Center Frankfurt Rhine-Main, Frankfurt am Main, Germany; Philipps-University Marburg, Epilepsy Center Hessen, Marburg, Germany.
Felix
F
Rosenow
Goethe University Frankfurt, Epilepsy Center Frankfurt Rhine-Main, Frankfurt am Main, Germany; Philipps-University Marburg, Epilepsy Center Hessen, Marburg, Germany. Electronic address: strzelczyk@med.uni-frankfurt.de.
Adam
A
Strzelczyk
D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use*; D002220:Carbamazepine / Q000009:adverse effects* / Q000627:therapeutic use; D003984:Dibenzazepines / Q000627:therapeutic use*; D017034:Epilepsy, Frontal Lobe / Q000188:drug therapy / Q000235:genetics; D005076:Exanthema / Q000209:etiology* / Q000235:genetics; D005260:Female; D059910:HLA-B15 Antigen / Q000235:genetics*; D006239:Haplotypes; D006801:Humans; D000071184:Pharmacogenomic Variants; D061567:Voltage-Gated Sodium Channel Blockers / Q000627:therapeutic use
D000927:Anticonvulsants; D003984:Dibenzazepines; C483536:HLA-B*15:02 antigen; D059910:HLA-B15 Antigen; D061567:Voltage-Gated Sodium Channel Blockers; D002220:Carbamazepine; C416835:eslicarbazepine acetate
Allergic; Carbamazepine epoxide; HLA-B*1502; Skin reaction