DRESS Syndrome After Lamotrigine Use in A Epilepsy Patient: A Case Report

Year 2021, Volume: 11 Issue: 3, 680 - 686, 22.09.2021

Muhammet Mesut Nezir Engin , Özlem Kaya , Hacer Efnan Melek Arsoy , Serdar Pop Öner Özdemir

https://doi.org/10.31832/smj.870429

Abstract

DRESS (Drug Rash with Eosinophilia and Systemic Symptoms) syndrome is an acute drug-induced hypersensitivity reaction. DRESS syndrome can cause morbidity and mortality, characterized by fever, skin rash, lymphadenopathy, hematological abnormalities (eosinophilia, atypical lymphocytes), internal (liver or other) organ involvement. Drugs that most commonly cause DRESS syndrome are anticonvulsants, dapsone, sulfonamides, allopurinol and minocycline. Clinical findings usually develop 1-7 weeks after the initiation of the responsible drug, this period may extend up to three months. There are reports stating that the mortality rate reaches up to 10%, and the most important cause of mortality is liver failure. Diagnostic criteria for DRESS syndrome have been established by the RegiSCAR group. In this article, a pediatric case who developed DRESS syndrome after lamotrigine treatment was presented, and the literature on current diagnosis and treatment approaches was reviewed.

Keywords

anticonvulsant drug, DRESS syndrome, lamotrigine

Epilepsi Hastasında Lamotrijin Kullanımından Sonra DRESS sendromu: Bir Olgu Sunumu

Abstract

DRESS (Drug Rash with Eosinophilia and Systemic Symptoms) sendromu ilaca bağlı akut bir aşırı duyarlılık reaksiyonudur. DRESS sendromu; ateş, deri döküntüsü, lenfadenopati, hematolojik anormallikler (eozinofili, atipik lenfositler), iç organ (karaciğer veya diğer) tutulumu ile karakterize olarak morbidite ve mortaliteye neden olabilir. DRESS sendromuna en sık neden olan ilaçlar antikonvülzanlar, dapson, sülfonamidler, allopurinol ve minosiklindir. Klinik bulgular genellikle sorumlu ilacın başlamasından 1-7 hafta sonra gelişir, bu süre üç aya kadar uzayabilir. Ölüm oranının % 10'lara kadar ulaştığını ve en önemli ölüm nedeninin karaciğer yetmezliği olduğunu bildiren makaleler vardır. DRESS sendromu için tanı kriterleri RegiSCAR grubu tarafından oluşturulmuştur. Bu yazıda lamotrijin tedavisi sonrası DRESS sendromu gelişen bir çocuk olgusu sunularak güncel tanı ve tedavi yaklaşımları ile ilgili literatür gözden geçirilmiştir.

Keywords

antikonvülsan ilaç, DRESS sendromu, lamotrijin

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