Lamotrijin İlişkili Dress Sendromu: Bir Vaka Sunumu

Dress sendromu drug rash with eosinophilia and systemic symptoms ateş, cilt döküntüsü, iç organ tutulumuyla karakterize yaşamı tehdit edebilen ender, akut başlangıçlı, şiddetli bir ilaç reaksiyonudur. En sık nedenleri aromatik antikonvülzanlar ve sülfonamidlerdir. Yeni bir antikonvül- zan olan lamotrijin de ender olarak Dress sendromuna yol açabilir. Valproat ile birlikte kullanıldığında lamotrijin ile ilişkili cilt döküntülerinin sıklığı artış gösterebilmektedir. Burada epilepsi tanısıyla valproat kullanırken, lamotrijin tedavisi eklendikten 12 gün sonra ateş, karın ağrısı, cilt döküntüsü yakınmaları ile başvurup, Dress sendromu tanı- sı konulan ve sistemik kortikosteroid ve intravenöz immung- lobulin IVIG ile başarılı bir şekilde tedavi edilen sekiz yaşında bir kız vaka sunulmaktadır

Lamotrigine Associated Dress Syndrome: A Case Report

Dress syndrome drug rash with eosinophilia and systemic symptoms is a rare, acute, severe, life-threatening drug reaction; characterized by fever, rash, internal organ involvement. Aromatic anticonvulsants and sulphonamides are most frequent causes. Lamotrigine, a new anticonvul- sant, is also known to be a rare cause. Skin rashes associ- ated with lamotrigine is more common when combined with valproate. Here we represent a case of an eight-years- old girl diagnosed as Dress syndrome who suffered from fever, rash, stomachache after 12 days of adding lamotri- gine to her valproate treatment which was administered for her epilepsy. She was successfuly treated with systemic corticosteroid and intravenous immunoglobulin IVIG

___

  • 1. Vaillant L. Drug hypersensitivity syndrome :drug rash with eosinophilia an systemic symptoms (DRESS). J Derm Treatment 1999; 10:267-72.
  • 2. Tas S, Simonart TH. Dress syndrome. Acta Clinica Belgica, 1999; 54-4:197-200.
  • 3. Tas S. Simonart T. Management of DRESS syndrome: an update. Dermatology 2003; 206:353-6.
  • 4. Chiou CC, Yang LC, Hung SI, et al. Clinicopathological features and prognosis of drug rash with eosinophilia and systemic symptoms: a study of 30 cases in Taiwan. JEADV 2008; 22:1044-9.
  • 5. Yun SJ, Lee JB, Kim EJ, et al. Drug rash with eosinophilia and systemic symptoms induced by valproate and carbamazepine: formation of circulating auto antibody against 190-kDa antigen. Acta Derm Venereol 2006; 86:241-4.
  • 6. Ganeva M, Gancheva T, Lazarova R, et al. Carbamazepine induced DRESS syndrome: report of four cases and brief review. Int J Derm 2008; 47:853-60
  • 7. Pellock JM. The clinical efficacy of lamotrigine as an antiepileptic drug. Neurology 1994; 44:29-85.
  • 8. Shelton MD, Calabrase JR. Lamotrigine. In: Schatzberg AF, Nemeroff CB. Textbook of Psychopharmacology, 3th ed, London, England 2004; 615-26.
  • 9. Naisbitt DJ, Farrell J, Wong G, et al. Characterization of drug spesific T cells in lamotrigin hypersensitivity. J Allergy Clin Immunol 2003; 111:1393-403.
  • 10. Ferahbaş A, Özyurt K. Antikonvülzan hipersensitivite sendromu. Erciyes Tıp Dergisi (Erciyes Med J) 2002; 24(2):107- 11.
  • 11. Şahin E, Karaman G, Şendur N, Şavk E. Antikonvülzan hipersensitivite sendromlu dört vaka. ADÜ Tıp Fakültesi Dergisi 2006; 7(1):39-42.
  • 12. Prais D, Straussberg R, Amir J, Nussinovitch M, Harel L. Treatment of anticonvulsant hypersensitivity syndrome with intravenous immunoglobulins and corticosteroids. J Child Neurol. 2006; 21:380-4
  • 13. Santos RP, Ramillo O, Barton T. Nevirapine-associated rash with eosinophilia and systemic symptoms in a child with Human Immunodeficiency Virus Infection. Pediatr Infect Dis J 2007; 26:1053-6.
Çocuk Dergisi-Cover
  • ISSN: 1302-9940
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2000
  • Yayıncı: İstanbul Üniversitesi