Lamotrigine-induced toxic epidermal necrolysis in a young epileptic

Sofi, Fayaz Ahmad; Koul, Parvaiz A; Mufti, Showkat Ali; Dhobi, Ghulam Nabi

doi:10.1136/bcr.04.2011.4149

Cited by 4 publications

(2 citation statements)

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“…Skin rashes may be the most common reason for drug withdrawal and treatment nonadherence. 23 The retention rate due to adverse reactions was 37.8% in this study.…”

Section: Discussionmentioning

confidence: 44%

Antiepileptic Drug Adverse Cutaneous Reaction in Childhood

Yimenicioglu

Ekici

Türkeli³

et al. 2022

Journal of Pediatric Epilepsy

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Antiepileptic drug (AED) side effects can result in treatment failure, morbidity, and mortality. Adverse cutaneous drug reactions (ACRs) frequently occur within the first 2 to 3 months of drug use. We wanted to discuss antiepileptic ACRs in childhood in this study. This was a study of 37 pediatric patients who were diagnosed with ACR and treated with AED in the last 5 years. Over a 5-year period, 37 (1.8%) of the 2,064 epilepsy patients had ACRs. There were 23 (62%) male patients and 14 (38%) female patients. Patients had a median age of 6 years (interquartile range: [IQR]: 3.5–10). The ACRs occurred in a median of 20 (IQR: 14–30) days. There were 28 (75%) patients receiving monotherapy and 9 (25%) patients receiving polytherapy. Overall, 22 (59.5%) of the 37 patients used aromatic drugs (AD), while 15 (40.5%) used nonaromatic drugs (NAD). Morbilliform eruptions accounted for the majority of ACRs (84%). Valproic acid (54%) was the most frequently used AED that resulted in ACRs. There was no significant difference in terms of eruption time, gender, or age between AD and NAD. Within 1 to 2 months of initiating a new AED, patients should be closely monitored for ACRs. If an ACR develops for one AED, greater caution should be taken when initiating the other AED. Although it is well established that ADs cause more skin reactions, we found that one of the NADs, valproic acid, causes more skin reactions.

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“…Skin rashes may be the most common reason for drug withdrawal and treatment nonadherence. 23 The retention rate due to adverse reactions was 37.8% in this study.…”

Section: Discussionmentioning

confidence: 44%

Antiepileptic Drug Adverse Cutaneous Reaction in Childhood

Yimenicioglu

Ekici

Türkeli³

et al. 2022

Journal of Pediatric Epilepsy

View full text Add to dashboard Cite

show abstract

“…Os cuidados suportivos devem ser iniciados, como hidratação, reposição de eletrólitos, cuidado com as vias aéreas, controle da temperatura ambiental e manipulação cuidadosa e asséptica.As lesões de pele são tratadas como queimaduras, entretanto não existe um consenso sobre os anos de idade, mas apresentava uma clínica sugestiva da síndrome de Stevens Johnson, além de estar em uso de um dos medicamentos que possui como efeitos adversos essa reação cutânea grave, o tempo utilizado do fármaco estar entre uma e três semanas do inicio dos sintomas (mesmo estando fora desse período não pode-se descartar o diagnóstico, mas esse é o período que normalmente ocorre) e pode ocorrer em todas as faixas etárias, sendo assim vista como um dos prováveis diagnósticos inicialmente. A Lamotrigina possui alguns efeitos adversos e dentre esses, 3 reações severas, a descrita no caso acima e temos: Necrólise Epidérmica Tóxica e Síndrome de Hipersensibilidade a Droga, que devem fazer parte do diagnóstico diferencial (SOFI et al, 2011)…”

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