Toxic epidermal necrolysis with isolated neutropenia related to the use of levetiracetam

Oh, Su Jin; Kwon, Hyoung Il; Moon, Seong Hun; Ro, Young Suck; Ko, Joo Yeon

doi:10.1111/1346-8138.13309

Cited by 5 publications

(2 citation statements)

References 4 publications

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“…106 Patients with SJS/TEN may develop neutropenia, especially in severe cases. 116,117 The role of recombinant human G-CSF in this setting is uncertain (median 5, DI 0.32). 118,119…”

Section: Infection Surveillancementioning

confidence: 99%

Society of Dermatology Hospitalists supportive care guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults

Seminario‐Vidal

Kroshinsky

Malachowski

et al. 2020

Journal of the American Academy of Dermatology

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Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening conditions with high morbidity and mortality. Supportive care management of SJS/TEN is highly variable. A systematic review of the literature was performed by dermatologists, ophthalmologists, intensivists and gynecologists with expertise in SJS/TEN to generate statements for supportive care guideline development. Members of the Society of Dermatology Hospitalists (SDH) with expertise in SJS/TEN were invited to participate in a modified, online Delphi-consensus. 9-point Likert scale questionnaires regarding 135 statements were administered. The RAND/UCLA appropriateness method was employed to evaluate and select proposed statements for guideline inclusion; statements with median ratings of 6.5-9 and disagreement index ≤1 were included in the guideline. For the final round, the guidelines were appraised by all the participants. An evidence-based discussion and recommendations for hospital setting and care team, wound care, ocular care, oral care, urogenital care, pain management, infection surveillance, fluid and electrolyte management, nutrition and stress ulcer prophylaxis, airway management, and anticoagulation in adult patients with SJS/TEN are included.

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“…106 Patients with SJS/TEN may develop neutropenia, especially in severe cases. 116,117 The role of recombinant human G-CSF in this setting is uncertain (median 5, DI 0.32). 118,119…”

Section: Infection Surveillancementioning

confidence: 99%

Society of Dermatology Hospitalists supportive care guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults

Seminario‐Vidal

Kroshinsky

Malachowski

et al. 2020

Journal of the American Academy of Dermatology

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“…Whether LEV causes hematological changes is controversial. Neutropenia, decreased lymphocyte count, or thrombocytopenia induced by LEV has been reported [26][27][28][29][30], while Dinopoulos et al [26] reported decreased lymphocyte count with no decrease in total WBC count. In our study, there were no significant differences between pre-and post-treatment values in all the he-matological parameters examined in patients administered LEV.…”

Section: Discussionmentioning

confidence: 98%

Effects of antiepileptic monotherapy on hematological and biochemical parameters

Yoshimura

Hara

Akaza

et al. 2019

E&S

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Sever e cytopenia and liver dysfunction ar e char acter ized as antiepileptic dr ug (AED) adverse effects dependent upon an idiosyncrasy. However, in clinical practice, we often find hematological and biochemical changes during AED treatment with causes other than an idiosyncrasy. This study aims to investigate the effect of antiepileptic monotherapy on hematological and biochemical parameters. Methods: We r etr ospectively r ecr uited 480 patients untr eated with AED at baseline. Changes in hematological and biochemical parameters before and after initiation of medication were investigated, and correlation with plasma concentrations of AED was analyzed. Results: Sixty-six of 480 patients treated with carbamazepine (CBZ: n = 27), sodium valproate (VPA: n = 19) or levetiracetam (LEV: n = 20) monotherapy were eventually selected for analysis. After CBZ treatment, decreased white blood cell (WBC) count and increased gamma-glutamyltransferase (GGT) and alkaline phosphatase (ALP) activities were recorded at high frequencies. Decreased WBC count tended to correlate with elevated serum CBZ level. Elevated GGT activity was observed in all patients treated with CBZ. In patients treated with VPA, platelet (PLT) counts decreased. In patients treated with LEV, there were no significant differences in the measured parameters before and after medication. Discussion: We consider ed that the r eduction in WBC count might be dose-dependently related to AEDs. Elevated GGT activity was observed in all patients treated with CBZ, but the average increase in GGT activity was 35.19 ± 33.08 U/L. In patients undergoing VPA treatment, decreased PLT counts were also observed at high frequency. Thus, hematological and biochemical parameters should be closely monitored in patients receiving AED, especially in patients treated with high doses of AEDs.

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Levetiracetam

2016

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Toxic epidermal necrolysis with isolated neutropenia related to the use of levetiracetam

Cited by 5 publications

References 4 publications

Society of Dermatology Hospitalists supportive care guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults

Society of Dermatology Hospitalists supportive care guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults

Effects of antiepileptic monotherapy on hematological and biochemical parameters

Levetiracetam

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