Xiang-qing Wang1, Bin Lv2, Hong-fen Wang2, Xu Zhang2, Sheng-yuan Yu2, Xu-sheng Huang2, Jia-tang Zhang2, Cheng-lin Tian2, Sen-yang Lang3. 1. Department of Neurology, The Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing 100853, China. Electronic address: bjxqwang13@163.com. 2. Department of Neurology, The Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing 100853, China. 3. Department of Neurology, The Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing 100853, China. Electronic address: lansy@263.net.
Abstract
OBJECTIVE: To evaluate the clinical features, course, response to treatment, and outcome of lamotrigine induced drug-induced hypersensitivity syndrome (DIHS) or drug reaction with eosinophilia and systemic symptoms (DRESS). METHODS: A comprehensive PubMed and Scopus search (covering the period from January 1999 through April 2014) of the English and non-English literature (with English abstract) was conducted to identify published reports of severe cutaneous adverse reactions (SCARs) associated with lamotrigine therapy. RESULTS: This study population included 57 patients, of whom 38 (66.67%) were female and 19 (33.33%) were male. The latency period varied from 9 days to 120 days, with a mean of 27.58 ± 20.65 days. Multisystem involvement was present in 97.37% (37/38) patients. Systemic corticosteroids were administered to (61.29%) 19/31 patients. 35/38 (92.11%) patients recovered completely, one patient developed liver failure and needed liver transplant, one died from septic shock and one died from multiple organ failure. CONCLUSIONS: We found a greater predominance of women with LTG-DIHS/DRESS, and 68.42% patients were >18 years of age. The presenting symptoms in most of patients were fever, skin rash, liver involvement, hypereosinophilia, and lymphadenopathy. Lamotrigine is associated to a rather high risk of severe cutaneous adverse reactions and to the risk of dying from such reactions, likes many other anticonvulsants. Early recognition and withdrawal of the suspected agent may avoid irreversible damage to the organs will be life saving.
OBJECTIVE: To evaluate the clinical features, course, response to treatment, and outcome of lamotrigine induced drug-induced hypersensitivity syndrome (DIHS) or drug reaction with eosinophilia and systemic symptoms (DRESS). METHODS: A comprehensive PubMed and Scopus search (covering the period from January 1999 through April 2014) of the English and non-English literature (with English abstract) was conducted to identify published reports of severe cutaneous adverse reactions (SCARs) associated with lamotrigine therapy. RESULTS: This study population included 57 patients, of whom 38 (66.67%) were female and 19 (33.33%) were male. The latency period varied from 9 days to 120 days, with a mean of 27.58 ± 20.65 days. Multisystem involvement was present in 97.37% (37/38) patients. Systemic corticosteroids were administered to (61.29%) 19/31 patients. 35/38 (92.11%) patients recovered completely, one patient developed liver failure and needed liver transplant, one died from septic shock and one died from multiple organ failure. CONCLUSIONS: We found a greater predominance of women with LTG-DIHS/DRESS, and 68.42% patients were >18 years of age. The presenting symptoms in most of patients were fever, skin rash, liver involvement, hypereosinophilia, and lymphadenopathy. Lamotrigine is associated to a rather high risk of severe cutaneous adverse reactions and to the risk of dying from such reactions, likes many other anticonvulsants. Early recognition and withdrawal of the suspected agent may avoid irreversible damage to the organs will be life saving.
Authors: Song Hee Han; Min Seok Hur; Hae Jeong Youn; Nam Kyung Roh; Yang Won Lee; Yong Beom Choe; Kyu Joong Ahn Journal: Ann Dermatol Date: 2017-03-24 Impact factor: 1.444
Authors: Fabrizio De Luca; Laura Michelina Losappio; Corrado Mirone; Jan Walter Schroeder; Antonella Citterio; Maria Gloria Aversano; Joseph Scibilia; Elide Anna Pastorello Journal: Clin Mol Allergy Date: 2017-10-04