Anticonvulsant hypersensitivity syndrome

Anticonvulsant/sulfonamide hypersensitivity syndrome is a potentially serious hypersensitivity reaction that can be seen with medications with an aromatic amine chemical structure, such as aromatic anticonvulsants (e.g. diphenylhydantoin, phenobarbital, phenytoin, carbamazepine, lamotrigine), sulfonamides, or other medications with an aromatic amine (e.g., procainamide). Cross-reactivity should not occur between medications with an aromatic amine and medications without an aromatic amine (e.g., sulfonylureas, thiazide diuretics, furosemide, and acetazolamide); therefore, these medications can be safely used in the future.[1]

The hypersensitivity syndrome is characterized by a rash that is initially rash that appears similar to measles (morbilliform).[2]: 118 The rash may also be one of the potentially lethal severe cutaneous adverse reactions, the DRESS syndrome, Stevens–Johnson syndrome, or toxic epidermal necrolysis.[3][4] Systemic manifestations occur at the time of skin manifestations and include a high number of eosinophils in the blood, liver inflammation, and interstitial nephritis. However, a subgroup of patients may become hypothyroid as part of an autoimmune thyroiditis up to 2 months after the initiation of symptoms.[1]

This kind of adverse drug reaction is caused by the accumulation of toxic metabolites; it is not the result of an IgE-mediated reaction. The risk of first-degree relatives developing the same hypersensitivity reaction is higher than in the general population.[1]

As this syndrome can present secondary to multiple anticonvulsants, the general term "anticonvulsant hypersensitivity syndrome" (AHS) is favored over the original descriptive term "dilantin hypersensitivity syndrome."[2]: 118 As of 2015, two cases of AHS have been reported that manifested during long-term treatment with multiple anti-seizure medications. Death due to multiple organ failure can occur; symptoms also mimic lymphoma and AHS has been called "pseudolymphoma" as a result. Changing the medications involved to those in a different class can avoid further problems.[5]

## See also

* Severe cutaneous adverse reactions (i.e. SCARs)
* Skin lesion
* List of cutaneous conditions

## References

1. ↑ 1.0 1.1 1.2 ACP Medicine Board Review from Medscape (2005)
2. ↑ 2.0 2.1 James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
3. ↑ "Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): An Interplay among Drugs, Viruses, and Immune System". International Journal of Molecular Sciences 18 (6): 1243. 2017. doi:10.3390/ijms18061243. PMID 28598363.
4. ↑ "Current Perspectives on Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis". Clinical Reviews in Allergy & Immunology 54 (1): 147–176. February 2018. doi:10.1007/s12016-017-8654-z. PMID 29188475.
5. ↑ Geyduk, Ayfer (2015). "Late-onset Anticonvulsant Hypersensitivity Syndrome Mimicking Lymphoma". Internal Medicine 54 (24): 3201–3204. doi:10.2169/internalmedicine.54.5111. ISSN 1349-7235. PMID 26666613.

## External links

Classification|

* ICD-10: Y46
* ICD-9-CM: E936

|

* v
* t
* e

Drug reactions (Y40-Y59, E930-E949)

Adverse drug reaction/
drug eruption|

* antibiotics: Penicillin drug reaction
* Sulfonamide hypersensitivity syndrome
* Urticarial erythema multiforme
* Adverse effects of fluoroquinolones

* hormones: Steroid acne
* Steroid folliculitis

* chemotherapy: Chemotherapy-induced acral erythema
* Chemotherapy-induced hyperpigmentation
* Scleroderma-like reaction to taxanes
* Hydroxyurea dermopathy
* Exudative hyponychial dermatitis

* blood: Anticoagulant-induced skin necrosis
* Warfarin necrosis
* Vitamin K reaction
* Texier's disease

* anticonvulsant: Anticonvulsant hypersensitivity syndrome

* water-balance/acid-base: Allopurinol hypersensitivity syndrome

* pulmonary: Leukotriene receptor antagonist-associated Churg–Strauss syndrome

* vaccine: Eczema vaccinatum

* other specified agents: Adverse reaction to biologic agents
* Adverse reaction to cytokines
* Bromoderma
* Halogenoderma
* Iododerma
* Red man syndrome
* Methotrexate-induced papular eruption

* unspecified agent: Acute generalized exanthematous pustulosis
* Bullous drug reaction
* Drug-induced acne
* Drug-induced angioedema
* Drug-related gingival hyperplasia
* Drug-induced lichenoid reaction
* Drug-induced lupus erythematosus
* Drug-induced nail changes
* Drug-induced pigmentation
* Drug-induced pseudolymphoma
* Drug-induced urticaria
* Fixed drug reaction
* Stevens–Johnson syndrome
* Injection site reaction
* Linear IgA bullous dermatosis
* Toxic epidermal necrolysis
* HIV disease-related drug reaction
* Photosensitive drug reaction
* Serum sickness-like reaction

0.00

(0 votes)

Original source: https://en.wikipedia.org/wiki/Anticonvulsant hypersensitivity syndrome. Read more

|

Retrieved from "https://handwiki.org/wiki/index.php?title=Medicine:Anticonvulsant_hypersensitivity_syndrome&oldid=1014430"
*[v]: View this template
*[t]: Discuss this template
*[e]: Edit this template