Clinical and pathological analysis in one case of antiepileptic drug hypersensitivity syndrome
- VernacularTitle:抗癫痫药高敏综合征临床及病理分析
- Author:
Lihua ZHENG
- Publication Type:Journal Article
- Keywords:
Antiepileptic;
Drug hypersensitivity
- From:
Journal of Chongqing Medical University
1986;0(02):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To discuss the clinical features,diagnosis,pathogenesis and treatment of antiepileptic drug hypersensitivity syndrome(AHS).Methods: A retrospective analysis of one case of AHS was focused on his clinical data.Results: About six weeks after carbamazepine treatment the patient presented fever firstly.The highest temperature is up to 39.6℃.Subsequently he developed diffusible red maculopapular rash and swollen superficial lymph nodes.Physical examination found internal organs involvement(mainly liver and lung).Laboratory examinations showed that the leucocyte increased to 54.21?109/L,and the percentage and absolute count of eosinophil rose,while IgG and IgM decreased.The CT of thoracic part showed the lymph nodes of hilum of lung and mediastina swelled together with pleural effusion.A biopsy study of lymph node suggested the reactive hyperplasia which was not equal to lymphoma.The bone marrow smear showed granulocytic cell line hyperplasia and abnormal lymphocyte were observed.After discontinuing carbamazepine in time and applying corticosteroids,the temperature descended rapidly and the swollen lymph nodes recovered soon.Conclusion: AHS is an idiosyncratic reaction.It usually occurs within 2 to 8 weeks after initiation of antiepileptic drug therapy,and typically manifests itself as fever,eruption and internal organ involvements.Pathogenesis is still not definite.Important basis for diagnosis and differential diagnosis depends on clinical manifestations and laboratory examinations.Early recognition of AHS and timely discontinuing of the suspected drugs are the essential therapy.
