Yıl: 2002 Cilt: 36 Sayı: 2 Sayfa Aralığı: 125 - 128 Metin Dili: Türkçe

Karbamazepine bağlı ilaç hipersensitivite sendromu

Öz:
İlaç hipersensitivite sendromu (İHS), bazı ilaçların kullanımı sırasında ortaya çıkan ateş, lenfadenopati, deri lezyonları ve iç organ tutulumu ile karakterize bir tablodur. Karbamazepin gibi aromatik yapıdaki antiepileptikler önemli sebepleri arasındadır. Antiepileptik kullananların ortalama 3000'de 1 'inde yaklaşık 1 hafta - 3 ay içinde ortaya çıkar. Hepatik, renal, hematolojik tutulum başta olmak üzere çeşitli iç organ tutulumları nedeniyle mortalitesi yüksektir. Deri lezyonları ön planda makülopapüler / morbiliform tiptedir, ancak eksfoliatif dermatit, hatta toksik epidermal nekroliz tarzında olabilir. Tablo infeksiyonlar, konnektif doku hastalıkları ve malinitelerle ayırıcı tanıya girer. Bu yazıda karbamazepin tedavisinin 50. gününde başlayan ateş, lenfadenopati, eksfolyatif dermatit ve karaciğer tutulumu ile karakterize bir ilaç hipersensitivite sendromu olgusu sunulmaktadır. Karbamazepin kesilmesine rağmen gerilemeyen tablo erken dönemde başlanan 40 mg/gün metilprednizolon i.m. tedavisine çok iyi cevap vererek 1 ay içinde tamamen gerilemiştir. Sonuç olarak, bu nadir ama ciddi reaksiyon, özellikle antiepileptik kullanan hastalarda gelişen deri lezyonlarının ayırıcı tanısında mutlaka akla gelmelidir.
Anahtar Kelime: Metilprednizolon Karbamazepin İlaç aşırı duyarlılığı Antikonvülzanlar Olgu sunumu Erişkin Tedavi sonucu

Carbamazepine hypersensitivity syndrome

Öz:
Background and design: Drug hypersensitivity syndrome is characterized by fever, lymphadenopathy, skin rash and internal organ involvement. Various drugs may cause this type of adverse drug reaction but it is mainly associated with the aromatic antiepileptic drugs carbamazepine, phenytoin, phenobarbital and primidone. The incidence is approximately 1 in 3000 exposures, and it usually starts between 1 week and 3 months after initiation of therapy. It is a potentially fatal reaction mainly as a result of internal manifestations, such as hepatic, renal or bone marrow involvement. Skin rash can range from maculopapular I morbilliform eruption to exfoliative dermatitis or toxic epidermal necrolysis. The syndrome can mimic infectious, neoplastic or connective tissue disorders. We herein present a case of carbamazepine-induced drug hypersensitivity syndrome who developed fever, lymphadenopathy, exfoliative dermatitis, and hepatitis 50 days after initiation of therapy. The reaction worsened even after cessation of carbamazepine therapy therefore methylprednisolone 40 mg/day i.m. was started, and an improvement could be achieved within one month. In conclusion, this rare but severe drug reaction should always be considered in the differential diagnosis of any skin eruption that would occur in patients receiving antiepileptic drugs.
Anahtar Kelime: Adult Anticonvulsants Treatment Outcome Case report Methylprednisolone Carbamazepine Drug Hypersensitivity

Belge Türü: Makale Makale Türü: Diğer Erişim Türü: Erişime Açık
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APA BAYAZIT Ö, NAR C (2002). Karbamazepine bağlı ilaç hipersensitivite sendromu. Türkderm-Deri Hastalıkları ve Frengi Arşivi, 36(2), 125 - 128.
Chicago BAYAZIT Özkaya Esen,NAR Cahide Karbamazepine bağlı ilaç hipersensitivite sendromu. Türkderm-Deri Hastalıkları ve Frengi Arşivi 36, no.2 (2002): 125 - 128.
MLA BAYAZIT Özkaya Esen,NAR Cahide Karbamazepine bağlı ilaç hipersensitivite sendromu. Türkderm-Deri Hastalıkları ve Frengi Arşivi, vol.36, no.2, 2002, ss.125 - 128.
AMA BAYAZIT Ö,NAR C Karbamazepine bağlı ilaç hipersensitivite sendromu. Türkderm-Deri Hastalıkları ve Frengi Arşivi. 2002; 36(2): 125 - 128.
Vancouver BAYAZIT Ö,NAR C Karbamazepine bağlı ilaç hipersensitivite sendromu. Türkderm-Deri Hastalıkları ve Frengi Arşivi. 2002; 36(2): 125 - 128.
IEEE BAYAZIT Ö,NAR C "Karbamazepine bağlı ilaç hipersensitivite sendromu." Türkderm-Deri Hastalıkları ve Frengi Arşivi, 36, ss.125 - 128, 2002.