Hypersensitivity syndrome induced by anticonvulsants: possible cross-reactivity between carbamazepine and lamotrigine

J Clin Pharmacol. 2009 Dec;49(12):1488-91. doi: 10.1177/0091270009344985. Epub 2009 Sep 1.

Abstract

A 14-year-old male presents with erythroderma and fever 44 days after carbamazepine intake. Laboratory exams show eosinophilia and elevated liver enzymes, and thoracic imaging reveals interstitial pneumonitis. All symptoms disappear after carbamazepine withdrawal. A patch test to carbamazepine performed 6 weeks after recovery is positive. About 8 months later, the patient exhibits the same clinical and biological picture 52 days after lamotrigine intake. Lamotrigine is stopped and all symptoms disappear. A patch test to LMG is positive. This case illustrates a possible cross-reactivity between carbamazepine and lamotrigine, which are aromatic and nonaromatic anticonvulsants, respectively.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Anticonvulsants / adverse effects*
  • Anticonvulsants / immunology
  • Carbamazepine / adverse effects*
  • Carbamazepine / immunology
  • Cross Reactions
  • Drug Eruptions / etiology*
  • Drug Eruptions / pathology
  • Drug Hypersensitivity / immunology*
  • Drug Hypersensitivity / pathology
  • Humans
  • Lamotrigine
  • Male
  • Patch Tests
  • Skin / drug effects
  • Skin / pathology
  • Syndrome
  • Triazines / adverse effects*
  • Triazines / immunology

Substances

  • Anticonvulsants
  • Triazines
  • Carbamazepine
  • Lamotrigine