Drug Reaction With Eosinophilia and Systemic Symptoms Syndrome in a Patient Taking Lamotrigine: A Case Report Based Literature Review

被引:2
作者
Khan, Zahid [1 ]
Warrier, Vinod [2 ]
Muhammad, Syed Aun [3 ]
Gupta, Animesh [4 ]
Yousif, Yousif [5 ]
Khan, Ayub [6 ]
Afghan, Abdullah [7 ]
Taucius, Donatas [8 ]
Abumedian, Mohammed [9 ]
Ibrahim, Maab [10 ]
Mohammed, Mohammed [5 ]
Mlawa, Gideon [11 ]
机构
[1] Royal Free Hosp NHS Fdn Trust, Cardiol, London, England
[2] Mid & South Essex NHS Fdn Trust, Internal Med, Southend On Sea, England
[3] Mid & South Essex NHS Fdn Trust, Cardiol, Southend On Sea, England
[4] Barking Havering & Redbridge Univ Hosp NHS Trust, Acute Internal Med, London, England
[5] Barking Havering & Redbridge Univ Hosp NHS Trust, Internal Med, London, England
[6] Barking Havering & Redbridge Univ Hosp NHS Trust, Emergency Med, London, England
[7] Daisy Hill Acute Hosp, Internal Med, Newry, Ireland
[8] Mid & South Essex NHS Fdn Trust, Gastroenterol, Southend On Sea, England
[9] Barking Havering & Redbridge Univ Hosp NHS Trust, Geriatr, London, England
[10] Sandwell & West Birmingham NHS Trust, Internal Med Haematol, Birmingham, W Midlands, England
[11] Barking Havering & Redbridge Univ Hosp NHS Trust, Internal Med & Diabet & Endocrinol, London, England
关键词
drug-induced urticarial rash; drug-induced hepatitis; international normalized ratio; international normalized; high fever; systemic steroids; generalized rash; allergy test; allergy and anaphylaxis; INDUCED HYPERSENSITIVITY SYNDROME; DRESS SYNDROME; CLINICAL-FEATURES; RASH;
D O I
10.7759/cureus.22359
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
A 29-year-old patient presented to the hospital with worsening generalized rash for the last two days from a mental health facility. The patient was commenced on lamotrigine two weeks earlier, and he developed fever and generalized macular rash on his body. His blood tests showed deranged liver function tests (LFTs) and clotting with raised eosinophil count, and he was treated for lamotrigine-induced drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome. The patient was commenced on prednisolone 50 mg once daily with a proton pump inhibitor cover, and lamotrigine was suspended on advice from Dermatology. The patient showed improvement after 3-4 days of treatment. His skin biopsy showed prominent suppurative granulomatous folliculitis, mild perivascular chronic inflammation, and red blood cell extravasation, including the rare eosinophil. He was weaned off from prednisolone by 5 mg weekly and had complete resolution of symptoms.
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页数:6
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