Anticonvulsiva-Hypersensitivitäts-Syndrom auf Carbamazepin |
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Authors: | H Gall H Merk W Scherb W Sterry |
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Institution: | Abteilung Dermatologie und Venerologie (Direktor: Prof. Dr. W. Sterry), Universit?tsklinikum Ulm, DE Universit?ts-Hautklinik (Direktor: Prof. Dr. T. Krieg), K?ln, DE Abteilung Neurologie und Psychiatrie (Leitender Arzt: Prof. Dr. J. Kriebel) des Bundeswehrkrankenhauses Ulm, DE
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Abstract: | Summary. In a 39-year-old woman an anticonvulsant therapy was initiated because of focal attacks in the left arm and face. The patient
experienced generalized maculopapular skin rashes in response to each of four chemically similar anticonvulsant drugs: phenytoin,
carbamazepine, primidone and clonazepam. During administration of carbamazepine the clinical features included fever, hepatitis
and haemotological eosinophilia in addition to the skin rash (anticonvulsant hypersensitivity syndrome). The anticonvulsant
hypersensitivity syndrome is defined as an idiosyncratic reaction caused by disturbed drug metabolism. Positive lymphocytetransformation
tests with carbamazepine and phenytoin indicate an immunological mechanism underlying the rashes in our patient. Patch testing
with the four anticonvulsant drugs gave positive results only with carbamazepine. Skin biopsy showed the histological features
of a delayed-type allergy. The anticonvulsant therapy was continued with a chemically unrelated preparation, valproic acid;
this drug is well tolerated and has proved appropriate for prevention of seizures.
Eingegangen am 2. August 1993 / Angenommen am 27. Oktober 1993 |
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Keywords: | Schlüsselw?rter: Antikonvulsiva-Hypersensitivit?ts-Syndrom – Carbamazepin – Lymphozyten-Transformations-Test – Idiosynkrasie-Reaktion |
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