Carbamazepine induced anticonvulsant hypersensitivity syndrome

Abstract

Anticonvulsant hypersensitivity syndrome (AHS) is a potentially fatal drug-induced, multi-organ syndrome. The syndrome has been reported with anticonvulsants such as carbamazepine, phenytoin, phenobarbitone, and lamotrigine. A 17-year-old female who presented with papules and desquamation all over was diagnosed with AHS. She gave a history of fever, earache, peripheral edema, and erythematous papular eruptions 3 days prior. She gave a history of carbamazepine treatment since 15 days for generalized tonic-clonic seizures. On examination, there was cervical lymph node enlargement without tenderness. Investigations revealed elevated absolute eosinophil count at 550/mm 3 and positive C-reactive protein tests. Carbamazepine was immediately withdrawn. Symptomatic treatment was administered, and resolution of the symptoms was observed. In this case, causalty assessment using Naranjo adverse drug reaction probability scale showed that carbamazepine was a probable cause for the AHS (Score - 7).