Drug-induced hypersensitivity syndrome caused by carbamazepine

Abstract

A 31-year-old male patient received carbamazepine and mecobalamin for 2 weeks due to trigeminal neuralgia. After 15 days of drug withdrawal, the patient developed fever, sore throat, fatigue, and diffuse bright red maculopapular rashes in the trunk, accompanied by itching, which progressively worsen. Laboratory tests showed white blood cell count 13.1×109/L, neutrophil count 10.7×109/L, eosinophil count 0.5×109/L, C-reactive protein 807.5 mg/L, alanine aminotransferase 663 U/L, and aspartate aminotransferase 332 U/L. Drug-induced hypersensitivity syndrome was diagnosed in the clinical. Anti-allergic and liver-protective drugs such as methylprednisolone, human immunoglobulin, compound glycyrrhizin, reduced glutathione, and etc. were given. Nineteen days later, the symptoms improved and the patient was discharged. At 2 weeks of follow-up, the patient showed normal blood routine test and liver function test results. According to the drug labels and the literature, it was considered that the drug-induced hypersensitivity syndrome was likely to be caused by carbamazepine. Key words: Drug hypersensitivity syndrome; Carbamazepine; HLA antigens