Nefritis intersticial inducida por oxcarbacepina en un paciente con síndrome de hipersensibilidad a fármacos

Abstract

Antiepileptic drugs (AED) have long been known to have a series of side effects and descriptions of drug hypersensitivity syndrome (DHS) have often linked it with these agents. This is more especially so in the case of those with an aromatic ring, but also in those that lack such a structure. We describe a case of DHS related to the administration of oxcarbazepine (OXC), a ketoanalogue of carbamazepine (CBZ) that has recently appeared on the market in our country, which coursed with interstitial nephritis as the most important clinical manifestation. Our patient developed fever, vomiting, itchy exanthema, kidney failure and biochemical anomalies in the liver after two weeks treatment with this drug. After stopping administration of this anticonvulsant and giving the patient corticoids, the clinical manifestations disappeared and the analytical anomalies began to improve. OXC can give rise to DHS in the same way as other AED with an aromatic ring structure (phenytoin, phenobarbital, primidone, CBZ and probably also lamotrigine) or without an aromatic ring structure (valproic). Interstitial nephritis may be the most significant and serious clinical manifestation of DHS produced by OXC. According to the review of the literature we carried out, to date no descriptions of this association of nephritis caused by OXC in the context of DHS have been reported.