Romero Maldonado Nuria, Sendra Tello Javier, Raboso Garcia-Baquero Eduardo, Harto Castaño Antonio
Department of Dermatology, Hospital Ramón y Cajal, Carretera de Colmenar, Kilometro 9,100, 28034 Madrid, Spain.
Eur J Dermatol. 2002 Sep-Oct;12(5):503-5.
Anticonvulsant hypersensitivity syndrome is a disease characterized by multisystemic involvement, fever, lymphadenopathy, mucocutaneous rash, hypertransaminasemia and peripheral eosinophilia. This rare syndrome seems to be related to arene oxide metabolites of aromatic anticonvulsants (phenytoin, phenobarbital and carbamazepine). Anticonvulsant hypersensitivity seems to be much more aggressive in patients undergoing concomitant radiotherapy. We report a case of anticonvulsant hypersensitivity syndrome developing toxic epidermal necrolysis with fatal outcome in a patient receiving cranial irradiation and aromatic anticonvulsants for seizure prophylaxis. This report attempts to emphasize the importance of an early diagnosis of this syndrome, the knowledge of the common cross-reactivity among the major anticonvulsants and the need for an appropriate measurement of the true benefits of seizure prophylaxis in patients with brain tumors.
抗惊厥药超敏反应综合征是一种以多系统受累、发热、淋巴结病、黏膜皮肤皮疹、高转氨酶血症和外周嗜酸性粒细胞增多为特征的疾病。这种罕见综合征似乎与芳香族抗惊厥药（苯妥英、苯巴比妥和卡马西平）的芳烃氧化物代谢产物有关。抗惊厥药超敏反应在接受同步放疗的患者中似乎更具侵袭性。我们报告一例抗惊厥药超敏反应综合征患者，该患者在接受颅脑照射和使用芳香族抗惊厥药预防癫痫发作时发生中毒性表皮坏死松解症并导致死亡。本报告旨在强调早期诊断该综合征的重要性、了解主要抗惊厥药之间常见的交叉反应以及对脑肿瘤患者预防癫痫发作真正益处进行适当评估的必要性。
