Ouellet Georges, Tremblay Lydjie, Marleau Denis
Department of Medicine, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada.
South Med J. 2009 Jan;102(1):82-4. doi: 10.1097/SMJ.0b013e3181878b95.
Anticonvulsant hypersensitivity syndrome (AHS) is a potentially life-threatening adverse drug reaction presenting with fever, skin eruptions, and internal organ involvement. We describe a case of AHS with fulminant hepatitis that occurred two weeks after introduction of lamotrigine in a 40-year-old female patient with a recently diagnosed bipolar disorder, no pre-existent systemic organ involvement, and no other medication. Lamotrigine was introduced at a dosage of 25 mg daily and increased to 50 mg daily 12 days later. The patient had favorable evolution with cessation of lamotrigine and supportive treatment. This report suggests that AHS with fulminant hepatitis may occur idiosyncratically, independent of dosage, titration and comedication with other potentially hepatotoxic drugs.
抗惊厥药超敏反应综合征（AHS）是一种潜在的危及生命的药物不良反应，表现为发热、皮疹和内脏器官受累。我们描述了一例在一名40岁女性患者中发生的伴有暴发性肝炎的AHS病例，该患者最近被诊断为双相情感障碍，此前无全身性器官受累，也未服用其他药物。拉莫三嗪以每日25毫克的剂量开始服用，12天后增加至每日50毫克。患者停用拉莫三嗪并接受支持治疗后病情好转。本报告表明，伴有暴发性肝炎的AHS可能是特发性的，与剂量、滴定以及与其他潜在肝毒性药物的合并用药无关。
