Department of Pediatrics, Gazi University Faculty of Medicine, Ankara, Turkey.
Divisions of Pediatric Neurology, Gazi University Faculty of Medicine, Ankara, Turkey.
Turk J Pediatr. 2021;63(3):506-509. doi: 10.24953/turkjped.2021.03.019.
Antiepileptic drugs (AEDs) are among the most common causes of severe delayed-type hypersensitivity reactions such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) and Drug Reaction with Eosinophilia and Systemic Symptoms(DRESS) in children. These reactions are more commonly seen with aromatic AEDs such as phenytoin and carbamazepine than the non-aromatic or new generation AEDs. However immediate-type hypersensitivity reactions such as urticaria/angioedema, anaphylaxis are very rare with AEDs.
Levetiracetam is an increasingly used new non-aromatic antiepileptic drug and reported to have a better safety profile in daily practice. We present the first adolescent case who developed an anaphylactic reaction with intravenous levetiracetam, not reported in this age group before in the literature.
Hypersensitivity reactions in the form of anaphylaxis can be rarely observed with new generation AEDs. Therefore, when any antiepileptic drug is started on any patient, immediate type serious reactions such as anaphylaxis should be kept in mind, not only focusing on delayed reactions such as SJS, TEN,or DRESS.
抗癫痫药物(AEDs)是儿童中最常见的严重迟发性超敏反应的原因之一,如史蒂文斯-约翰逊综合征(SJS)、中毒性表皮坏死松解症(TEN)和伴有嗜酸性粒细胞增多和全身症状的药物反应(DRESS)。这些反应在芳香族 AEDs 如苯妥英钠和卡马西平比非芳香族或新一代 AEDs 更常见。然而,AEDs 引起的速发型过敏反应,如荨麻疹/血管性水肿、过敏反应非常罕见。
左乙拉西坦是一种越来越常用的新型非芳香族抗癫痫药物,据报道在日常实践中具有更好的安全性。我们报告了首例青少年静脉用左乙拉西坦引起过敏反应的病例,这在以前的文献中尚未在该年龄组报道过。
新型 AEDs 也可能会出现过敏反应等速发型过敏反应。因此,当给任何患者开始使用任何抗癫痫药物时,不仅要关注 SJS、TEN 或 DRESS 等迟发性反应,还应注意过敏反应等立即发生的严重反应。