Faizan Unaiza, Ramsey Allison
Rochester Regional Health, Rochester, NY, USA.
School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA.
Curr Allergy Asthma Rep. 2025 Jan 29;25(1):12. doi: 10.1007/s11882-024-01188-0.
Antiepileptics are the mainstay of treatment for seizure management. Immediate and delayed hypersensitivity reactions associated with antiepileptics are common. It is important to differentiate between these reactions as management and prognosis varies.
This review article aims to describe the types of hypersensitivity reactions reported with antiepileptics with emphasis on delayed hypersensitivity reactions, as these can be life-threatening.
Online databases including PubMed and Cochrane were searched, from the inception of the literature to 5/10/24. Studies focusing on hypersensitivity reactions to antiepileptics were reviewed. Case reports, case series, observational studies, and clinical trials were included. Abstracts and studies published in languages other than English were not included.
Immediate reactions can occur with antiepileptics however the incidence is lower than that of delayed hypersensitivity reactions. Delayed hypersensitivity reactions include benign rash as well as severe cutaneous adverse reactions. Acute generalized exanthematous pustulosis, drug rash with eosinophilia and systemic symptoms, Steven Johnson syndrome, and toxic epidermal necrolysis are discussed in detail in this review. We focused on pathogenesis, genetic predisposition, clinical presentation, treatment, and prognosis.
Severe cutaneous adverse reactions can be lethal. It is important to make the correct diagnosis and treat patients accordingly. More studies comparing therapeutic options head-to-head are needed.
抗癫痫药物是癫痫治疗的主要手段。与抗癫痫药物相关的速发型和迟发型超敏反应很常见。区分这些反应很重要，因为管理和预后各不相同。
这篇综述文章旨在描述抗癫痫药物所报告的超敏反应类型，重点是迟发型超敏反应，因为这些反应可能危及生命。
检索了包括PubMed和Cochrane在内的在线数据库，检索时间从文献起始至2024年5月10日。对专注于抗癫痫药物超敏反应的研究进行了综述。纳入了病例报告、病例系列、观察性研究和临床试验。不包括英文以外语言发表的摘要和研究。
抗癫痫药物可引发速发型反应，但其发生率低于迟发型超敏反应。迟发型超敏反应包括良性皮疹以及严重的皮肤不良反应。本综述详细讨论了急性泛发性脓疱性皮病、伴嗜酸性粒细胞增多和全身症状的药疹、史蒂文斯 - 约翰逊综合征和中毒性表皮坏死松解症。我们重点关注了发病机制、遗传易感性、临床表现、治疗和预后。
严重的皮肤不良反应可能致命。做出正确诊断并相应地治疗患者很重要。需要更多直接比较治疗方案的研究。
