Anticonvulsant Hypersensitivity Syndrome

doi:10.1001/archinte.1995.00430210033005

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Vol. 155 No. 21, 27 NOVEMBER 1995

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Anticonvulsant Hypersensitivity Syndrome

Carmela C. Vittorio, MD; Jennie J. Muglia, MD

Arch Intern Med. 1995;155(21):2285-2290.

Abstract

Anticonvulsant hypersensitivity syndrome is a potentially fataldrug reaction with cutaneous and systemic reactions (incidence,one in 1000 to one in 10 000 exposures) to the arene oxide-producinganticonvulsants—phenytoin, carbamazepine, and phenobarbitalsodium. In most cases, the hallmark features of fever, rash,and lymphadenopathy are accompanied by multiorgan-system abnormalities.Fatal outcomes are most often associated with liver failure.Recognition of the syndrome, which may have variable presentations,is the key to prompt discontinuation of the drug, close monitoring,and management. The reaction may be genetically determined,and siblings of patients with anticonvulsive hypersensitivitysyndrome may be at increased risk of developing this syndrome.The timely recognition of anticonvulsant hypersensitivity syndromeis important, because accurate diagnosis avoids potentiallyfatal reexposure and affects subsequent anticonvulsant treatmentoptions.

(Arch Intern Med. 1995;155:2285-2290)

Author Affiliations

From the Department of Dermatology, Roger Williams Medical Center, Brown University, Providence, RI.

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