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Case of lamotrigine-induced drug adverse reaction under tocilizumab treatment with clinical and virological features of drug-induced hypersensitivity syndrome.
- Source :
-
The Journal of dermatology [J Dermatol] 2018 Jun; Vol. 45 (6), pp. 738-741. Date of Electronic Publication: 2018 Mar 22. - Publication Year :
- 2018
-
Abstract
- The pathological mechanisms and immunological kinetics of drug-induced hypersensitivity syndrome (DIHS), including the relevance of interleukin (IL)-6, remain unclear. We report a case of drug adverse reaction that does not fulfill the diagnostic criteria of DIHS but mimics its characteristic features. Because the patient was under anti-IL-6 therapy at the onset, some symptoms typically seen in DIHS were absent, such as fever and leukocyte count abnormalities. However, the characteristic features of DIHS were clearly observed in the subsequent course, including the repeated recurrence of skin rash, prolonged liver dysfunction and reactivation of herpes viruses. This case suggested that IL-6 role at the onset is not a main factor to determine the subsequent pathomechanism of DIHS and attention should be paid to the preceding therapy for achieving accurate diagnosis.<br /> (© 2018 Japanese Dermatological Association.)
- Subjects :
- Adult
Antibodies, Monoclonal, Humanized therapeutic use
Biopsy
C-Reactive Protein analysis
DNA, Viral isolation & purification
Drug Hypersensitivity Syndrome blood
Drug Hypersensitivity Syndrome drug therapy
Drug Hypersensitivity Syndrome etiology
Exanthema chemically induced
Exanthema diagnosis
Exanthema drug therapy
Exanthema pathology
Female
Fever blood
Fever chemically induced
Fever diagnosis
Fever drug therapy
Herpesviridae genetics
Herpesviridae isolation & purification
Humans
Interleukin-6 antagonists & inhibitors
Lamotrigine
Prednisone therapeutic use
Recurrence
Skin drug effects
Skin pathology
Anticonvulsants adverse effects
Arthritis, Rheumatoid drug therapy
Drug Hypersensitivity Syndrome diagnosis
Epilepsy drug therapy
Triazines adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1346-8138
- Volume :
- 45
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- The Journal of dermatology
- Publication Type :
- Academic Journal
- Accession number :
- 29569382
- Full Text :
- https://doi.org/10.1111/1346-8138.14288