A 14-year-old female with fever, rash, lymphadenopathy, and pancytopenia: a case report

Anticonvulsant hypersensitivity syndrome is a rare adverse drug reaction associated with aromatic anticonvulsant drugs. This syndrome can range from mild cutaneous rash to drug reaction with eosinophilia and systemic symptoms that include fever, rash, lymphadenopathy, pancytopenia, and involvement o...

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Bibliographic Details
Published in:Journal of medical case reports 2020-01, Vol.14 (1), p.20-5, Article 20
Main Authors: Varshochi, Mojtaba, Ravanbakhsh Gavgani, Reyhaneh, Naghili, Behrooz, Bayatmakoo, Zhinus, Poorshahverdi, Parinaz, Ravanbakhsh Gavgani, Fatemeh
Format: Article
Language:English
Subjects:
Abdomen
Anemia
Anticonvulsants
Biopsy
Blood
Case Report
Case reports
Chemical plants
Complications and side effects
Convulsions & seizures
Cytomegalovirus
Drugs
Eosinophilia
Fever
Hepatitis
Hospitals
Laboratories
Lamotrigine
Levetiracetam
Lymphadenopathy
Lymphatic diseases
Lymphatic system
Oxcarbazepine
Pancytopenia
Pathogenesis
Patients
Physicians
Rash
Seizures (Medicine)
Womens health
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Summary:Anticonvulsant hypersensitivity syndrome is a rare adverse drug reaction associated with aromatic anticonvulsant drugs. This syndrome can range from mild cutaneous rash to drug reaction with eosinophilia and systemic symptoms that include fever, rash, lymphadenopathy, pancytopenia, and involvement of multiple internal organs. We aimed to report this case in the literature and make physicians aware of the uncommon symptoms of this syndrome when they prescribe antiepileptic medications in particular. A 14-year-old Middle Eastern female patient from Iran with free past medical and allergic history was admitted to hospital because of fever, rash, lymphadenopathy, and pancytopenia after taking anticonvulsants due to new-onset seizure. High fever and cutaneous rash along with lymphadenopathy following administration of anticonvulsant medications that could not be explained by other causes alerted the physician to the possibility of this syndrome. Our investigation revealed no further diagnosis and 1 week after discontinuation of the drugs, her symptoms were resolved. Anticonvulsant hypersensitivity syndrome is a diagnosis of exclusion and immediate discontinuation of the suspicious drugs is necessary. Hence, early recognition can prevent permanent multiorgan damage. Chlorpheniramine as a simple treatment was provided for this syndrome.
ISSN:1752-1947
1752-1947
DOI:10.1186/s13256-019-2286-2