DRUG RASH WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS ASSOCIATED WITH CARBAMAZEPINE: A CASE REPORT
DADA MOBOLAJI USMAN *
Department of Psychiatry, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria.
ADEGOKE BENJAMIN
Department of Psychiatry, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria.
ARAROMI EBISOLA JONATHAN
Department of Pharmacology and Therapeutics, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria.
EBIGBAGHA ESTHER
Department of Psychiatry, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria.
OLASEHINDE TOLULOPE
Department of Psychiatry, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
DRESS syndrome is a severe drug hypersensitivity reaction with an estimated incidence ranging from 1 in 1000 to 1 in 10,000 drug exposures with Carbamazepine being the most commonly implicated drug. We present the case of a 25-year-old male who was being managed for bipolar affective disorder with carbamazepine. He developed multiple maculopapular rashes, facial puffiness, fever, lymphadenopathy with leucocytosis and eosinophilia about four weeks after commencing carbamazepine. He was managed with prednisolone with a very good outcome. Naranjo’s algorithm was used to confirm the possible involvement of Carbamazepine in this case and diagnosis of DRESS syndrome was confirmed using Regis CAR criteria.
This syndrome is a severe and life-threatening condition that requires a high index of suspicion in patients who are taking Carbamazepine. The consensus on the management is immediate stoppage of the drug and commencement of systemic corticosteroids. Awareness of this rare side effect of Carbamazepine by Clinicians will help in reducing the mortality associated with this drug reaction.
Keywords: Carbamazepine, dress syndrome, drug reaction