Vol 79, No 1 (2011)
Case report
Published online: 2010-12-28
Submitted: 2013-02-22
Drug-induced hypersensitivity syndrome - a literature review and the case report
Krzysztof Gomułka, Danuta Kuliczkowska, Maria Cisło, Zdzisław Woźniak, Bernard Panaszek
Pneumonol Alergol Pol 2011;79(1):52-57.
Vol 79, No 1 (2011)
CASE REPORTS
Published online: 2010-12-28
Submitted: 2013-02-22
Abstract
Drug-induced hypersensitivity syndrome (DIHS) is characterized by fever, rash and internal organ involvement, mostly in
form of hepatitis, myocarditis, nephritis or pneumonitis, which may occur 1–8 weeks after medicine exposure. Fever is an
early feature, usually preceding a widespread erythematous skin eruption, but the severity of the skin-related changes does
not correlate with the extent of internal organ involvement. It is considered that anticonvulsants (particularly carbamazepine),
antibiotics, allopurinol are the most frequent causative agents of DIHS. The underlying mechanisms causing DIHS are poorly
understood - defective detoxification of the reactive drug’s metabolites or genetic predisposition have been implicated.
Diagnosis of DIHS is based on clinical presentation connected with drug intake, supported by a finding of eosinophilia,
increased concentration of inflammation markers and abnormal biochemical parameters, mainly liver function tests. Treatment
consists of immediate withdrawal of all suspected medicines, followed by supportive systemic corticosteroids. We
describe a case of a 72-years-old female who developed symptoms of drug-induced hypersensitivity syndrome after
approximately 4 weeks of taking anticonvulsant (Amizepin) due to sensual axonal polyneuropathy. Withdrawal of drug and
treatment with systemic corticosteroids caused clinical improvement rapidly.
Pneumonol. Alergol. Pol. 2011; 79, 1: 52-56
Abstract
Drug-induced hypersensitivity syndrome (DIHS) is characterized by fever, rash and internal organ involvement, mostly in
form of hepatitis, myocarditis, nephritis or pneumonitis, which may occur 1–8 weeks after medicine exposure. Fever is an
early feature, usually preceding a widespread erythematous skin eruption, but the severity of the skin-related changes does
not correlate with the extent of internal organ involvement. It is considered that anticonvulsants (particularly carbamazepine),
antibiotics, allopurinol are the most frequent causative agents of DIHS. The underlying mechanisms causing DIHS are poorly
understood - defective detoxification of the reactive drug’s metabolites or genetic predisposition have been implicated.
Diagnosis of DIHS is based on clinical presentation connected with drug intake, supported by a finding of eosinophilia,
increased concentration of inflammation markers and abnormal biochemical parameters, mainly liver function tests. Treatment
consists of immediate withdrawal of all suspected medicines, followed by supportive systemic corticosteroids. We
describe a case of a 72-years-old female who developed symptoms of drug-induced hypersensitivity syndrome after
approximately 4 weeks of taking anticonvulsant (Amizepin) due to sensual axonal polyneuropathy. Withdrawal of drug and
treatment with systemic corticosteroids caused clinical improvement rapidly.
Pneumonol. Alergol. Pol. 2011; 79, 1: 52-56
Keywords
drug-induced hypersensitivity syndrome; carbamazepine; hepatitis
Title
Drug-induced hypersensitivity syndrome - a literature review and the case report
Journal
Advances in Respiratory Medicine
Issue
Vol 79, No 1 (2011)
Article type
Case report
Pages
52-57
Published online
2010-12-28
Bibliographic record
Pneumonol Alergol Pol 2011;79(1):52-57.
Keywords
drug-induced hypersensitivity syndrome
carbamazepine
hepatitis
Authors
Krzysztof Gomułka
Danuta Kuliczkowska
Maria Cisło
Zdzisław Woźniak
Bernard Panaszek