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Anticonvulsant hypersensitivity reaction in pregnancy
Shad H Deering1, Kay Thompson, Janine Taylor
1Department of Obstetrics and Gynecology, National Naval Medical Center, Bethesda, Maryland, USA. deering95@hotmail.com
Background:
Anticonvulsant hypersensitivity reaction is a multisystem disorder that occurs after exposure to aromatic anticonvulsants. It is potentially fatal, with a mortality rate up to 50%. We report a case of an anticonvulsant hypersensitivity reaction that occurred during pregnancy at 10 weeks' gestation.
Case:
A grand multipara was being treated with carbamazapine for a seizure disorder. She developed a maculopapular rash, elevated liver enzymes, and pancytopenia. Withdrawal of aromatic anticonvulsants and supportive therapy resulted in resolution of her illness. The remainder of her pregnancy was uneventful, and she delivered a healthy infant at term.
Conclusion:
All pregnant women treated with aromatic anticonvulsants are at risk for anticonvulsant hypersensitivity reaction, and a high degree of clinical suspicion is essential for diagnosis.
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