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[Anticonvulsant hypersensitivity syndrome in children]

Ana Ehrhardt Pinheiro1, Raquel Ferreira, Gonçalo Cordeiro Ferreira

  • 1Unidade de Infecciologia, Hospital Dona Estefânia, Lisboa.

Acta Medica Portuguesa
|August 7, 2010
PubMed

Insights

Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) is a severe reaction to antiepileptic drugs. Early recognition of fever, rash, and organ involvement is crucial for diagnosis and treatment.

Area of Science:

  • Pharmacology
  • Toxicology
  • Pediatrics

Background:

  • Anticonvulsant hypersensitivity syndrome, or Drug Rash with Eosinophilia and Systemic Symptoms (DRESS), is a rare, potentially fatal multisystem disorder.
  • It is primarily associated with aromatic antiepileptic drugs.

Observation:

  • A case report details a child treated with sodium valproate for epilepsy who developed a febrile rash.
  • The rash appeared 4 weeks after initiating phenobarbital therapy.

Findings:

  • Laboratory tests confirmed leukocytosis with eosinophilia, elevated C-reactive protein, and liver enzymes.
  • Phenobarbital was discontinued, leading to a gradual and complete recovery.

Implications:

  • DRESS syndrome can mimic other serious conditions like infections, immunologic disorders, or neoplasms, potentially delaying diagnosis.
  • Prompt exclusion of DRESS is vital when characteristic clinical features and drug exposure are present in patients.

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