Phenytoin
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Anticonvulsant hypersensitivity syndrome and DRESS in children: 2 case reports Two children developed anticonvulsant hypersensitivity syndrome, and patient 1 also developed drug rash with eosinophilia and systemic symptoms (DRESS), while receiving phenytoin [dosage and indication not clearly stated]. Patient 1, a 5-year-old girl, presented with high fever, lymphadenopathy, an exfoliative skin eruption and nonpitting oedema of her extremities; Kawasaki’s syndrome was suspected and she received IV immune globulin. She failed to respond to treatment, and progressed to hepatosplenomegaly and severe respiratory insufficiency, leading to hospitalisation. Laboratory analyses revealed mild thrombocytopenia, a mild increase in transaminase level and leucocytosis with mild eosinophilia. A chest X-ray showed a perihilar infiltrate. On further investigation, she was found to have a 1-month history of phenytoin therapy [time to onset not clearly stated]. Phenytoin was withdrawn and methylprednisolone was initiated, with an excellent response. Patient 2, a 7-year-old boy, presented with fever, a skin eruption and lymphadenopathy. Laboratory analyses revealed leucopenia and an increased erythrocyte sedimentation rate (ESR; 135). On further investigation, he was found to have a 1-month history of phenytoin therapy. Phenytoin was discontinued, with resolution of his rash and fever, and a decrease in ESR (35), after 2 weeks. Chavoshzadeh Z, et al. Severe anti convulsant hypersensitivity syndrome: report of 801104983 two cases. Allergy 62 (Suppl. 83): 545 abstr. 1590, 2007 - Iran
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Reactions 22 Mar 2008 No. 1194
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