Stevens-johnson syndrome triggered by a combination of clobazam, lamotrigine and valproic acid in a 7-year-old child
Annals of Burns and Fire Disasters, cilt.27, sa.3, ss.121-125, 2014 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 27 Sayı: 3
- Basım Tarihi: 2014
- Dergi Adı: Annals of Burns and Fire Disasters
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.121-125
- Anahtar Kelimeler: Clobazam, Lamotrigine, Stevens-Johnson Syndrome, Toxic epidermal necrolysis, Valproic acid
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) are diseases within the spectrum of severe cutaneous adverse reactions affecting skin and mucous membranes. Antiepileptic drugs (AEDs) are used in combination, leading to potential pharmacokinetic or pharmacodynamic interactions, causing more adverse effects than might occur when the AED is taken as monotherapy. Here, we report a rare case of SJS triggered by a combination of clobazam, lamotrigine and valproic acid in a 7-year-old boy. Because of inadequate seizure control, lorazepam was replaced with clobazam. Four weeks after the addition of clobazam, the patient developed SJS with a generalized rash, fever, with liver and kidney involvement, and eosinophilia one week after the initiation of treatment. All antiepileptic drugs were discontinued, and intravenous methylprednisolone, prophylactic systemic antibiotics, intravenous fluid supplement, antipyretic, special wound care, and supportive medical care for SJS were administered. He was discharged in a stable condition on the 18th day. Our case suggests that a drug-drug interaction between valproate, lamotrigine and clobazam contributed to the development of SJS. When the clobazam was added to valproic acid and lamotrigine co-medication, the lamotrigine dose should have been decreased.