Eslicarbazepine acetate as a therapeutic option in a patient with carbamazepine-induced rash and HLA-A*31:01

Seizure. 2017 Apr:47:81-82. doi: 10.1016/j.seizure.2017.02.019. Epub 2017 Mar 18.

Abstract

Eslicarbazepine acetate (ESL) is an anticonvulsant drug approved for the treatment of focal epilepsies, and related to oxcarbazepine and carbamazepine (CBZ), which are also derivatives of the dibenzazepine family. ESL is contraindicated in patients with hypersensitivity reactions to CBZ.We report a patient with frontal lobe epilepsy responding to treatment with ESL without any serious adverse effects after developing a severe skin rash following treatment with CBZ. HLA testing revealed an HLA-A*31:01 haplotype, that increases the risk of CBZ-induced cutaneous reactions.This case study shows that, in clinical practice, ESL may be considered in a patient with the HLA-A*31:01 haplotype and a hypersensitivity reaction to CBZ.

Keywords: Allergic; Carbamazepine epoxide; HLA-B*1502; Skin reaction.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anticonvulsants / adverse effects*
  • Anticonvulsants / therapeutic use*
  • Carbamazepine / adverse effects*
  • Carbamazepine / therapeutic use
  • Dibenzazepines / therapeutic use*
  • Epilepsy, Frontal Lobe / drug therapy
  • Epilepsy, Frontal Lobe / genetics
  • Exanthema / etiology*
  • Exanthema / genetics
  • Female
  • HLA-B15 Antigen / genetics*
  • Haplotypes
  • Humans
  • Pharmacogenomic Variants
  • Voltage-Gated Sodium Channel Blockers / therapeutic use

Substances

  • Anticonvulsants
  • Dibenzazepines
  • HLA-B*15:02 antigen
  • HLA-B15 Antigen
  • Voltage-Gated Sodium Channel Blockers
  • Carbamazepine
  • eslicarbazepine acetate