Recrudescence of Severe Carbamazepine- Induced DRESS Syndrome after Initiation of Levetiracetam

Skinmed. 2023 Dec 5;21(6):445-447. eCollection 2023.

Abstract

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a potentially fatal cutaneous hypersensitivity reaction commonly precipitated by antiepileptic drugs (AEDs). Cross-reactivity among aromatic AEDs is well-documented, but between aromatic and nonaromatic AEDs. We report a patient with severe DRESS syndrome precipitated by aromatic AED carbamazepine with recrudescence approximately 2 weeks after substitution with nonaromatic AED levetiracetam. The patient was treated with high-dose corticosteroids and switched to the benzodiazepine AED clobazam. At follow-up appointment several weeks later, the patient's rash, liver injury, and eosinophilia had resolved.

Publication types

  • Case Reports

MeSH terms

  • Anticonvulsants / adverse effects
  • Benzodiazepines / adverse effects
  • Carbamazepine / adverse effects
  • Drug Hypersensitivity Syndrome* / drug therapy
  • Drug Hypersensitivity Syndrome* / etiology
  • Eosinophilia* / chemically induced
  • Eosinophilia* / drug therapy
  • Humans
  • Levetiracetam / therapeutic use

Substances

  • Levetiracetam
  • Carbamazepine
  • Anticonvulsants
  • Benzodiazepines