Drug Reaction With Eosinophilia and Systemic Symptoms Syndrome in a Patient Taking Lamotrigine: A Case Report Based Literature Review.
Khan, Zahid Warrier, Vinod Muhammad, Syed Aun Gupta, Animesh Yousif, Yousif Khan, Ayub Afghan, Abdullah Taucius, Donatas Abumedian, Mohammed Ibrahim, Maab
Khan, Zahid
Warrier, Vinod
Muhammad, Syed Aun
Gupta, Animesh
Yousif, Yousif
Khan, Ayub
Afghan, Abdullah
Taucius, Donatas
Abumedian, Mohammed
Ibrahim, Maab
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Affiliation
Royal Free Hospital NHS Foundation Trust; Mid and South Essex NHS Foundation Trust; Barking, Havering and Redbridge University Hospitals NHS Trust; Sandwell and West Birmingham NHS Trust
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Publication date
2022-02-18
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Abstract
A 29-year-old patient presented to the hospital with worsening generalized rash for the last two days from a mental health facility. The patient was commenced on lamotrigine two weeks earlier, and he developed fever and generalized macular rash on his body. His blood tests showed deranged liver function tests (LFTs) and clotting with raised eosinophil count, and he was treated for lamotrigine-induced drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome. The patient was commenced on prednisolone 50 mg once daily with a proton pump inhibitor cover, and lamotrigine was suspended on advice from Dermatology. The patient showed improvement after 3-4 days of treatment. His skin biopsy showed prominent suppurative granulomatous folliculitis, mild perivascular chronic inflammation, and red blood cell extravasation, including the rare eosinophil. He was weaned off from prednisolone by 5 mg weekly and had complete resolution of symptoms.
Citation
Khan, Z., Warrier, V., Muhammad, S. A., Gupta, A., Yousif, Y., Khan, A., Afghan, A., Taucius, D., Abumedian, M., Ibrahim, M., Mohammed, M., & Mlawa, G. (2022). Drug Reaction With Eosinophilia and Systemic Symptoms Syndrome in a Patient Taking Lamotrigine: A Case Report Based Literature Review. Cureus, 14(2), e22359. https://doi.org/10.7759/cureus.22359
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Article