Fatal eosinophilic myocarditis and submassive hepatic necrosis in lamotrigine induced DRESS syndrome
Abstract Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome is a rare but severe and sometimes fatal adverse drug reaction that is known to occur with a number of antiepileptic drugs. It often follows a prolonged clinical course, which can worsen even after discontinuing the caus...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-10-01
|
| Series: | Allergy, Asthma & Clinical Immunology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13223-023-00848-6 |
| _version_ | 1797558954955374592 |
|---|---|
| author | Khanh Duy Doan Adeyinka Akinsanya Matthew Kuhar Hector Mesa |
| author_facet | Khanh Duy Doan Adeyinka Akinsanya Matthew Kuhar Hector Mesa |
| author_sort | Khanh Duy Doan |
| collection | DOAJ |
| description | Abstract Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome is a rare but severe and sometimes fatal adverse drug reaction that is known to occur with a number of antiepileptic drugs. It often follows a prolonged clinical course, which can worsen even after discontinuing the causative drug and administering steroid treatment. Failure to promptly identify the delayed involvement of vital organs, such as the heart and liver, may result in irreversible organ failure and death. We report a case of a presumed sudden death of a young woman who had a documented history of a protracted intermittent hypersensitivity reaction to lamotrigine. Postmortem examination revealed the presence of eosinophilic myocarditis and submassive hepatic necrosis diagnostic of fatal DRESS syndrome that progressed despite early discontinuation of the medication and improvement of dermatologic and hematologic symptoms following steroid therapy. |
| first_indexed | 2024-03-10T17:38:48Z |
| format | Article |
| id | doaj.art-97e1b2f3ed444876b1d486866aa7bc16 |
| institution | Directory Open Access Journal |
| issn | 1710-1492 |
| language | English |
| last_indexed | 2024-03-10T17:38:48Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Allergy, Asthma & Clinical Immunology |
| spelling | doaj.art-97e1b2f3ed444876b1d486866aa7bc162023-11-20T09:45:46ZengBMCAllergy, Asthma & Clinical Immunology1710-14922023-10-011911610.1186/s13223-023-00848-6Fatal eosinophilic myocarditis and submassive hepatic necrosis in lamotrigine induced DRESS syndromeKhanh Duy Doan0Adeyinka Akinsanya1Matthew Kuhar2Hector Mesa3Department of Pathology and Laboratory Medicine, Temple University HospitalDepartment of Pathology and Laboratory Medicine, Indiana University School of MedicineDepartment of Pathology and Laboratory Medicine, Indiana University School of MedicineDepartment of Pathology and Laboratory Medicine, Temple University HospitalAbstract Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome is a rare but severe and sometimes fatal adverse drug reaction that is known to occur with a number of antiepileptic drugs. It often follows a prolonged clinical course, which can worsen even after discontinuing the causative drug and administering steroid treatment. Failure to promptly identify the delayed involvement of vital organs, such as the heart and liver, may result in irreversible organ failure and death. We report a case of a presumed sudden death of a young woman who had a documented history of a protracted intermittent hypersensitivity reaction to lamotrigine. Postmortem examination revealed the presence of eosinophilic myocarditis and submassive hepatic necrosis diagnostic of fatal DRESS syndrome that progressed despite early discontinuation of the medication and improvement of dermatologic and hematologic symptoms following steroid therapy.https://doi.org/10.1186/s13223-023-00848-6LamotrigineDrug hypersensitivity syndromeMyocarditisMassive hepatic necrosisThyroiditisAutopsy |
| spellingShingle | Khanh Duy Doan Adeyinka Akinsanya Matthew Kuhar Hector Mesa Fatal eosinophilic myocarditis and submassive hepatic necrosis in lamotrigine induced DRESS syndrome Allergy, Asthma & Clinical Immunology Lamotrigine Drug hypersensitivity syndrome Myocarditis Massive hepatic necrosis Thyroiditis Autopsy |
| title | Fatal eosinophilic myocarditis and submassive hepatic necrosis in lamotrigine induced DRESS syndrome |
| title_full | Fatal eosinophilic myocarditis and submassive hepatic necrosis in lamotrigine induced DRESS syndrome |
| title_fullStr | Fatal eosinophilic myocarditis and submassive hepatic necrosis in lamotrigine induced DRESS syndrome |
| title_full_unstemmed | Fatal eosinophilic myocarditis and submassive hepatic necrosis in lamotrigine induced DRESS syndrome |
| title_short | Fatal eosinophilic myocarditis and submassive hepatic necrosis in lamotrigine induced DRESS syndrome |
| title_sort | fatal eosinophilic myocarditis and submassive hepatic necrosis in lamotrigine induced dress syndrome |
| topic | Lamotrigine Drug hypersensitivity syndrome Myocarditis Massive hepatic necrosis Thyroiditis Autopsy |
| url | https://doi.org/10.1186/s13223-023-00848-6 |
| work_keys_str_mv | AT khanhduydoan fataleosinophilicmyocarditisandsubmassivehepaticnecrosisinlamotrigineinduceddresssyndrome AT adeyinkaakinsanya fataleosinophilicmyocarditisandsubmassivehepaticnecrosisinlamotrigineinduceddresssyndrome AT matthewkuhar fataleosinophilicmyocarditisandsubmassivehepaticnecrosisinlamotrigineinduceddresssyndrome AT hectormesa fataleosinophilicmyocarditisandsubmassivehepaticnecrosisinlamotrigineinduceddresssyndrome |