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Revista del Cuerpo Médico Hospital Nacional Almanzor Aguinaga Asenjo
versión impresa ISSN 2225-5109versión On-line ISSN 2227-4731
Resumen
MEREGILDO-RODRIGUEZ, Edinson Dante; ASMAT-RUBIO, Martha Genara; SANCHEZ-CARRILLO, Halbert Christian y CHAVARRI-TRONCOSO, Frank Poul. Toxic epidermal necrolysis associated with anticonvulsants. Rev. Cuerpo Med. HNAAA [online]. 2021, vol.14, n.3, pp.383-386. Epub 26-Nov-2021. ISSN 2225-5109. http://dx.doi.org/10.35434/rcmhnaaa.2021.143.1266.
Background and Objectives:
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are considered as a continuum of the same process. TEN or Lyell Syndrome is the most severe form. Both entities involve an acute mucocutaneous blistering reaction associated with systemic inflammation.
Materials and Methods:
We present a case of a young woman who developed TEN following concomitant treatment with valproate, lamotrigine, and phenobarbital. Despite the extensive mucocutaneous detachment (over 90%), prognostic evaluation was favorable (SCORTEN score 2; probability of survival 88%), and this patient evolved satisfactorily. Five days after admission, valproate was reinitiated without any subsequent adverse reaction.
Results:
Causality evaluation identified both lamotrigine and phenobarbital as “very probable” (ALDEN score = 6) causes and valproate as “very unlikely” (ALDEN score = 0) cause of TEN.
Conclusions:
SJS and TEN are true life-threatening medical emergencies. This case emphasizes the importance of early diagnosis and treatment, including the discontinuation of the causative agent, which can be lifesaving.
Palabras clave : Stevens-Johnson syndrome; toxic epidermal necrolysis; drug eruptions; anticonvulsants.