Fatal eosinophilic myocarditis and submassive hepatic necrosis in lamotrigine induced DRESS syndrome.

Autopsy Drug hypersensitivity syndrome Lamotrigine Massive hepatic necrosis Myocarditis Thyroiditis

Journal

Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology
ISSN: 1710-1484
Titre abrégé: Allergy Asthma Clin Immunol
Pays: England
ID NLM: 101244313

Informations de publication

Date de publication:
25 Oct 2023
Historique:
received: 26 06 2023
accepted: 02 10 2023
medline: 26 10 2023
pubmed: 26 10 2023
entrez: 26 10 2023
Statut: epublish

Résumé

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.

Identifiants

pubmed: 37880699
doi: 10.1186/s13223-023-00848-6
pii: 10.1186/s13223-023-00848-6
pmc: PMC10601244
doi:

Types de publication

Journal Article

Langues

eng

Pagination

92

Informations de copyright

© 2023. Canadian Society of Allergy & Clinical Immunology.

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Auteurs

Khanh Duy Doan (KD)

Department of Pathology and Laboratory Medicine, Temple University Hospital, Philadelphia, PA, USA.

Adeyinka Akinsanya (A)

Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, 350 W 11th St, Indianapolis, IN, 46202, USA.

Matthew Kuhar (M)

Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, 350 W 11th St, Indianapolis, IN, 46202, USA.

Hector Mesa (H)

Department of Pathology and Laboratory Medicine, Temple University Hospital, Philadelphia, PA, USA. hmesa@iu.edu.
Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, 350 W 11th St, Indianapolis, IN, 46202, USA. hmesa@iu.edu.

Classifications MeSH