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

被引:0
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作者
Khanh Duy Doan
Adeyinka Akinsanya
Matthew Kuhar
Hector Mesa
机构
[1] Temple University Hospital,Department of Pathology and Laboratory Medicine
[2] Indiana University School of Medicine,Department of Pathology and Laboratory Medicine
来源
Allergy, Asthma & Clinical Immunology | / 19卷
关键词
Lamotrigine; Drug hypersensitivity syndrome; Myocarditis; Massive hepatic necrosis; Thyroiditis; Autopsy;
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摘要
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.
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