Toxic epidermal necrolysis carbamazepine-induced

Friedmann PS, Strickland I, Pirmohamed M, Park BK (1994) Investigation of mechanisms in toxic epidermal necrolysis induced by carbamazepine. Arch Dermatol 130 598-604 Fujino S, Andoh A, Bamba S, Ogawa A, Hata K, Araki Y, Bamba T, Fujiyama Y (2003) Increased expression of interleukin 17 in inflammatory bowel disease. Gut 52 65-70 Ganey PE, Luyendyk JP, Maddox JF, Roth RA (2004) Adverse hepatic drug reactions inflammatory episodes as consequence and contributOT. Chem Biol Interact 150 35-51 Gao B (2005) Cytokines, STATs and liver disease. Cell Mol Immunol 2 92—100... 

Carbamazepine (CBZ) is a widely used anticonvulsant that can cause rashes in up to 10% of patients, and in occasional cases this may be the precursor to the development of a hypersensitivity syndrome characterized by systemic manifestations such as fever and eosinophilia (Feeder 1998 Vittorio and Muglia 1995). Rarely, CBZ can induce blistering skin reactions such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis, two conditions associated with a high fatality rate (Rzany et al. 1999). There is now increasing laboratory evidence to show that... 

Genetic factors associated with severe adverse skin reactions induced by antiepileptic drugs in different ethnic populations have been discussed [80 , 81" ]. Several studies have shown that Han Chinese patients carrying the HLA-B 1502 are at high risk of Stevens-Johnson syndrome or toxic epidermal necrolysis when exposed to carbamazepine. 

In a case-control study to determine whether HLA-B 1502 is a valid pharmaco-genetic test for carbamazepine-induced Stevens-Johnson syndrome/toxic epidermal necrolysis in Thai patients, 79 with these serious complications carried... 

HLA allele B 1502 is a marker for an increased risk of carbamazepine-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in Han Chinese. The FDA has therefore changed the carbamazepine label, recommending genotyping in all Asians [90 ]. 

Carbamazepine-induced toxic epidermal necrolysis has been reported in a child [91 ]. 

The association between HLA-B 1502 and carbamazepine-induced Stevens- Johnson syndrome and toxic epidermal necrolysis has been investigated in eight Indian patients, of whom six had the HLA-B 1502 allele, confirming the association in Indian patients [93 ]. 

In a young patient with carbamazepine-induced toxic epidermal necrolysis, blister fluid was analysed for protein, chemical, and mineral contents [95 ]. There was a threefold increase in albumin and protein compared with bums blisters. 

Kaniwa N, Saito Y, Aihara M, Matsunaga K, Tohkin M, Kurose K, et al. HLA-B 1511 is a risk factor for carbamazepine-induced Steveirs-Johnson syndrome and toxic epidermal necrolysis in Japanese patients. Epilepsia 2010 51 2461-5. 

---