J Clin Pharmacol
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First published on September 1, 2009, doi:10.1177/0091270009344985
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©© 2009 American College of Clinical Pharmacology, Inc.
The Journal of Clinical Pharmacology, 10.1177/0091270009344985

Article

Hypersensitivity Syndrome Induced by Anticonvulsants: Possible Cross-Reactivity Between Carbamazepine and Lamotrigine

Karim Aouam 1*, Foued Ben Romdhane 2, Chaouki Loussaief 2, Randa Salem 2, Adnène Toumi 2, Hichem Belhadjali 2, Amel Chaabane 1, Naceur A. Boughattas 1, and Mohamed Chakroun 2

1 Laboratoire de Pharmacologie, Faculté de Médecine, Monastir, Tunisia
2 CHU Fattouma Bourguiba, Monastir, Tunisia

* To whom correspondence should be addressed. E-mail: aouam_k{at}yahoo.fr.


  Abstract
A 14-year-old male presents with erythroderma and fever 44 days after carbamazepine intake. Laboratory exams show eosinophilia and elevated liver enzymes, and thoracic imaging reveals interstitial pneumonitis. All symptoms disappear after carbamazepine withdrawal. A patch test to carbamazepine performed 6 weeks after recovery is positive. About 8 months later, the patient exhibits the same clinical and biological picture 52 days after lamotrigine intake. Lamotrigine is stopped and all symptoms disappear. A patch test to LMG is positive. This case illustrates a possible cross-reactivity between carbamazepine and lamotrigine, which are aromatic and nonaromatic anticonvulsants, respectively.
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