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Toxic epidermal necrolysis in patients receiving
anticonvulsants and cranial irradiation: a risk to consider
Aguiar D, Pazo R, Duran I, Terrasa J, Arrivi A, Manzano H, Martin J, Rifa J
Servicio de Oncologia Medica, Hospital Universitario Son Dureta,
Palma de Mallorca, Islas Baleares, Spain. dagubuj@gobiernodecanarias.org
Toxic epidermal necrolysis (TEN) is an infrequent disease but with a high
mortality rate.
It is a mucocutaneous reaction resulting from hypersensitivity to a variety of
agents including most anticonvulsants.
Many patients with primary or metastatic intracranial tumours receive
anticonvulsants for seizure prophylaxis despite their efficacy not having been
clearly demonstrated.
Moreover, several cases have been reported in the literature in which serious
adverse drug reactions such as TEN and Stevens-Johnson syndrome (SJS) have
occurred following anticonvulsants exposure.
In some of these cases the effect of radiation therapy and the tapering of
steroid dose on the pathogenesis of these reactions have been highlighted.
We report, here, a case of TEN that appeared in a patient receiving phenytoin,
and shortly after the end of cranial and thoracic irradiation therapy for brain
metastases of non-small cell lung cancer.
Clinical considerations about diagnosis of SJS and TEN are presented.
The use of prophylactic anticonvulsants is also discussed as well as a review of
the literature.
PMID: 15015667 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15015667
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