Zusammenfassung
Bei einer 51-jährigen Patientin mit bekannter endogener Depression entwickelte sich 4 Wochen nach Einleitung einer Carbamazepin-Therapie ein generalisiertes makulo-papulöses Exanthem. Neben septisch verlaufenden Temperaturen, einer Splenomegalie und einer generalisierten Lymphadenopathie zeigten sich deutliche Erhöhungen der Transaminasen und eine ausgeprägte Eosinophilie. Nach Abbruch der Carbamazepin-Therapie und systemischer Behandlung mit Kortikosteroiden kam es zu einer vollständigen Rückbildung der klinischen und laborchemischen Symptomatik.
Das hier vorgestellte Hypersensitivitätssyndrom muss zur Gruppe der potenziell lebensbedrohlichen Arzneimittelreaktionen gezählt werden. Dabei ist die Prognose von einer frühzeitig einsetzenden, hochdosierten Behandlung mit Kortikosteroiden abhängig. Vor diesem Hintergrund ist die differenzialdiagnostische Abgrenzung des Hypersensitivitätssyndroms von klinisch ähnlich verlaufenden Virusinfektionen zwingend notwendig.
Abstract
After a four weeks period of taking carbamazepine for treatment of endogenous depression a 51 years old female patient developed a widespread eruption of erythematous macules and papules. Additionally the patient showed septic temperatures, splenomegaly, a pronounced lymphadenopathy and a clear increase of transaminases and eosinophilic leucocytes. When therapy with carbamazepine was stopped and after treatment with systemic steroids clinical symptoms and laboratory parameter completely resolved.
A hypersensitivity syndrome has to be taken into account as a potential life threatening drug eruption. The prognosis depends on early onset of steroid medication. Therefore virus infections should urgently be considered as a differential diagnosis.
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