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KMID : 0854720070270010066
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Korean Journal of Asthma, Allergy and Clinical Immunology
2007 Volume.27 No. 1 p.66 ~ p.69
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Rhabdomyolysis as a Manifestation of Phenytoin-induced Anticonvulsant Hypersensitivity Syndrome
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Kim Young-Hoon
Lee Chae-Wook
Kim Ki-Ho
Kim Sang-Ho
Shin Bong-Chul
Seo Hyo-Rim
Kim Bo-Kyung
Heo Jeong-Hun
Yang Doo-Kyung
Lee Soo-Keol
Son Choon-Hee
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Abstract
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Anticonvulsant hypersensitivity syndrome (AHS) is a multisystemic disorder with cutaneous changes and typical blood abnormalities that may be triggered by any of the aromatic anticonvulsant drugs. Hepatic involvement is most common among internal organ involvements. Rhabdomyolysis is a rare manifestation of AHS. We present the case of a woman who, following phenytoin treatment, developed AHS with rhabdomyolysis. A 21-year-old woman was consulted to Allergy Clinic due to fever, rash, myalgia, and marked periorbital and facial edema that developed 10 days after the start of phenytoin therapy for seizure. Her hospitalcourse was remarkable with an increased serum creatine phosphokinase level of 8,576 IU/liter. Peripheral blood cell counts showed eosinophilia (1,100/microliter) and thrombocytopenia (112,000/microliter). Liver function tests revealed increased levels of liver enzymes (AST/ALT=1,0011/611 IU/L) and hyperbilirubinemia (total bilirubin/direct bilirubin=2.9/1.6 mg/dL). After the discontinuation of phenytoin and treatment with oral prednisolone for three weeks, her skin lesion and laboratory abnormalities improved.
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KEYWORD
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Phenytoin, Drug hypersensitivity, Rhabdomyolysis
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