Anticonvulsant Hypersensitivity Syndrome With Marked Eosinophilia in Treatment of Diabetic Neuropathy
- Nobuko Yamada, MD,
- Kentaro Kaneko, MD,
- Yasushi Saito, MD, PHD and
- Ichiro Tatsuno, MD, PHD
- Department of Clinical Cell Biology, Graduate School of Medicine, Chiba University, Chiba, Japan
Anticonvulsant hypersensitivity syndrome (AHS) caused by phenytoin, carbamazepine, or phenobarbital sodium is a rare, but sometimes life-threatening, drug reaction (1,2). These drugs have been widely used not only for convulsive disease but also for neuralgia in diabetic neuropathy (3). Here, we report a very rare case of AHS with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) with marked eosinophilia in a patient with diabetic neuropathy.
CASE REPORT
A 50-year-old man with type 2 diabetes was prescribed carbamazepine for painful diabetic neuropathy. At 5 weeks after exposure, he suffered from malaise, appetite loss, rash, and intermittent fever. Carbamazepine was immediately stopped and he was admitted. He appeared drowsy and had intermittent fever (temperatures to 39.0°C), lymphadenopathy at the left axillary without tenderness, and purpuric skin rash on his face, trunk, and extremities. Laboratory studies revealed an alanine aminotransferase level of 754 …
