Document Detail


Toxic epidermal necrolysis in patients receiving anticonvulsants and cranial irradiation: a risk to consider.
MedLine Citation:
PMID:  15015667     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
David Aguiar; Roberto Pazo; Ignacio Durán; Josefa Terrasa; Antonio Arrivi; Herminio Manzano; Javier Martín; Julio Rifá
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of neuro-oncology     Volume:  66     ISSN:  0167-594X     ISO Abbreviation:  J. Neurooncol.     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-03-12     Completed Date:  2004-04-01     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8309335     Medline TA:  J Neurooncol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  345-50     Citation Subset:  IM    
Affiliation:
Servicio de Oncología Médica, Hospital Universitario Son Dureta, Palma de Mallorca, Islas Baleares, Spain. dagubuj@gobiernodecanarias.org
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MeSH Terms
Descriptor/Qualifier:
Anticonvulsants / adverse effects*
Brain Neoplasms / secondary,  therapy
Carcinoma, Non-Small-Cell Lung / secondary,  therapy
Cranial Irradiation / adverse effects*
Epidermal Necrolysis, Toxic / diagnosis,  etiology*
Humans
Lung Neoplasms / pathology,  therapy
Male
Middle Aged
Phenytoin / adverse effects*
Chemical
Reg. No./Substance:
0/Anticonvulsants; 57-41-0/Phenytoin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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