Toxic epidermal necrolysis associated with antiepileptic drugs and cranial radiation therapy.
Toxic epidermal necrolysis associated with antiepileptic drugs and cranial radiation therapy.
复制标题
与抗癫痫药物和头颅放射治疗有关的中毒性表皮坏死症。
DOI：
10.1155/2013/415031
复制
发表时间：
2013
影响因子：
0.9
通讯作者：
Jacob CM
中科院分区：
文献类型：
--
作者：
Elazzazy S;Abu Hassan T;El Seid A;Jacob CM
关于苯妥英钠与颅放射治疗同时给药相关的中毒性表皮坏死松解症（TEN）的病例报告（Ahmed（2004）、Criton et al.（1997）和Rzany et al.（1996）），但关于左乙拉西坦和颅放射治疗患者可能发生的多形性红斑的报告非常有限。本文提供的证据表明，TEN可能是由同时使用苯妥英和左乙拉西坦的辐射诱导的。我们的病例是一名42岁的男性患者，患有神经胶质肉瘤，在联合颅脑放射治疗时发生了与苯妥英钠相关的紫癜性皮炎;尽管苯妥英钠停药并改用左乙拉西坦，但患者在左乙拉西坦治疗时出现了更严重的中毒性表皮坏死松解症（TEN）症状;患者通过积极的症状管理、停用抗癫痫药物（AED）和停止放射治疗而改善。虽然TEN是一种罕见的毒性，但医生应特别注意监测脑肿瘤患者在颅脑照射期间接受抗癫痫预防治疗;此外，如果患者出现任何新的或不寻常的症状，应建议患者通知医生。
Case reports on the development of toxic epidermal necrolysis (TEN) associated with concurrent administration of phenytoin with cranial radiation therapy (Ahmed (2004), Criton et al. (1997), and Rzany et al. (1996)), but reports about erythema multiforme, which can develop in patients treated with levetiracetam and cranial irradiation, are very limited. This paper presents evidence that TEN may be induced by concurrent use of radiation with both phenytoin and levetiracetam. Our case is a 42-year-old male patient, a case of gliosarcoma who developed purpuric dermatitis associated with phenytoin when combined with cranial radiation therapy; although phenytoin was discontinued and switched to levetiracetam, the patient had more severe symptoms of toxic epidermal necrolysis (TEN) on levetiracetam; the patient improved with aggressive symptom management, discontinuation of antiepileptic drugs (AEDs), and holding radiotherapy. Although TEN is a rare toxicity, physicians should pay a special attention to the monitoring of brain tumor patients on antiepileptic prophylaxis during cranial irradiation; furthermore, patients should be counselled to notify their physicians if they develop any new or unusual symptoms.