Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Steroid Therapy in Phenytoin Hypersensitivity Syndrome Patient

Phenytoin에 의한 항경련제 과민증후군의 스테로이드 치험증례

  • Kim, Young-Ok (Department of Internal Medicine, Uijongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Suh, Jung-Pil (Department of Internal Medicine, Uijongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kim, Eun-Il (Department of Internal Medicine, Uijongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Cho, Seok-Goo (Department of Internal Medicine, Uijongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Lee, Chang-Don (Department of Internal Medicine, Uijongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Yi, Jong-Yuk (Department of Dermatology, Uijongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Yoo, Do-Sung (Department of Neurosurgery, Uijongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kim, Dal-Soo (Department of Neurosurgery, Uijongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
  • 김영옥 (가톨릭대학교 의과대학 내과학교실) ;
  • 서정필 (가톨릭대학교 의과대학 내과학교실) ;
  • 김은일 (가톨릭대학교 의과대학 내과학교실) ;
  • 조석구 (가톨릭대학교 의과대학 내과학교실) ;
  • 이창돈 (가톨릭대학교 의과대학 내과학교실) ;
  • 이종육 (가톨릭대학교 의과대학 피부과학교실) ;
  • 유도성 (가톨릭대학교 의과대학 신경외과학교실) ;
  • 김달수 (가톨릭대학교 의과대학 신경외과학교실)
  • Received : 2000.06.02
  • Accepted : 2000.09.07
  • Published : 2000.12.28
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Abstract

Anticonvulsant hypersensitivity syndrome is a rare but fatal complication. It manifests as fever, skin rash, lymphadenopathy, and hepatitis. Phenytoin, phenobarbital, and carbamazepine are the most frequently involved drugs. We here report a case of phenytoin-induced anticonvulsant hypersensitivity syndrome. A 37-year-old woman presented with fever and generalized skin rash, 3 weeks following commencement of phenytoin 400mg daily for treatment of seizure after superficial temporal artery-middle cerebral artery(STA-MCA) anastomosis for moyamoya disease. Her temperature was $39.3^{\circ}C$ and her face was edematous. Laboratory findings showed elevated hepatic enzymes and eosinophilia. Blood and urine culture were all negative. Initially, prednisolone was commenced at 30 mg daily. But fever and skin rash did not improved and hepatic function was more aggravated. After increasing dose of steroid(methylprednisolone 125mg/day), fever and skin rash disappeared and hepatic enzymes returned to normal range.

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