DRUG-INDUCED HYPERSENSITIVITY SYNDROME CAUSED BY LAMOTRIGINE, A CASE REPORT/SINDROM PREOSJETLJIVOSTI UZROKOVAN LAMOTRIGINOM; PRIKAZ SLUCAJA

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome, also known as drug-induced hypersensitivity syndrome (DIHS), is an under-recognized and potentially life-threatening hypersensitivity reaction associated with a variety of medications, many of them antiepileptics. Patients with DRESS syndrome typically present with rash, swelling, fever, and systemic manifestations. We report a case of a patient admitted to out hospital after the administration of an anticonvulsive drug lamotrigine. She was presented with high fever, rash, face oedema and elevated liver enzymes. At admission, all previous medications were discontinued, systemic corticosteroid therapy was administered, and the patient was monitored for signs of clinical recovery. This case report suggests that in patients presenting with skin rash and systemic abnormalities after a recent change in medications, physicians should consider DRESS syndrome as a possible diagnosis and switch to a more aggressive therapy if removal of the offending agent does not result in clinical improvement. Early diagnosis can reduce the risk of complications and the mortality rate. Key words: drug-induced hypersensitivity, drug reaction, lamotrigine Reakcija na lijek s eozinofilijom i sistemskim simptomima (DRESS, engl. Drug Reaction with Eosinophilia and Systemic Symptoms), ili sindrom preosjetljvosti uzrokovan lijekom (DIHS, engl.Drug-inducec Hypersensitivity Syndrome), je cesto neprepoznato i potencijalno zivotno ugrozavajuca reakcija preosjetljivosti povezana s uzimanjem raznih lijekova, najcesce antiepilepticima. Pacijenti s DRESS/DIHS se najcesce prezentiraju osipom, febrilitetom i zahvacanjem unutarnjih organa. U ovom prikazu slucaja predstavljena je pacijentica koja je nakon uzimanja lamotrigina razvila osip, visoki febrilitet, edem lica te hepatitis. Po primitku u bolnicu, iskljucena je sva dotadasnja terapija te zapoceto sistemsko lijecene kortikosteroidima. Ovaj rad sugerira razmatranje dijagnoze DRESS/DIH kod pacijenata s naglom pojavom osipa te sistemskim simptomima, a nakon uvodenja novog lijeka u terapiju te se preporuca agresivniji pristup u terapiji osim prestanka uzimanja uzrocnog lijeka. Rano prepoznavanje moze smanjiti rizik komplikacija i mortalitet. Kljucne rijeci: preosjetljivost uzrokovana lijekom, reakcija na lijek, lamotrigin