Hypersensitivity Reactions to Anticonvulsants

Department

Medicine

Additional Department

Allergy and Immunology

Document Type

Article

Publication Title

Current Allergy and Asthma Reports

Abstract

Background: Antiepileptics are the mainstay of treatment for seizure management. Immediate and delayed hypersensitivity reactions associated with antiepileptics are common. It is important to differentiate between these reactions as management and prognosis varies.

Objective: This review article aims to describe the types of hypersensitivity reactions reported with antiepileptics with emphasis on delayed hypersensitivity reactions, as these can be life-threatening.

Methods: Online databases including PubMed and Cochrane were searched, from the inception of the literature to 5/10/24. Studies focusing on hypersensitivity reactions to antiepileptics were reviewed. Case reports, case series, observational studies, and clinical trials were included. Abstracts and studies published in languages other than English were not included.

Results: Immediate reactions can occur with antiepileptics however the incidence is lower than that of delayed hypersensitivity reactions. Delayed hypersensitivity reactions include benign rash as well as severe cutaneous adverse reactions. Acute generalized exanthematous pustulosis, drug rash with eosinophilia and systemic symptoms, Steven Johnson syndrome, and toxic epidermal necrolysis are discussed in detail in this review. We focused on pathogenesis, genetic predisposition, clinical presentation, treatment, and prognosis.

Conclusion: Severe cutaneous adverse reactions can be lethal. It is important to make the correct diagnosis and treat patients accordingly. More studies comparing therapeutic options head-to-head are needed.

First Page

12

DOI

10.1007/s11882-024-01188-0

Volume

25

Issue

1

Publication Date

1-29-2025

Medical Subject Headings

Humans; Anticonvulsants (adverse effects); Drug Hypersensitivity (therapy, diagnosis, immunology, etiology); Hypersensitivity, Delayed (chemically induced, immunology); Seizures (drug therapy)

PubMed ID

39875598

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