Korean J Asthma Allergy Clin Immunol.  2007 Mar;27(1):66-69.

Rhabdomyolysis as a Manifestation of Phenytoin-induced Anticonvulsant Hypersensitivity Syndrome

Abstract

Anticonvulsant hypersensitivity syndrome (AHS) is a multisystemic disorder with cutaneous changes and typical blood abnormalities that may be triggered by any of the aromatic anticonvulsant drugs. Hepatic involvement is most common among internal organ involvements. Rhabdomyolysis is a rare manifestation of AHS. We present the case of a woman who, following phenytoin treatment, developed AHS with rhabdomyolysis. A 21-year-old woman was consulted to Allergy Clinic due to fever, rash, myalgia, and marked periorbital and facial edema that developed 10 days after the start of phenytoin therapy for seizure. Her hospitalcourse was remarkable with an increased serum creatine phosphokinase level of 8,576 IU/liter. Peripheral blood cell counts showed eosinophilia (1,100/microliter) and thrombocytopenia (112,000/microliter). Liver function tests revealed increased levels of liver enzymes (AST/ALT=1,0011/611 IU/L) and hyperbilirubinemia (total bilirubin/direct bilirubin=2.9/1.6 mg/dL). After the discontinuation of phenytoin and treatment with oral prednisolone for three weeks, her skin lesion and laboratory abnormalities improved.

MeSH Terms

Anticonvulsants
Blood Cell Count
Creatine Kinase
Drug Hypersensitivity
Edema
Eosinophilia
Exanthema
Female
Fever
Humans
Hyperbilirubinemia
Hypersensitivity*
Liver
Liver Function Tests
Myalgia
Phenytoin
Prednisolone
Rhabdomyolysis*
Seizures
Skin
Thrombocytopenia
Young Adult
Anticonvulsants
Creatine Kinase
Phenytoin
Prednisolone