Bacallao MRA, López ML, Pérez MDY

Language: Spanish
References: 16
Page: 1-9
PDF size: 183.90 Kb.

ABSTRACT

Introduction: anticonvulsant hypersensitivity syndrome due to phenytoin use sometime presents with severe dermatologic symptoms as toxic epidermal necrolysis. As part of internal organ involvement acute tubulointerstitial nephritis is seen, although it is just exceptionally of granulomatous type.
Objective: to demonstrate the coexistence of anticonvulsant hypersensitivity syndrome with toxic epidermal necrolysis and acute granulomatous tubulointerstitial nephritis.
Case report: a 60 years' male patient with a history of seizures due to subarachnoid hemorrhage caused by a cerebral aneurysm, surgically treated, received treatment with phenytoin and after 10 weeks of treatment developed fever and cutaneous erythema, that evolved to epidermal necrolysis. Beside, the patient presented with lymphadenopathies, jaundice and acute renal dysfunction. These clinical findings caused the interruption of phenytoin treatment and a steroid treatment was initiated, but after eight weeks of treatment there was not response, and a renal biopsy was performed where was found an acute granulomatous tubulointerstitial nephritis. With the continuity of steroid treatment there was a recovery of renal function and a disappearance of rest of symptoms.
Conclusions: throughout the reported case it was demonstrated the coexistence of anticonvulsant hypersensitivity syndrome with toxic epidermal necrolysis and acute granulomatous tubulointerstitial nephritis.

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