Procalcitonin, a high acute phase reactant in antiepileptic hypersentivity syndrome in pediatric age

Eur J Paediatr Neurol. 2012 Mar;16(2):200-2. doi: 10.1016/j.ejpn.2011.06.007. Epub 2011 Jul 28.

Abstract

Antiepileptic hypersensitivity syndrome (AHS) is a potentially life-threatening syndrome in pediatric cases. It is associated with aromatic anticonvulsivant drugs and others antibiotics with or without associated reactivation of virus. The pathogenesis of the process is not clear. Clinical feature of this syndrome include cutaneous reactions, fever and lymphadenopathies, but different organs can be involved. In laboratory analyses we can find leucocytosis, eosinophilia, and increase in transaminase levels. Significant elevation of procalcitonin (PCT) has been described in two adults patients. This study we report two cases of a 14-year-old male and a 13-year-old female with a AHS and a high level of the PCT. These are the first cases described in pediatric age. Establishing a diagnosis of AHS is important to avoid the use of the involved drug. The treatment is based on the withdrawal of the drugs that are supposed and if there is no improvement or a deterioration of the patient, the use of systemic corticosteroids is often useful.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Anticonvulsants / adverse effects*
  • Calcitonin / blood*
  • Calcitonin Gene-Related Peptide
  • Carbamazepine / adverse effects
  • Drug Eruptions
  • Drug Hypersensitivity / blood
  • Drug Hypersensitivity / complications
  • Drug Hypersensitivity / diagnosis*
  • Epilepsy, Frontal Lobe / complications
  • Epilepsy, Frontal Lobe / drug therapy
  • Epstein-Barr Virus Infections / complications
  • Female
  • Humans
  • Male
  • Pentobarbital / adverse effects
  • Phenytoin / adverse effects
  • Protein Precursors / blood*
  • Transaminases / blood

Substances

  • Anticonvulsants
  • CALCA protein, human
  • Protein Precursors
  • Carbamazepine
  • Phenytoin
  • Calcitonin
  • Transaminases
  • Pentobarbital
  • Calcitonin Gene-Related Peptide