ラモトリギンが関与したDIHSの2例

・ラモトリギンによるdrug-induced hypersensitivity syndrome（DIHS）の2例を経験した．症例1：53歳，女．カルバマゼピン投与開始21日後，ラモトリギン投与開始19日後に皮疹出現．症例2：69歳，女．ラモトリギン投与開始33日後に皮疹出現．2例とも投与期間は2週間を超えていたが，増量後2週間以内に発症していた．

・ともに初診時に肝機能障害を認めたが，白血球は遅れて上昇してきた．HHV-6の再活性化を認め，急性期DLSTが陽性であった．

・症例1は補液とステロイド外用による保存的治療，症例2はステロイドの全身投与を選択し，治癒した．

（「症例のポイント」より）

　

Two cases of DIHS involving lamotrigine

　

Tsujino, Yoshio1）Mihara, Yuko1）Ishitobi, Tomoko1） 1）Division of Dermatology, Shimane Prefectural Central Hospital

　

We experienced two cases of DIHS involving lamotrigine. Case 1：a 53-year-old woman developed eruption after starting administration of carbamazepine and lamotrigine. Case 2：a 69-year-old woman developed eruption after starting lamotrigine administration. In both cases, the administration period exceeded 2 weeks, but it occurred after the increase. Liver dysfunction was observed in both cases at the first visit, but leukocytes have risen late, reactivation of HHV-6 was recognized and acute stage DLST was positive. Case 1 selected conservative treatment with replacement fluid and topical steroid application, and case 2 was cured with systemic steroid administration.