Hypersensitivity to antiepileptic drugs in children

Background Aromatic (lamotrigin, carbamazepine, phenobarbital) and non aromatic antiepileptic (valproat, topiramate) drugs are frequently associated with hypersensitivity reactions mainly cutaneous such as maculopapular exanthems and bullous and pustular eruptions on the basis of their clinical, cellular and molecular pathophysiology. They usually occur more than 1 hour after the last drug administration and are self-limiting and benign. However, some severe life-threatening reactions have been reported characterized by high fever, malaise, erythema, skin blistering and ulceration of mucous membrans, or hypersensitivity syndromewith fever, lymphadenopaty and systemic symptoms with cutaneous eruption. The underlying mechanisms of these manifestations are not yet completely understood. A cell-mediated pathogenic mechanism has been demonstrated in some cases on the basis of positive patch tests and/or lymphocyte transformation test. The arm of this study was to confirm or rule out the diagnosis of hypersensitivity reactions to antiepileptic drugs in children.