Lamotrigine Induced DRESS Syndrome in a Patient with Malignant Melanoma
DOI:
https://doi.org/10.51338/rppsm.314Keywords:
Drug Hypersensitivity Syndrome/etiology, Lamotrigine/adverse effects, Melanoma/drug therapy, PolypharmacyAbstract
A síndrome de DRESS (drug reaction with eosinophilia and systemic symptoms) constitui uma forma rara de reação adversa medicamentosa grave com envolvimento sistémico. Descreve‑se
o caso clínico de doente com diagnóstico de
melanoma maligno, que se dirigiu ao serviço de urgência com quadro de exantema morbiliforme generalizado, edema facial e astenia. Encontrava‑se
sob terapêutica com pembrolizumab desde há 5 meses e, no contexto de depressão bipolar,
tinha iniciado lamotrigina 14 dias antes da admissão. Analiticamente destacava‑se
trombocitopenia, eosinofilia, PCR elevada e alterações das provas hepáticas. Considerou‑se
o diagnóstico de síndrome de DRESS a lamotrigina, tendo este fármaco sido suspenso e iniciada corticoterapia sistémica, com resolução completa do quadro em 30 dias. A suspensão do fármaco responsável constitui a medida mais importante na redução da morbilidade e mortalidade associadas à síndrome de DRESS. A identificação do agente causal em doentes polimedicados pode tornar‑se
um verdadeiro desafio.
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