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Case Reports
. 2024 Nov 26:2024:4835223.
doi: 10.1155/crcc/4835223. eCollection 2024.

A Singular Case Analysis: Lamotrigine-Associated Stevens-Johnson Syndrome

Albin Joshi  1 , Anjula Palikhe  1 , Santosh Acharya  2 , Puskar Kunwor  3
Affiliations
Case Reports

A Singular Case Analysis: Lamotrigine-Associated Stevens-Johnson Syndrome

Albin Joshi et al. Case Rep Crit Care. .

Abstract

Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) is an immune complex-mediated hypersensitivity reaction linked as an adverse side effect to many drugs. There have been case reports of similar incidences in Nepal related to various medications. Here, we present a case of a 29-year-old lady who developed a generalized erythematous rash over her body and erosion of the oral mucous membrane. Two weeks back she gave a history of initiation of lamotrigine, olanzapine, and sertraline. Given the strong association between SJS and lamotrigine, and the usual presentation being within the first 8 weeks of exposure to susceptible medications; she was diagnosed as SJS/TEN induced by lamotrigine. On April 1, 2024, she was admitted to the ICU at KIST MCTH. All the medicines were withheld, and she was managed with corticosteroids and antihistamines. She improved significantly within 7 days. Early identification of SJS, discontinuation of triggering medicines, and prompt initiation of supportive therapy improved the prognosis.

Keywords: Stevens–Johnson syndrome (SJS); adverse drug reaction (ADR); antiepileptic drugs; case report; lamotrigine; toxic epidermal necrolysis (TEN).

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Initial presentation of oral mucosa erosion and maculopapular rashes.
Figure 2
Figure 2
Flowchart of a sequence of events of the patient leading to SJS/TEN diagnosis.
Figure 3
Figure 3
Oral mucosa erosion and rashes present during ICU stay.
Figure 4
Figure 4
Resolving oral mucosa erosion and rashes during ward stay.
Figure 5
Figure 5
Adverse drug reaction alert sticker implementation in the patient document.
See this image and copyright information in PMC

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