LYMPHOCYTE-STIMULATION TESTS AND PATCH TESTS IN CARBAMAZEPINE HYPERSENSITIVITY

  • 1 January 1977
    • journal article
    • research article
    • Vol. 29  (2) , 272-277
Abstract
Cases (7) of severe hypersensitivity to carbamazepine (Tegretol) were described in patients with epilepsy or trigeminal neuralgia. Clinical manifestations consisted of fever, rash, facial edema, lymphadenopathy, impaired liver function, eosinophilia and atypical lymphocytes in the peripheral blood. Lymphocyte-stimulation tests with carbamazepine in vitro showed positive results in all cases; patch tests with carbamazepine were positive in 6 cases. In 2 cases the lymphocyte-stimulation tests with carbamazepine apparently were negative during, and shortly after, the illness. When the tests were repeated several months later, they turned out to be positive. Lymphocyte reactivity to PPD [purified protein derivative] and PHA [phytohemagglutinin] in vitro was impaired during the acute phase of the disease. Thus false-negative lymphocyte-stimulation tests may be found in the 1st months following such a hypersensitivity reaction, probably due to impaired lymphocyte reactivity. As carbamazepine is a potent drug and is often prescribed for long periods together with other anticonvulsants, it seems important to prove that the allergic reaction is caused by carbamazepine. If the lymphocyte-stimulation test in vitro or the patch test with carbamazepine negative during or shortly after the illness, they should be repeated several months later.