Hypersensitivity syndrome due to 2 anticonvulsant drugs

Drug-induced hypersensitivity syndrome is a multiorgan-system reaction char acterized by fever, pleomorphic eruption, lymphadenopathy, eosinophilia, ly mphocytosis and hepatitis. We report a drug hypersensitivity syndrome in a 6-year-old Tunisian child treated for epileptic absences with sodium valpro ate and ethosuximide. Imputability of these 2 drugs is probable because of the chronological and clinical features. Positive rechallenge with ethosuxi mide confirmed the toxicity of this drug. Sodium valproate was also respons ible because patch testing was positive and followed by a generalized erupt ion. Human herpesvirus 6 (HHV6) antibody titers increased significantly wit hin 15 days. There was a favourable outcome after discontinuation of the dr ugs and corticosteroid therapy. Our case is interesting because this drug h ypersensitivity syndrome occurred with non-aromatic anticonvulsant drugs. I t is the Ist case with ethosuximide and the 2nd with sodium valproate. We a lso observed a reactivation of HHV6 infection that may contribute to the de velopment of this hypersensitivity syndrome.