Anticonvulsant hypersensitivity reaction in pregnancy

BACKGROUND: Anticonvulsant hypersensitivity reaction is a multisystem disorder that occurs after exposure to aromatic anticonvulsants. It is potentially fatal, with a mortality rate up to 50%. We report a case of an anticonvulsant hypersensitivity reaction that occurred during pregnancy at 10 weeks' gestation. CASE: A grand multipara was being treated with carbamazapine for a seizure disorder. She developed a maculopapular rash, elevated liver enzymes, and pancytopenia. Withdrawal of aromatic anticonvulsants and supportive therapy resulted in resolution of her illness. The remainder of her pregnancy was uneventful, and she delivered a healthy infant at term. CONCLUSION: All pregnant women treated with aromatic anticonvulsants are at risk for anticonvulsant hypersensitivity reaction, and a high degree of clinical suspicion is essential for diagnosis.