Diarrhea, negative t-waves, fever and skin rash, rare manifestation of carbamazepine hypersensitivity: a case report

INTRODUCTION: Antiepileptic drug induced hypersensitivity syndrome is a rare side effect of some of the first line anticonvulsive drugs such as carbamazepine and other aromatic agents. We are the first to mention a rare case of gastrointestinal, skin and cardiac findings related to carbamazepine administration, which is very uncommon and needs to be reported. CASE PRESENTATION: We report on a 62-year-old Caucasian woman with carbamazepine associated hypersensitivity syndrome, who developed diarrhea, fever, skin lesions, pericardial effusion and pathology on electrocardiogram with terminal negative T waves in I, II, aVL, V(5 )and V(6),. After withdrawal of carbamazepine and administration of methylprednisolone, all initial symptoms improved, white blood cell count normalized, pericardial effusion resolved and pathologic electrocardiogram findings resolved. CONCLUSION: Anticonvulsive drug hypersensitivity syndromes can present with a wide spectrum of unspecific symptoms, which the prescribing clinician should be aware of.