Severe hepatic injury induced by carbamazepine associated with toxic epidermal necrolysis. Report of a case.

Abstract

Toxic epidermal necrolysis and Stevens Johnson syndrome are rare and fatal disorders, characterized by severe skin and mucosal injury. These disorders are the same condition, it is differentiated by the degree of affection of the total body surface. The hypersensitivity reaction of drugs is the most frequent etiology of these two entities; On the other hand, the liver is also a target of lesions caused by medications, which can lead to severe hepatitis and even worse acute liver failure, leading to jaundice, encephalopathy and coagulopathy. The present case is a patient suffering a head trauma with the presence of subdural hematoma, days after the start of consumption of carbamazepine as anticonvulsant prophylaxis and acetaminophen for pain, generating skin lesion that compromised more than 30% of the body surface, injury severe hepatic disease with marked elevation of transaminases and encephalopathy, which could well correspond to subdural hematoma or hepatic damage; This generated great interest.