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VOL. 10, ISSUE 2 (2025)
Levetiracetam-induced dress syndrome in an elderly patient: a rare but serious adverse reaction
Authors
Dr. Ramkumar L Maddapur, Dr. Tasmiya M Pathan, Vivek Ramesh Gokhale, Aishwarya siddamallanagoudpatil, Dr. Ajay R
Abstract
Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) is an
uncommon but serious adverse drug reaction that can affect multiple organs and
become life-threatening if not identified in time. It typically develops within
2 to 8 weeks of starting the offending drug, most often certain antiepileptic
medications such as phenytoin or carbamazepine. Levetiracetam, although
considered a safer alternative among antiepileptic, has only rarely been linked
to DRESS. We describe the case of a 78-year-old woman with a background of
cerebrovascular accident and a recently diagnosed seizure disorder, which was
started on levetiracetam. Four weeks into therapy, she developed high-grade
fever, altered mental status, and widespread fluid-filled skin lesions. Blood
tests showed elevated Eosinophils counts, anemia, increased inflammatory
markers, and worsening renal function. A Tzanck smear ruled out autoimmune
blistering diseases. Based on clinical findings and RegiSCAR scoring, a
diagnosis of DRESS was established. Levetiracetam was discontinued immediately,
and the patient was treated with corticosteroids and supportive care, leading
to steady clinical improvement. This case highlights the need to remain
vigilant for DRESS, even with drugs that are typically well-tolerated. Early
recognition and withdrawal of the causative drug are essential to prevent
serious complications and improve recovery outcomes.
Pages:73-75
How to cite this article:
Dr. Ramkumar L Maddapur, Dr. Tasmiya M Pathan, Vivek Ramesh Gokhale, Aishwarya siddamallanagoudpatil, Dr. Ajay R "Levetiracetam-induced dress syndrome in an elderly patient: a rare but serious adverse reaction". International Journal of Pharmaceutical Science and Research, Vol 10, Issue 2, 2025, Pages 73-75
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