Carbamazepine-Induced Dihs/Dress Syndrome Leading To Hemophagocytic Lymphohistiocytosis In A Woman Carrying The Hla-B*1301 Gene

Here, we present a case of hemophagocytic lymphohistiocytosis secondary to DiHS/DRESS syndrome after using carbamazepine in a woman who carried the HLA-B*1301 gene. A 66-year-old woman developed skin allergies and a high fever 20 days after taking carbamazepine for tinnitus. During hospitalization, there were three peaks of skin lesions, including patches and plaques, even blister and skin loosening. Moreover, skin lesions were accompanied by liver damage and hemophagocytic lymphohistiocytosis syndrome. She was cured after the application of systemic glucocorticoid methylprednisolone, antibiotics, and ganciclovir to prevent activation of the herpes virus. Moreover, she got support from plasma, gamma globulin, and exogenous fibrinogen. According to the medical history, physical examination, and histopathological examination, the patient was diagnosed as carbamazepine-induced DiHS/DRESS syndrome, resulting in hemophagocytic lymphohistiocytosis. Furthermore, the blood analysis showed she carried the HLA-B*1301 gene.