Sindrom Stevens-Johnson yang Disebabkan oleh Carbamazepine pada Pasien Epilepsi: Laporan Kasus
Laporan Kasus
DOI:
https://doi.org/10.55175/cdk.v53i01.1811Kata Kunci:
Carbamazepine, laporan kasus, sindrom Stevens-Johnson, toxic epidermal necrolysisAbstrak
Pendahuluan: Sebagai lini pertama obat antiepilepsi untuk bangkitan parsial dan tonik-klonik, carbamazepine digunakan jangka panjang.Obat ini berisiko menimbulkan sindrom Stevens-Johnson (SJS) ataupun toxic epidermal necrolysis (TEN). Kasus: Perempuan berusia 23 tahun dengan riwayat kejang; mengalami kemerahan pada wajah, leher, dada, punggung belakang, dan ekstremitas atas kiri dan kanan seluas 10% body surface area (BSA) setelah mengonsumsi carbamazepine 200 mg 2 kali sehari untuk kejang. Diskusi: Pasien diterapi tablet methylprednisolone 16 mg 2 kali sehari dan diphenhydramine IV 2 kali sehari, serta obat simtomatik lain. Setelah dirawat 9 hari, pasien dipulangkan dengan phenytoin 100 mg 2 kali sehari sebagai pengganti carbamazepine. Pengobatan awal dengan steroid sistemik dosis tinggi memberikan manfaat berupa pemulihan yang lebih cepat, terutama pada pasien SJS dengan kerusakan kulit yang belum terlalu luas dan masih dapat diperbaiki melalui efek antiinflamasi dari steroid. Penatalaksanaan utama SJS/TEN adalah pengenalan dini dan penghentian segera obat penyebab. Simpulan: Carbamazepine sering menjadi faktor risiko SJS sehingga memerlukan terapi alternatif.
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