Induction of Hypersensitivity to a Previously Tolerated Antiepileptic Drug by a Second Antiepileptic Drug
Bibliographic record
Abstract
PURPOSE: To describe the induction of hypersensitivity to one antiepileptic drug (AED) by a second AED. METHODS: Case report and review of the relevant literature. RESULTS: A patient is reported who was treated with phenytoin (PHT) for 6 months without adverse effect, but developed a hypersensitivity reaction with rash, fever, elevated liver enzymes, lymphadenopathy, and colitis 6 weeks after the introduction of carbamazepine (CBZ). PHT and CBZ were discontinued. Seizures continued despite treatment with valproic acid and clobazam. A decision was made to cautiously reintroduce PHT. Diffuse skin rash and pharyngitis appeared after two doses of PHT. CONCLUSIONS: The AED hypersensitivity syndrome has been thought to occur as a consequence of preexisting pharmacogenetic and immunologic abnormalities. Our case demonstrates induction of hypersensitivity to an AED that had been formerly well tolerated, after a hypersensitivity reaction to another AED. This is distinct from simple cross-reactivity between one or more drugs. Such induction of hypersensitivity with AEDs has not been previously described.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".