Erythema Multiforme Exudativum Major Caused by Isoniazid Hypersensitivity in a Child
Erythema Multiforme Exudativum Major (EMEM) is one of the drug allergy diseases. Drug allergies caused by isoniazid rarely causes EMEM. Cutaneous reactions caused by isoniazid were obtained in 0.98% of patients, but the precise occurrence of Steven Johnson’s Syndrome (SJS) and Toxic Epidermolisis Necrolisis (TEN) due to isoniazid is not known for certain. We present this case to show hypersensitivity of isoniazid in a child. Based on the history of drug intake, physical diagnostic tests, drug elimination and provocation; we established the diagnosis of isoniazid hypersensitivity. The child showed improvement on skin manifestation after stopped isoniazid therapy.
 Mario Sánchez-Borges, Bernard Thong, Miguel Blanca, Luis Felipe Chiaverini Ensina, Sandra González-Díaz, Paul A Greenberger et al. Hypersensitivity reactions to non beta-lactam antimicrobial agents, a statement of the WAO special committee on drug allergy. World Allergy Organization Journal. 2013. 6:18.
 Bernard Yu-Hor Thong. Update on the Management of Antibiotic Allergy. Allergy Asthma Immunol Res. 2010.2(2):77-86
 Forget EJ, Menzies D. Adverse reactions to first-line antituberculosis drugs. Expert Opin Drug Saf. 2006.5:231-49.
 Bernard Y-H. Thong & Teck-Choon Tan. Epidemiology and risk factors for drug allergy. Br J Clin Pharmacol. 2010.71:5.684–700 (5) Bernard, Tan. Drug Allergies. Worldallergy.org. 2014.
 Tan W. C, Ong C. K, Kand S. C, Razak M. A: Two years review of cutaneous adverse drug reaction from first line anti-tuberculosis drugs. Med J Malaysia. 2007. 62:143–6.
 Roland Solensky, MD, and David A. Khan, MD. Drug Allergy: An Updated Practice Parameter. Joint Council of Allergy, Asthma & Immunology. 2010.105(273).
 Thong BY, Leong KP, Tang CY, Chng HH. Drug allergy in a general hospital: Results of a novel prospective inpatient reporting system. Ann Allergy Asthma Immunol. 2003. 90:342-7.
 Brockow, A. Romano, M. Blanca, J. Ring, W. Pichler, P. Demoly. General considerations for skin test procedures in the diagnosis of drug hypersensitivity. Allergy. 2002. 57: 45–51.
 Greenberger P. A: Drug allergy. Allergy Asthma Proc. 2012. 33:S103– S107.
 Edwards I. R, Aronson J. K. Adverse drug reactions: definitions, diagnosis, and management. Lancet Journal. 2000. 356: 1255-59
 Johansson S. G, Bieber T, Dahl R, et al. Revised nomenclature for allergy for global use. Report of the Nomenclature Review Committee of the World Allergy Organization, October 2003. J Allergy Clin Immunol. 2004;113: 832-836.
 Greenberger P. A. 8. Drug allergy. J Allergy Clin Immunol. 2006. 117 (2 Suppl Mini-Primer): S464-S470.
 Francis C. K. Thien. Drug hypersensitivity. MJA. 2006. 185(6);333-38
 Rive, Craig M, Jack Bourke, Elizabeth J. Phillips. Testing for Drug Hypersensitivity Syndromes. Clin Biochem Rev.2013. I:15-38.
 Centers for disease control and prevention, treatment of tuberculosis, American thoracic society, CDC, and infectious diseases society of America. MMWR. 2003, 52:20–21. No. RR-11.
 Michele, Lamoreux, Marna R. Sternbach, W. Teresa. Erythema Multiforme. Am Fam Physician. 2006.1;74(11):1883-88.
 Labrèze, T. Lamireau, D. Chawki, J. Maleville, A. Taïeb. Diagnosis, classification, and management of erythema multiforme and Stevens– Johnson syndrome. Arch Dis Child. 2000. 83:347–52.
 Harry D. Mckinnon, Thomas Howard. Evaluating the febrile patient with a rash. Am fam physician. 2000. 15;62(4):804-16.
 Kroonen, Lisa M. Erythema Multiforme: Case Report and Discussion. ABFP. 1998. 11(1);63-5.
 Demoly P, Bousquet J. Drug allergy diagnosis work up. Allergy. 2002. 57(Suppl. 72):73–60.
 Aberer W, A. Bircher, A. Romano, M. Blanca, P. Campi, J. Fernandez, et al. Drug provocation testing in the diagnosis of drug hypersensitivity reactions: general considerations. Allergy. 2003. 58: 854–63.
 Goldsby R. A., Kindt T. J., Osborne & Kuby J. Immunology, 5th Edition. 2003.
 Madhu Pruthi. Basic concepts of autoimmunity, hypersensitivity and immunodeficiency disorders. 2007.