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| ARTICLES |
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| Year : 1981 | Volume
: 29
| Issue : 2 | Page : 105-106 |
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Erythema multiforme secondary to acetazolamide (Diamox)
A Jayakrishna Nayak, PN Srinivasa Rao
O.E. U. Institute of Ophthalmology, Kasturba Medical College Hospital, Manipal, India
Correspondence Address:
A Jayakrishna Nayak
O.E. U. Institute of Ophthalmology, Kasturba Medical College Hospital, Manipal-576119
India
 Source of Support: None, Conflict of Interest: None  | Check |
PMID: 7327686 
How to cite this article:
Nayak A J, Srinivasa Rao P N. Erythema multiforme secondary to acetazolamide (Diamox). Indian J Ophthalmol 1981;29:105-6 |
Acetazolamide (Diamox), a sulphonamide derivative is widely used in daily ophthalmic practice. Though side effects like headache, drowsiness, paraesthesia, anorexia and other gastro-intestinal symptoms are common after its use, severe reactions like blood dyscrasias, renal calculi and secondary erythema multiforme are rare. The following is a case report of severe secondary erythema multiforme which required discontinuance of acetazolamide.
| Case report | |  |
A 12 years old boy presented with complaints of burning sensation and discharge from both eyes, burning sensation in mouth and skin lesions over the hands and feet of 8 days duration.
8 days before coming to hospital, he had mild fever. After one day, fever subsided with appearence of slight discharge from both eyes with burning sensation in eyes and mouth. Subsequently skin lesions appeared over the hands and feet. There was no personal or family history of allergy or previous drug sensitivity. Since 2 months patient was on acetazolamide 250 mg. daily and Potassium chloride 2 teaspoonful twice daily for papilloedema due to benign intracranial hypertension, prescribed else where. No other drug was taken by patient.
On Examination patient was a young boy, moderately built with normal temperature. Patient had mild catarrhal conjunctivitis with ulcerative lesions in the mouth and maculopapulobullous skin erruptions involving mostly dorsum of hands and feet. Ocular fundi showed mild papilloedema and vision was normal. All routine investigations were normal.
A diagnosis of secondary erythema multiforme due to acetazolamide was made and patient asked to discontinue the drug. After fifteen days patient was reviewed with marked improvement, after a course of antibiotics, antihistaminics and multivitamins.
| Discussion | | |
Minor side effects of acetazolamide that have been reported are headache, nausea, vomiting, paraesthesia etc., which subside when treatment is stopped. Severe reactions like skin rashes, blood dyscrasias, renal ealculi have been very rare.[1],[2],[3]
Actazolamide is a derivative of sulphonamide, a group of drugs known to produce erythema multiforme and has been reported to have induced agranulocytosis[3] thrombocytopenia,[4] and fatal bone narrow depression with agranulocytosis and anaemia.[5]
Aetiology of erythema multiforme is stilt obscure but often it seems to occur as a hypersensitive reaction to drugs particularly more common with sulphonamides. It attacks children and young adults. Usually this disease is of short in duration and the prognosis is good.
| Summary | | |
A rare idiosyncratic reaction to acetazolamide which is chemically related to sulphonamide in a young boy of 12 years is reported.
| References | | |
| 1. | Duke-Elders S., 1962, System of Ophthalmology Vol.III. The Foundations of Ophthalmology, Henry Kimpton, London p 650.  |
| 2. | Havener, H; 1978, Ocular pharmacology IV Edition. The C.V. Mosby Company Saint Louis, p 486 |
| 3. | Pearson, J.R; Binder C.I; and Neber J., 1955, J.A.M.A. 157 :339. |
| 4. | Beisner, E.H., and Morgan, M.C., 1956, J. A. M.A. 160:206. |
| 5. | Underwood, L.C., 1956, J.A.M.A. 161: 1467. |
[Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4]
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