Reactions 1403 - 26 May 2012

SCarbamazepine

Thrombocytopenia: case reportA 17-year-old girl developed thrombocytopenia during

treatment with carbamazepine [route not stated].The girl, who had refractory epilepsy, was initially treated

with carbamazepine 400mg daily. One week later, her dosewas increased to 600 mg/day (given on a twice dailyschedule). She developed an upper respiratory tractinfection 3 days later. She developed a rash and haematuria4 days later, and she was admitted to a hospital. She hadecchymoses and diffuse petechiae on admission, and herplatelet count was 3 × 109/L. Haemoglobin and numerousRBCs were seen upon urinalysis. Severe thrombocytopeniawas seen upon a peripheral blood smear.

Idiopathic thrombocytopenic purpura was suspected,and the patient started receiving prednisone 1 mg/kg daily.Her platelet count increased rapidly then decreased again48 hours later. Carbamazepine was withdrawn for possibledrug-induced thrombocytopenia. Four days later, herplatelet count reached normal limits.

Due to the development of frequent seizures, whichpersisted despite phenobarbital administration,carbamazepine was restarted. The patient’s seizuresstopped. Despite steroid therapy, her platelet countsdropped 3 days later. Carbamazepine was discontinued,and her platelet count rose rapidly. At last follow-up, herplatelet count was within the normal range.

Author comment: "The sequence of events in our patientunequivocally established a cause-effect relationship betweencarbamazepine and thrombocytopenia."Taher AT, et al. Carbamazepine-induced thrombocytopenia. Blood Cells,Molecules and Diseases 48: 197-198, No. 3, 15 Mar 2012. Available from: URL:http://dx.doi.org/10.1016/j.bcmd.2012.01.003 - Lebanon 803070949

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Reactions 26 May 2012 No. 14030114-9954/10/1403-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved