Carbamazepine
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Reactions 759 - 10 Jul 1999 S Carbamazepine Hypersensitivity in an elderly patient: case report An 81-year-old man experienced a multisystem hypersensitivity reaction during treatment with carbamazepine 200mg 3 times daily for seizures. After approximately 5 weeks’ treatment with carbamazepine, the man developed pruritus, followed about 10 days later by weakness, asthenia, anorexia and fever. He then developed a generalised rash and jaundice and was hospitalised. Examination showed a morbilliform rash extending over much of the surface of the man’s skin and he had eosinophilia. Carbamazepine was discontinued and he was treated with fluids. Ultrasound showed his liver to be enlarged. Over the ensuing days, he developed generalised erythroderma, followed by extensive skin exfoliation. His fever resolved within 72 hours after stopping carbamazepine and his liver function tests normalised. Three days after hospitalisation, the man developed oligouria and proteinuria. His leukocyte count and haemoglobin level decreased. A bone marrow aspirate revealed hypercellularity with marked dyserythropoietic abnormalities. A bone marrow biopsy showed evidence of low-grade small lymphocytic lymphoma. The man was inadvertently given 1 carbamazepine tablet 9 days after admission and he developed severe pruritus, rash, hyperthermia, followed by a decrease in his haemoglobin and leukocyte levels. He was treated with prednisone and his condition improved. The man was discharged after 44 days. At the time, he had only small fissures on his soles. His peripheral blood cell counts and haemoglobin levels normalised, but a follow-up bone marrow biopsy 8 months after carbamazepine discontinuation confirmed low-grade non-Hodgkin’s lymphoma. Author comment: ‘It is very difficult to speculate whether the lymphoma was induced by carbamazepine or if it was an underlying state.’ Lombardi SM, et al. Severe multisystemic hypersensitivity reaction to carbamazepine including dyserythropoietic anemia. Annals of Pharmacotherapy 33: 571-575, May 1999 - Italy 800776742 1 Reactions 10 Jul 1999 No. 759 0114-9954/10/0759-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Carbamazepine
Reactions 759 - 10 Jul 1999
SCarbamazepine
Hypersensitivity in an elderly patient: case reportAn 81-year-old man experienced a multisystem
hypersensitivity reaction during treatment withcarbamazepine 200mg 3 times daily for seizures.
After approximately 5 weeks’ treatment withcarbamazepine, the man developed pruritus, followed about10 days later by weakness, asthenia, anorexia and fever. Hethen developed a generalised rash and jaundice and washospitalised.
Examination showed a morbilliform rash extending overmuch of the surface of the man’s skin and he had eosinophilia.Carbamazepine was discontinued and he was treated withfluids. Ultrasound showed his liver to be enlarged. Over theensuing days, he developed generalised erythroderma,followed by extensive skin exfoliation. His fever resolvedwithin 72 hours after stopping carbamazepine and his liverfunction tests normalised.
Three days after hospitalisation, the man developedoligouria and proteinuria. His leukocyte count andhaemoglobin level decreased. A bone marrow aspiraterevealed hypercellularity with marked dyserythropoieticabnormalities. A bone marrow biopsy showed evidence oflow-grade small lymphocytic lymphoma.
The man was inadvertently given 1 carbamazepine tablet 9days after admission and he developed severe pruritus, rash,hyperthermia, followed by a decrease in his haemoglobin andleukocyte levels. He was treated with prednisone and hiscondition improved.
The man was discharged after 44 days. At the time, he hadonly small fissures on his soles. His peripheral blood cellcounts and haemoglobin levels normalised, but a follow-upbone marrow biopsy 8 months after carbamazepinediscontinuation confirmed low-grade non-Hodgkin’slymphoma.
Author comment: ‘It is very difficult to speculate whetherthe lymphoma was induced by carbamazepine or if it was anunderlying state.’Lombardi SM, et al. Severe multisystemic hypersensitivity reaction tocarbamazepine including dyserythropoietic anemia. Annals of Pharmacotherapy 33:571-575, May 1999 - Italy 800776742
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Reactions 10 Jul 1999 No. 7590114-9954/10/0759-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
