Carbamazepine
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Reactions 794 - 25 Mar 2000 S Carbamazepine Systemic lupus erythematosus presenting as cardiac tamponade: case report A 45-year-old man developed cardiac tamponade as a severe manifestation of carbamazepine-induced systemic lupus erythematosus. Eight months after starting carbamazepine [dosage not stated] for generalised seizures, the man developed chest discomfort and dyspnoea. After several days, his symptoms suddenly worsened so he presented to an emergency department. Investigations revealed a large pericardial effusion, persistent inversion of the right atrium and right ventricular diastolic collapse, consistent with cardiac tamponade. Pericardiocentesis was performed and about 850ml of fluid was removed. The patient improved immediately and a follow- up ECG showed improvement in the pericardial effusion and resolution of cardiac tamponade. Further clinical and laboratory findings were highly suggestive of a drug-induced systemic lupus erythematosus syndrome, including the presence of antihistone and antinuclear antibodies and the absence of high titres of anti-double-stranded DNA antibodies. The man’s anticonvulsant therapy was changed to phenobarbital and he was discharged. At follow-up 1 year later he had not experienced any recurrence of pericardial effusion and his antinuclear and antihistone antibodies were negative. Author comment: Systemic lupus erythematosus is a well described adverse reaction of carbamazepine. However, cardiac tamponade is a very rare complication of drug-induced systemic lupus erythematosus. Verma SP, et al. Carbamazepine-induced systemic lupus erythematosus presenting as cardiac tamponade. Chest 117: 597-598, Feb 2000 - USA 800815842 1 Reactions 25 Mar 2000 No. 794 0114-9954/10/0794-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Carbamazepine
Reactions 794 - 25 Mar 2000
SCarbamazepine
Systemic lupus erythematosus presenting ascardiac tamponade: case report
A 45-year-old man developed cardiac tamponade as asevere manifestation of carbamazepine-induced systemiclupus erythematosus.
Eight months after starting carbamazepine [dosage notstated] for generalised seizures, the man developed chestdiscomfort and dyspnoea. After several days, his symptomssuddenly worsened so he presented to an emergencydepartment. Investigations revealed a large pericardialeffusion, persistent inversion of the right atrium and rightventricular diastolic collapse, consistent with cardiactamponade.
Pericardiocentesis was performed and about 850ml of fluidwas removed. The patient improved immediately and a follow-up ECG showed improvement in the pericardial effusion andresolution of cardiac tamponade. Further clinical andlaboratory findings were highly suggestive of a drug-inducedsystemic lupus erythematosus syndrome, including thepresence of antihistone and antinuclear antibodies and theabsence of high titres of anti-double-stranded DNA antibodies.
The man’s anticonvulsant therapy was changed tophenobarbital and he was discharged. At follow-up 1 year laterhe had not experienced any recurrence of pericardial effusionand his antinuclear and antihistone antibodies were negative.
Author comment: Systemic lupus erythematosus is a welldescribed adverse reaction of carbamazepine. However,cardiac tamponade is a very rare complication of drug-inducedsystemic lupus erythematosus.Verma SP, et al. Carbamazepine-induced systemic lupus erythematosus presentingas cardiac tamponade. Chest 117: 597-598, Feb 2000 - USA 800815842
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Reactions 25 Mar 2000 No. 7940114-9954/10/0794-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
