Reactions 1177 - 10 Nov 2007

★ SCarbamazepine

First report of squamous metaplasia: case reportA 22-year-old man developed conjunctival squamous

metaplasia while receiving carbamazepine.The man underwent impression cytology as part of a study.

Prior to the procedure, he reported slight ocular symptoms,including dryness and a foreign body sensation. He reportedslight ocular discomfort (score of 81/100 in both eyes). He wasreceiving oral carbamazepine 200mg twice daily [therapeuticindication and duration of treatment not stated]. An externaleye examination showed slight hyperaemia and some dilatedconjunctival vessels, especially on the nasal aspect of hisbulbar conjunctiva. In the same area, there was diffuse blotchyfluorescein staining and slightly irregular tear meniscus in thepuncta vicinity. His superior eyelid skin had slight erythema.An impression cytology sample from the nasal aspect of thebulbar conjunctiva in his right eye revealed several thousandcells, predominantly in a monolayer. There was a very lowgoblet cell count. The cells were uniformly squamous. Theaverage cell area was 1509 µm2, and the average nucleus areawas 132 µm2. [Patient outcome not stated.]Doughty MJ, et al. Impression cytology of a case of conjunctival metaplasiaassociated with oral carbamazepine use? Contact Lens and Anterior Eye 30:254-257, No. 4, Sep 2007 - Scotland 801048278

» Editorial comment: A search of AdisBase and Medline didnot reveal any previous case reports of squamous metaplasiaassociated with carbamazepine. The WHO Adverse DrugReactions database contained no reports of squamouscarcinoma associated with carbamazepine.

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Reactions 10 Nov 2007 No. 11770114-9954/10/1177-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved