Carbamazepine
1
Reactions 1256 - 13 Jun 2009 Carbamazepine Falsely positive screening tests for Cushing’s syndrome: case report A 26-year-old woman receiving carbamazepine had falsely positive results while undergoing screening for Cushing’s syndrome. The woman had a history of complex partial seizures and was receiving carbamazepine 400mg twice daily [duration of therapy not stated]. She was referred for investigation of possible Cushing’s syndrome with symptoms of hirsutism, polyuria and polydypsia. She appeared to have an excessive intake of water. Facial hirsutism was thought to be secondary to carbamazepine. Two 24-hour urine-free cortisol (UFC) collections were consistently elevated at 8426 and 1680 nmol/L with urine volumes of 2.9L and 2.1L, respectively. Her serum and urine osmolarities were 287 and 189 mmol/L, respectively. A 1-mg overnight dexamethasone suppression test demonstrated inadequate suppression (first morning s-cortisol level of 391 nmol/L and a second morning s-cortisol level of 286 nmol/L). Her 24 hour s-cortisol rhythm had an almost normal diurnal rhythm; however, her midnight sleeping s-cortisol was slightly raised at 84 nmol/L. It was concluded that the woman’s failed biochemical results were primarily due to carbamazepine; subsequent reviews have shown no further signs of Cushing’s syndrome. Tiong K, et al. Carbamazepine and falsely positive screening tests for Cushing’s syndrome. New Zealand Medical Journal 122: 100-102, No. 1288, 23 Jan 2009 - Australia 801146029 1 Reactions 13 Jun 2009 No. 1256 0114-9954/10/1256-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Transcript of Carbamazepine
Reactions 1256 - 13 Jun 2009
Carbamazepine
Falsely positive screening tests for Cushing’ssyndrome: case report
A 26-year-old woman receiving carbamazepine hadfalsely positive results while undergoing screening forCushing’s syndrome.
The woman had a history of complex partial seizures andwas receiving carbamazepine 400mg twice daily [durationof therapy not stated]. She was referred for investigation ofpossible Cushing’s syndrome with symptoms of hirsutism,polyuria and polydypsia. She appeared to have an excessiveintake of water. Facial hirsutism was thought to besecondary to carbamazepine. Two 24-hour urine-freecortisol (UFC) collections were consistently elevated at8426 and 1680 nmol/L with urine volumes of 2.9L and 2.1L,respectively. Her serum and urine osmolarities were 287and 189 mmol/L, respectively. A 1-mg overnightdexamethasone suppression test demonstrated inadequatesuppression (first morning s-cortisol level of 391 nmol/Land a second morning s-cortisol level of 286 nmol/L). Her24 hour s-cortisol rhythm had an almost normal diurnalrhythm; however, her midnight sleeping s-cortisol wasslightly raised at 84 nmol/L.
It was concluded that the woman’s failed biochemicalresults were primarily due to carbamazepine; subsequentreviews have shown no further signs of Cushing’ssyndrome.Tiong K, et al. Carbamazepine and falsely positive screening tests for Cushing’ssyndrome. New Zealand Medical Journal 122: 100-102, No. 1288, 23 Jan 2009 -Australia 801146029
1
Reactions 13 Jun 2009 No. 12560114-9954/10/1256-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
