Carbamazepine
1
Reactions 1364 - 13 Aug 2011 Carbamazepine Biotin deficiency in a child: case report A 5-year-old girl developed biotin deficiency following treatment with carbamazepine. The girl was diagnosed with glycogen storage disease (GSD) type Ib at the age of 2 months, and subsequently required dietary therapy with GSD formula. She had thin hair throughout infancy. At 3 years of age, she was hospitalised after experiencing a severe hypoglycaemic episode and status epilepticus. She recovered after 1 week and commenced prophylactic antiepileptic therapy with carbamazepine [route and dosage not stated]. Carbamazepine was withdrawn 1 month later due to a suspected drug eruption. Despite topical therapy, her skin eruption failed to improve. Five months later, biotin deficiency was suspected. Laboratory findings included a serum free biotin level below the detectable level, a low serum carnitine level, an elevated C5-OH level and an increased C3/C2 ratio. Urinalysis revealed elevated 3-methylcrotonylglycine, methylcitric acid and 3-hydroxyisovaleric acid levels. She was diagnosed with biotin deficiency. Treatment included supplementation with biotin and levocarnitine. Within 2 weeks, the girl’s dermatitis and hair thickness had improved. Her skin lesions had resolved after 3 months of biotin supplementation, and her hair growth and blood acylcarnitine levels had also normalised. Author comment: "[W]e hypothesize that starting carbamazepine administration may have led to decreased biotin production." Ihara K, et al. Biotin deficiency in a glycogen storage disease type 1b girl fed only with glycogen storage disease-related formula. Pediatric Dermatology 28: 339-341, No. 3, May-Jun 2011. Available from: URL: http://dx.doi.org/10.1111/ j.1525-1470.2011.01238.x - Japan 803058614 1 Reactions 13 Aug 2011 No. 1364 0114-9954/10/1364-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Transcript of Carbamazepine
Reactions 1364 - 13 Aug 2011
Carbamazepine
Biotin deficiency in a child: case reportA 5-year-old girl developed biotin deficiency following
treatment with carbamazepine.The girl was diagnosed with glycogen storage disease
(GSD) type Ib at the age of 2 months, and subsequentlyrequired dietary therapy with GSD formula. She had thinhair throughout infancy. At 3 years of age, she washospitalised after experiencing a severe hypoglycaemicepisode and status epilepticus. She recovered after 1 weekand commenced prophylactic antiepileptic therapy withcarbamazepine [route and dosage not stated].Carbamazepine was withdrawn 1 month later due to asuspected drug eruption. Despite topical therapy, her skineruption failed to improve. Five months later, biotindeficiency was suspected. Laboratory findings included aserum free biotin level below the detectable level, a lowserum carnitine level, an elevated C5-OH level and anincreased C3/C2 ratio. Urinalysis revealed elevated3-methylcrotonylglycine, methylcitric acid and3-hydroxyisovaleric acid levels. She was diagnosed withbiotin deficiency.
Treatment included supplementation with biotin andlevocarnitine. Within 2 weeks, the girl’s dermatitis and hairthickness had improved. Her skin lesions had resolved after3 months of biotin supplementation, and her hair growthand blood acylcarnitine levels had also normalised.
Author comment: "[W]e hypothesize that startingcarbamazepine administration may have led to decreasedbiotin production."Ihara K, et al. Biotin deficiency in a glycogen storage disease type 1b girl fed onlywith glycogen storage disease-related formula. Pediatric Dermatology 28: 339-341,No. 3, May-Jun 2011. Available from: URL: http://dx.doi.org/10.1111/j.1525-1470.2011.01238.x - Japan 803058614
1
Reactions 13 Aug 2011 No. 13640114-9954/10/1364-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
