Carbamazepine
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Reactions 1414 - 11 Aug 2012 S Carbamazepine Interstitial pneumonitis and panhypogammaglobulinaemia in a child: case report A 7-year-old boy developed interstitial pneumonitis and panhypogammaglobulinaemia following treatment with carbamazepine for epilepsy. The boy was switched from valproic acid to carbamazepine [dosage and route not stated] following a recent seizure. He presented 4 weeks after initiation of carbamazepine with fever, cough and dyspnoea. A 10-day course of clarithromycin was initiated but his symptoms did not improve so betamethasone and salbutamol [albeterol] were introduced. He re-presented 2 weeks later with fever, a non-productive cough, asthenia and worsening dyspnoea. A chest x-ray revealed bilateral interstitial infiltrates and pulmonary auscultation revealed diffuse crackles and wheezes in both lungs leading to a presumptive diagnosis of pneumonia. Investigations for atypical pneumonia were negative and a subsequent CT scan revealed multiple cylindrical bronchiectasis in all pulmonary lobes compatible with bilateral interstitial pneumonitis. Despite treatment, his condition did not improve and further laboratory testing revealed panhypogammaglobulinaemia. Carbamazepine was discontinued under suspicion of drughypersensitivity. Topiramate therapy was initiated and an infusion of immunoglobulin G was administered. The boy was discharged after 3 weeks on a tapering dose of prednisone. His immunoglobulin levels had normalised 6 months after cessation of carbamazepine although decreased exercise tolerance persisted alongside restrictive pulmonary function. Author comment: "[W]e describe the case of a boy who developed an interstitial pneumonitis and a pan- hypogammaglobulinemia following [carbamazepine] therapy". Goncalves D, et al. Carbamazepine-induced interstitial pneumonitis associated with pan-hypogammaglobulinemia. Respiratory Medicine Case Reports 5: 6-8, 2012. Available from: URL: http://dx.doi.org/10.1016/j.rmedc.2011.12.001 - Portugal 803075170 1 Reactions 11 Aug 2012 No. 1414 0114-9954/10/1414-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Carbamazepine
Reactions 1414 - 11 Aug 2012
SCarbamazepine
Interstitial pneumonitis andpanhypogammaglobulinaemia in a child: casereport
A 7-year-old boy developed interstitial pneumonitis andpanhypogammaglobulinaemia following treatment withcarbamazepine for epilepsy.
The boy was switched from valproic acid tocarbamazepine [dosage and route not stated] following arecent seizure. He presented 4 weeks after initiation ofcarbamazepine with fever, cough and dyspnoea. A 10-daycourse of clarithromycin was initiated but his symptomsdid not improve so betamethasone and salbutamol[albeterol] were introduced. He re-presented 2 weeks laterwith fever, a non-productive cough, asthenia andworsening dyspnoea. A chest x-ray revealed bilateralinterstitial infiltrates and pulmonary auscultation revealeddiffuse crackles and wheezes in both lungs leading to apresumptive diagnosis of pneumonia. Investigations foratypical pneumonia were negative and a subsequent CTscan revealed multiple cylindrical bronchiectasis in allpulmonary lobes compatible with bilateral interstitialpneumonitis. Despite treatment, his condition did notimprove and further laboratory testing revealedpanhypogammaglobulinaemia.
Carbamazepine was discontinued under suspicion ofdrughypersensitivity. Topiramate therapy was initiated andan infusion of immunoglobulin G was administered. Theboy was discharged after 3 weeks on a tapering dose ofprednisone. His immunoglobulin levels had normalised6 months after cessation of carbamazepine althoughdecreased exercise tolerance persisted alongside restrictivepulmonary function.
Author comment: "[W]e describe the case of a boy whodeveloped an interstitial pneumonitis and a pan-hypogammaglobulinemia following [carbamazepine] therapy".Goncalves D, et al. Carbamazepine-induced interstitial pneumonitis associated withpan-hypogammaglobulinemia. Respiratory Medicine Case Reports 5: 6-8, 2012.Available from: URL: http://dx.doi.org/10.1016/j.rmedc.2011.12.001 -Portugal 803075170
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Reactions 11 Aug 2012 No. 14140114-9954/10/1414-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
