Carbamazepine
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Carbamazepine Systemic lupuc erythemetOlUs A mild rash and adenopathy developed in an 8-year-old girl with complex partial seizures controUed by carbamazepine. Subsequently. carbamazepine was replaced by phenobarbitone_ However. phenobarbitone did not provide adequate seizure control and, at the age of 11 years, the patient returned to carbamazepine (300mg bid) therapy. Mild adenopathy and a rash developed again but resolved without the discontinuation of carbamazepine. Mild transient polyarthritis (ESR 23mm in the first hour; antistreptolysin 0 titre 720 Todd units) also occurred and the patient was treated with penicillin prophylaxis because rheumatic fever was suspected. After approximately 5 months' carbamazepine treatment, the patient presented with mild polyarthritis. butterfly facial rash, weakness and anxiety. The following abnormal laboratory results were also recorded: ESR 33mm in the first hour; positive antinUClear factor titre; elevated anti-DNA antibodies titre (58 U/ml), antistreptolysin o titre (1440 Todd units), IgG (274 IU/ml) and lactate dehydrogenase (250 Ujl); and depressed haemoglobin concentration (101 giL) and leucocyte count (5.4 X 10 9 jL with 75% neutrophils. 11% lymphocytes and 10% eosinophils). Carbamazepine was withdrawn and the patient treated with sodium valproate and prednisolone 40 mg/day. Within 4 months the girl showed significant clinical improvement and prednisolone was withdrawn. At follow- up> 1 year later, the patient remained well with well- controlled epilepsy but she still had a positive antinuclear factor titre and an elevated antistreptolysin 0 titre (720 Todd units). The high antistreptolysin 0 titre may be either nonspecifiC or the result of an unidentified streptococcal infection. McNicholl, B .: British Medical Jouma/291: 1126 (19 Oct 1985)
Transcript of Carbamazepine
Carbamazepine Systemic lupuc erythemetOlUs
A mild rash and adenopathy developed in an 8-year-old girl with complex partial seizures controUed by carbamazepine. Subsequently. carbamazepine was replaced by phenobarbitone_ However. phenobarbitone did not provide adequate seizure control and, at the age of 11 years, the patient returned to carbamazepine (300mg bid) therapy. Mild adenopathy and a rash developed again but resolved without the discontinuation of carbamazepine. Mild transient polyarthritis (ESR 23mm in the first hour; antistreptolysin 0 titre 720 Todd units) also occurred and the patient was treated with penicillin prophylaxis because rheumatic fever was suspected.
After approximately 5 months' carbamazepine treatment, the patient presented with mild polyarthritis. butterfly facial rash, weakness and anxiety. The following abnormal laboratory results were also recorded: ESR 33mm in the first hour; positive antinUClear factor titre; elevated anti-DNA antibodies titre (58 U/ml), antistreptolysin o titre (1440 Todd units), IgG (274 IU/ml) and lactate dehydrogenase (250 Ujl); and depressed haemoglobin concentration (101 giL) and leucocyte count (5.4 X 109jL with 75% neutrophils. 11% lymphocytes and 10% eosinophils).
Carbamazepine was withdrawn and the patient treated with sodium valproate and prednisolone 40 mg/day. Within 4 months the girl showed significant clinical improvement and prednisolone was withdrawn. At follow-up> 1 year later, the patient remained well with wellcontrolled epilepsy but she still had a positive antinuclear factor titre and an elevated antistreptolysin 0 titre (720 Todd units). The high antistreptolysin 0 titre may be either nonspecifiC or the result of an unidentified streptococcal infection. McNicholl, B.: British Medical Jouma/291 : 1126 (19 Oct 1985)
