Carbamazepine
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Carbamazepine Memlnnout gIomeruIopeIhy luoc:ind with I type III IIIrgIc mpon .. : first report A short history of malaise and peripheral oedema prompted the presentation of a 25-year-old man with grand mal epilepsy treated with phenobarbitone 180mg for :l!: 10 years and carbamazepine 1200mg daily for 3 years. On examination the patient was normotensive with pitting oedema to mid-calf level, serum albumin 27g/1. urine protein 7-10 g/24 hours, creatinine clearance> 120 ml/min and reduced serum 1 gG (38 lUlL). Examination of a renal biopsy specimen revealed extensive subepithelial dense deposits with Intervening 'splke' extensions of the lamina densa. C 3 and IgG were revealed . by Immunofluorescence. to be dlstnbuted In the basement membrane and mesangium. typical of a type III allergic reaction . Withdrawal of carbamazeplne and replacement with sodium valproate resulted in a subjective improvement In wellbeing and resolution of proteinuna and hypoalbuminaemia. This was believed to be the first case of membranous glomerulopathy associated with a type III allergic response and 'In conclusion it was suggested that " .. catfHlm.zeplne should be added to the II.t 01 drugs wItIch m. ay ,*,se the nopIvofIc ayndrome.' Hordon LD. Turney JH British Medical Journal 294 375. 7 Feb 1987 0156-2703/87/0228-0006/0101. 00/0 e ADlS Press
Transcript of Carbamazepine
Carbamazepine Memlnnout gIomeruIopeIhy luoc:ind with I type III IIIrgIc mpon .. : first report
A short history of malaise and peripheral oedema prompted the presentation of a 25-year-old man with grand mal epilepsy treated with phenobarbitone 180mg for :l!: 10 years and carbamazepine 1200mg daily for 3 years.
On examination the patient was normotensive with pitting oedema to mid-calf level, serum albumin 27g/1. urine protein 7-10 g/24 hours, creatinine clearance> 120 ml/min and reduced serum 1 gG (38 lUlL). Examination of a renal biopsy specimen revealed extensive subepithelial dense deposits with Intervening 'splke' extensions of the lamina densa. C3 and IgG were revealed. by Immunofluorescence. to be dlstnbuted In the basement membrane and mesangium. typical of a type III allergic reaction .
Withdrawal of carbamazeplne and replacement with sodium valproate resulted in a subjective improvement In wellbeing and resolution of proteinuna and hypoalbuminaemia.
This was believed to be the first case of membranous glomerulopathy associated with a type III allergic response and 'In conclusion it was suggested that " .. catfHlm.zeplne should be added to the II.t 01 drugs wItIch m.ay ,*,se the nopIvofIc ayndrome.' Hordon LD. Turney JH British Medical Journal 294 375. 7 Feb 1987
0156-2703/87/0228-0006/0101.00/0 e ADlS Press
