Carbamazepine
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Reactions 604 - 8 Jun 1996 S Carbamazepine Hypogammaglobulinaemia and agranulocytosis: case report Hypogammaglobulinaemia and agranulocytosis associated with the use of carbamazepine, occurred in a 63-year-old man. The man had experienced a cerebral haemorrhage complicated by a grand mal seizure and had then taken carbamazepine 400mg twice daily. He also took lisinopril and atenolol to control his BP. Approximately 7 months after the episode, he presented with anorexia, bodyweight loss, and a cough. Haemophilus influenzae was identified in his sputum and tests showed panhypogammaglobulinaemia with absent B lymphocytes; at this time his granulocyte count was normal. Lisinopril was substituted with amlodipine, and the dosage of carbamazepine was reduced to 100mg twice daily. By the following month, the man had a fever, nausea, and a large ulcer on his lip; his WBC count was 1.4 x 10 9 /L, with 0.5 x 10 9 /L granulocytes. Carbamazepine was replaced by valproic acid. The agranulocytosis was treated successfully with 3 days of granulocyte colony-stimulating factor therapy, and this was followed by a resolution of the fever. The man was also treated with anti-infective agents. After approximately 3 months, mature B lymphocytes were detectable, and IgG, IgA, and IgM had increased, but IgG2 was still reduced. Author comment: ‘No pretreatment immunological results were available, but none the less it seems most likely that the adverse effects were associated with carbamazepine, as they did not improve until this drug was withdrawn.’ Spickett GP, et al. Hypogammaglobulinaemia with absent B lymphocytes and agranulocytosis after carbamazepine treatment. Journal of Neurology, Neurosurgery and Psychiatry 60: 459, Apr 1996 - England 800438621 1 Reactions 8 Jun 1996 No. 604 0114-9954/10/0604-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Carbamazepine
Reactions 604 - 8 Jun 1996
SCarbamazepine
Hypogammaglobulinaemia and agranulocytosis:case report
Hypogammaglobulinaemia and agranulocytosis associatedwith the use of carbamazepine, occurred in a 63-year-old man.
The man had experienced a cerebral haemorrhagecomplicated by a grand mal seizure and had then takencarbamazepine 400mg twice daily. He also took lisinopril andatenolol to control his BP. Approximately 7 months after theepisode, he presented with anorexia, bodyweight loss, and acough. Haemophilus influenzae was identified in his sputumand tests showed panhypogammaglobulinaemia with absent Blymphocytes; at this time his granulocyte count was normal.
Lisinopril was substituted with amlodipine, and the dosageof carbamazepine was reduced to 100mg twice daily. By thefollowing month, the man had a fever, nausea, and a largeulcer on his lip; his WBC count was 1.4 x 109/L, with 0.5 x 109/Lgranulocytes. Carbamazepine was replaced by valproic acid.
The agranulocytosis was treated successfully with 3 days ofgranulocyte colony-stimulating factor therapy, and this wasfollowed by a resolution of the fever. The man was also treatedwith anti-infective agents. After approximately 3 months,mature B lymphocytes were detectable, and IgG, IgA, and IgMhad increased, but IgG2 was still reduced.
Author comment: ‘No pretreatment immunological resultswere available, but none the less it seems most likely that theadverse effects were associated with carbamazepine, as theydid not improve until this drug was withdrawn.’Spickett GP, et al. Hypogammaglobulinaemia with absent B lymphocytes andagranulocytosis after carbamazepine treatment. Journal of Neurology,Neurosurgery and Psychiatry 60: 459, Apr 1996 - England 800438621
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Reactions 8 Jun 1996 No. 6040114-9954/10/0604-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
