Carbamazepine
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Reactions 959 - 12 Jul 2003 ★ S Carbamazepine First report of fatal atherosclerosis and myocardial infarction in a child?: case report An 11-year-old boy had marked atherosclerosis and experienced a myocardial infarction while receiving carbamazepine treatment for epilepsy; he subsequently died. The boy, who had started receiving daily carbamazepine treatment [dosage not stated] at age 3.5 years, was admitted to hospital with hyperpyrexia and status epilepticus. Soon after arrival he experienced a cardiac arrest. He was resuscitated but remained hypotensive with deterioration of his neurological status. The following day he developed coagulase-negative staphylococcal septicaemia with laboratory evidence of disseminated intravascular coagulation and myoglobulinuria, consistent with rhabdomyolysis and acute renal failure. He became comatose and died on the third day after admission. Autopsy confirmed the clinical findings and also revealed bilateral aspiration bronchopneumonia with massive hepatic centrolobular necrosis. The boy was found to have marked intimal proliferation with accumulation of foamy cells in his coronary arteries, the aorta and its vasa vasorum. The lumen of his coronary arteries was estimated to be reduced by up to 40%. Histological sections of his myocardium revealed widespread acute myocardial infarction of a hypertrophic heart. Author comment: "One cannot dismiss the notion that the atherosclerosis found at autopsy of this child may have resulted from or been aggravated by the long-term use of carbamazepine ." de Chadar´ evian JP, et al. Epilepsy, atherosclerosis, myocardial infarction, and carbamazepine. Journal of Child Neurology 18: 150-151, Feb 2003 - USA 807213642 » Editorial comment: A search of AdisBase and Medline did not reveal any previous case reports of atherosclerosis or myocardial infarction associated with carbamazepine. The WHO Adverse Drug Reactions database contained two reports of atherosclerosis and 15 of myocardial infarction associated with carbamazepine. 1 Reactions 12 Jul 2003 No. 959 0114-9954/10/0959-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Carbamazepine
Reactions 959 - 12 Jul 2003
★ SCarbamazepine
First report of fatal atherosclerosis and myocardialinfarction in a child?: case report
An 11-year-old boy had marked atherosclerosis andexperienced a myocardial infarction while receivingcarbamazepine treatment for epilepsy; he subsequently died.
The boy, who had started receiving daily carbamazepinetreatment [dosage not stated] at age 3.5 years, was admitted tohospital with hyperpyrexia and status epilepticus. Soon afterarrival he experienced a cardiac arrest. He was resuscitated butremained hypotensive with deterioration of his neurologicalstatus. The following day he developed coagulase-negativestaphylococcal septicaemia with laboratory evidence ofdisseminated intravascular coagulation and myoglobulinuria,consistent with rhabdomyolysis and acute renal failure. Hebecame comatose and died on the third day after admission.
Autopsy confirmed the clinical findings and also revealedbilateral aspiration bronchopneumonia with massive hepaticcentrolobular necrosis. The boy was found to have markedintimal proliferation with accumulation of foamy cells in hiscoronary arteries, the aorta and its vasa vasorum. The lumen ofhis coronary arteries was estimated to be reduced by up to40%. Histological sections of his myocardium revealedwidespread acute myocardial infarction of a hypertrophicheart.
Author comment: "One cannot dismiss the notion that theatherosclerosis found at autopsy of this child may have resultedfrom or been aggravated by the long-term use ofcarbamazepine ."de Chadarevian JP, et al. Epilepsy, atherosclerosis, myocardial infarction, andcarbamazepine. Journal of Child Neurology 18: 150-151, Feb 2003 -USA 807213642
» Editorial comment: A search of AdisBase and Medline didnot reveal any previous case reports of atherosclerosis ormyocardial infarction associated with carbamazepine. The WHOAdverse Drug Reactions database contained two reports ofatherosclerosis and 15 of myocardial infarction associated withcarbamazepine.
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Reactions 12 Jul 2003 No. 9590114-9954/10/0959-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
