Oxcarbazepine
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Reactions 1508, p28-29 - 5 Jul 2014 ★ S Oxcarbazepine First report of vanishing bile duct syndrome: case report A 55-year-old woman developed vanishing bile duct syndrome while receiving treatment with oxcarbazepine. The woman, who had Sjogren’s syndrome, was admitted to hospital because of jaundice and pruritus. She had been diagnosed with epilepsy 4 weeks previously and had started receiving oxcarbazepine 300mg twice daily [route not stated]. She had marked yellow discolouration of the eyes and skin. Her liver function tests were found to be elevated with the following results: total bilirubin 22.7 mg/dL, conjugated bilirubin 19.1 mg/dL, AST 77 IU/L, ALT 110 IU/L, ALP 480 IU/L, and GGT 1255 IU/L. Subsequently, toxic hepatitis due to oxcarbazepine was suspected. The woman’s oxcarbazepine was changed to levetiracetam. Histopathological examination of her liver biopsy specimen was consistent with vanishing bile duct syndrome and she was started on prednisolone. Further immunosuppressive treatment was considered due to her elevated liver enzymes, but fever occurred. In addition, she had severe neutropenia. She received broad-spectrum antibiotics. A bone marrow biopsy showed haemophagocytic syndrome and IV immunoglobulin was added to her therapy. However, she died due to septic shock on day 29 of her hospitalisation. Author comment: "To our knowledge, this is the first report of oxcarbazepine-induced [vanishing bile duct syndrome] in the literature." Tekin F, et al. The first report of oxcarbazepine-induced vanishing bile duct syndrome. Journal of Gastrointestinal and Liver Diseases 23: 222-223, No. 2, Jun 2014 - Turkey 803105336 » Editorial comment: A search of AdisBase, Medline, Embase, and the WHO ADR database did not reveal any previous case reports of vanishing bile duct syndrome associated with oxcarbazepine. 1 Reactions 5 Jul 2014 No. 1508 0114-9954/14/1508-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved
Transcript of Oxcarbazepine
Reactions 1508, p28-29 - 5 Jul 2014
★ SOxcarbazepine
First report of vanishing bile duct syndrome: casereport
A 55-year-old woman developed vanishing bile ductsyndrome while receiving treatment with oxcarbazepine.
The woman, who had Sjogren’s syndrome, was admitted tohospital because of jaundice and pruritus. She had beendiagnosed with epilepsy 4 weeks previously and had startedreceiving oxcarbazepine 300mg twice daily [route not stated].She had marked yellow discolouration of the eyes and skin.Her liver function tests were found to be elevated with thefollowing results: total bilirubin 22.7 mg/dL, conjugatedbilirubin 19.1 mg/dL, AST 77 IU/L, ALT 110 IU/L, ALP 480 IU/L,and GGT 1255 IU/L. Subsequently, toxic hepatitis due tooxcarbazepine was suspected.
The woman’s oxcarbazepine was changed to levetiracetam.Histopathological examination of her liver biopsy specimenwas consistent with vanishing bile duct syndrome and she wasstarted on prednisolone. Further immunosuppressivetreatment was considered due to her elevated liver enzymes,but fever occurred. In addition, she had severe neutropenia.She received broad-spectrum antibiotics. A bone marrowbiopsy showed haemophagocytic syndrome and IVimmunoglobulin was added to her therapy. However, she dieddue to septic shock on day 29 of her hospitalisation.
Author comment: "To our knowledge, this is the firstreport of oxcarbazepine-induced [vanishing bile ductsyndrome] in the literature."Tekin F, et al. The first report of oxcarbazepine-induced vanishing bile ductsyndrome. Journal of Gastrointestinal and Liver Diseases 23: 222-223, No. 2, Jun2014 - Turkey 803105336
» Editorial comment: A search of AdisBase, Medline, Embase,and the WHO ADR database did not reveal any previous casereports of vanishing bile duct syndrome associated withoxcarbazepine.
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Reactions 5 Jul 2014 No. 15080114-9954/14/1508-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved
