Reactions 1336 - 29 Jan 2011

SCarbamazepine

Systemic lupus erythematosus: case reportA woman, aged between 23 and 24 years old, developed

symptoms of systemic lupus erythematosus (SLE) whilereceiving carbamazepine [Tegretol] for epilepsy.

The woman, who was born in 1974, had been treated forepilepsy from 8 years old. Under treatment withantiepileptics, including valproate, she remained clinicallystable until 15 years of age. In 1992, she began receivingmethylphenobarbital and phenytoin after experiencinggrand mal seizures. Over the next year, she developedcomplex partial seizures of temporal origin. Shesubsequently began receiving carbamazepine [dosage androute not stated] and treatment with methylphenobarbitaland phenytoin was adjusted. After 4 years’ carbamazepine,she developed a skin rash, ulcers on the buccal mucosa andfatigue. Laboratory tests revealed the following results: ESR34 mm/h, WBC count 3600mm3, lymphocyte count <18%,urine proteins positive (1+), CRP 8.6 mg/dL, rheumatoidfactor level 66 IU/mL, a positive antinuclear factor titre andhyperimmunoglobulinaemia.

The woman began receiving chloroquine andcarbamazepine was discontinued. Within 2 weeks, her rashimproved, her ulcers and fatigue had resolved and her WBCcount was within normal ranges. Her SLE symptomsremained in remission, other than a rare relapseexperienced while receiving prednisolone treatment duringthe course of her ongoing antiepileptic therapy.Hajnsek S, et al. Carbamazepine induced systemic lupus erythematosus.Neurologia Croatica 59: 83-87, No. 1-2, 2010 [Croatian; summarised from atranslation] - Croatia 803048703

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Reactions 29 Jan 2011 No. 13360114-9954/10/1336-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved