Reactions 1335 - 22 Jan 2011

SCarbamazepine

B lymphopenia and agammaglobulinaemia: casereport

A 29-year-old woman developed B lymphopenia andagammaglobulinaemia during carbamazepine treatmentfor tonic clonic seizures.

The woman was admitted to hospital in August 2003 dueto weakness in her extremities. Examination showedweakness of the neck and limbs, exaggerated deep tendonreflexes, positive Babinski sign and sensory loss below C2.Investigations showed enlarged spinal cord lesions.Methylprednisolone improved her symptoms. A monthlater, she developed multiple episodes of painful tonicspasms on her right arm, which resolved withcarbamazepine 400 mg/day [route not stated]. Shepresented in December with pruritus and skindesquamation, and was later admitted to hospital forpneumonia. Investigations revealed low levels of IgG, IgAand IgM (<84, <5 and <4 mg/dL, respectively), suspectedto be caused by carbamazepine [time to reaction onset notclearly stated]. Further tests showed a lymphocyte count of1/mL3 and a CD19-positive lymphocyte percentage of0.11%. B-lymphocyte maturation was disturbed.

Carbamazepine was discontinued and the womanreceived antibacterials and γ-globulin; her symptomssubsequently improved. She was later diagnosed withneuromyelitis optica.Tanaka Y, et al. No relapse of neuromyelitis optica during drug-induced B-Lymphopenia with hypogammaglobulinemia. Neurology 75: e1745-1747, No. 19,9 Nov 2010. Available from: URL: http://dx.doi.org/10.1212/wnl.0b013e3181fc2788 - Japan 803048197

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Reactions 22 Jan 2011 No. 13350114-9954/10/1335-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved