PMID: 16505575Mar 1, 2006Paper

Anticonvulsant hypersensitivity syndrome to lamotrigine confirmed by lymphocyte stimulation in vitro

Indian Journal of Medical Sciences
Sunil KarandeNilima A Kshirsagar

Abstract

Anticonvulsant hypersensitivity syndrome (AHS) developing to lamotrigine, a non-aromatic anticonvulsant, has rarely been reported. We present a two-year-old boy with refractory epilepsy on valproic acid and lamotrigine therapy who developed fever and a maculopapular itchy rash. Blood investigations detected lymphocytosis and thrombocytopenia. With a presumptive diagnosis of AHS, lamotrigine was discontinued. The fever and rash resolved over the next three days and the child was discharged on valproic acid and clobazam. The diagnosis was confirmed by in vitro lymphocyte toxicity assay, which not only demonstrated increased cell death following exposure to lamotrigine, but also to the three first-line aromatic anticonvulsants: phenytoin, phenobarbital and carbamazepine. The potential of first-line aromatic anticonvulsants to cause AHS should be remembered in a patient who has developed AHS on exposure to lamotrigine. Timely recognition of this rare but potentially fatal drug reaction is important.

Citations

Dec 15, 2006·Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology·Cornelia S SeitzAxel Trautmann
Mar 3, 2010·CNS Drugs·Dean P Sarco, Blaise F D Bourgeois
Sep 28, 2007·Pharmacotherapy·KarenBeth H BohanNatalie M Wilson
Oct 11, 2008·The International Journal of Neuropsychopharmacology·Boris LorbergZubin Bhagwagar
Oct 2, 2009·Molecular Diagnosis & Therapy·Abdelbaset A ElzagallaaiGideon Koren

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