Lamotrigine-induced tubulointerstitial nephritis and uveitis-atypical Cogan syndrome

European Journal of Ophthalmology
Anton M Kolomeyer, Shyam Kodati

Abstract

To report a case of lamotrigine-induced tubulointerstitial nephritis and uveitis (TINU)-atypical Cogan syndrome. Case report. A 16-year-old boy with traumatic brain injury and seizures presented to the emergency department with facial swelling, rash, and back pain several days after increasing lamotrigine dose secondary to a breakthrough seizure. Creatinine, urine β2 microglobulin, and eosinophils were elevated. Antinuclear antibodies, antineutrophil cytoplasmic antibodies, angiotensin-converting enzyme, and complement were normal. Renal biopsy showed acute granulomatous tubulointerstitial nephritis. Lamotrigine was discontinued, intravenous steroids were initiated, and the patient was discharged on Ativan and prednisone. Subsequently, he was diagnosed with bilateral anterior uveitis (vision 20/30 bilaterally) and started on prednisolone and cyclopentolate. Two months later, he developed a branch retinal artery occlusion in the right eye (vision 20/70) and bilateral ocular hypertension for which timolol-brimonidine and dorzolamide were added. Neuroimaging and hypercoagulability workup was unremarkable. Vision and intraocular pressure improved, while uveitis remained recalcitrant. Several months later, the patient developed cent...Continue Reading

References

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May 3, 2015·Pharmacological Reports : PR·Barbara BłaszczykStanisław Jerzy Czuczwar

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Citations

Jul 12, 2017·Expert Review of Clinical Pharmacology·Sherifa Ahmed Hamed
Sep 18, 2018·Current Opinion in Ophthalmology·Ramana S MoorthyEmmett T Cunningham
Dec 18, 2016·Journal of Community Hospital Internal Medicine Perspectives·Atul MattaRicardo Conti

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Methods Mentioned

BETA
biopsy
biopsies

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