Carbamazepine
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Thrombocytopenia: case report A 17-year-old girl developed thrombocytopenia during treatment with carbamazepine [route not stated]. The girl, who had refractory epilepsy, was initially treated with carbamazepine 400mg daily. One week later, her dose was increased to 600 mg/day (given on a twice daily schedule). She developed an upper respiratory tract infection 3 days later. She developed a rash and haematuria 4 days later, and she was admitted to a hospital. She had ecchymoses and diffuse petechiae on admission, and her platelet count was 3 × 109/L. Haemoglobin and numerous RBCs were seen upon urinalysis. Severe thrombocytopenia was seen upon a peripheral blood smear. Idiopathic thrombocytopenic purpura was suspected, and the patient started receiving prednisone 1 mg/kg daily. Her platelet count increased rapidly then decreased again 48 hours later. Carbamazepine was withdrawn for possible drug-induced thrombocytopenia. Four days later, her platelet count reached normal limits. Due to the development of frequent seizures, which persisted despite phenobarbital administration, carbamazepine was restarted. The patient’s seizures stopped. Despite steroid therapy, her platelet counts dropped 3 days later. Carbamazepine was discontinued, and her platelet count rose rapidly. At last follow-up, her platelet count was within the normal range. Author comment: "The sequence of events in our patient unequivocally established a cause-effect relationship between carbamazepine and thrombocytopenia." Taher AT, et al. Carbamazepine-induced thrombocytopenia. Blood Cells, Molecules and Diseases 48: 197-198, No. 3, 15 Mar 2012. Available from: URL: 803070949 http://dx.doi.org/10.1016/j.bcmd.2012.01.003 - Lebanon
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Reactions 26 May 2012 No. 1403
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