Carbamazepine
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Lupus erythematosus: case report A 34-year-old woman developed lupus erythematosus during treatment with carbamazepine for epilepsy. The woman developed epilepsy following surgery for a congenital arterio-venous malformation. Five years after starting carbamazepine [route and dosage not stated], she presented with sudden-onset, scaly, photosensitive plaques on sunexposed areas of her body. The woman’s skin lesions resolved after topical steroid therapy, but subsequently recurred. Results of a skin biopsy were compatible with lupus erythematosus. Laboratory investigations included the following: reduced complement C3 and C4, positive IgG ANA and anti Ro-SSA, WBC count 2.6, neutrophil count 1.03 and lymphocyte count 0.88. Despite treatment with mepacrine, she developed arthralgia, myalgia and sicca symptoms. She opted not to discontinue carbamazepine, remaining on therapy in spite of her skin and musculoskeletal manifestations. Author comment: The patient’s "reluctance to stop [carbamazepine] leaves us with a diagnostic dilemma. The auto-antibody profile in [drug-induced lupus erythematosus] is not predictive of severity or extent of manifestation of symptoms. In our patient it is difficult to ascertain the course of the condition on continued challenge from a likely drug source." Castelino MI, et al. Autoantibodies and possible carbamazepine-induced lupus erythematosus: A clinical challenge. Lupus 19: 64 abstr. PO1.C.25, Jun 2010. Available from: URL: http://dx.doi.org/10.1177/09612033100190010101 - United 803058187 Kingdom
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Reactions 6 Aug 2011 No. 1363
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