Lamotrigine
- PDF / 141,637 Bytes
- 1 Pages / 623.591 x 841.847 pts Page_size
- 69 Downloads / 157 Views
1
S
Hepatitis: case report A 43-year-old woman developed severe hepatitis during treatment with lamotrigine. The woman had a history of depression and was being treated with oxcarbazepine. Lamotrigine was then added to her treatment [indication and dosage not stated]. She presented 2 weeks later with nausea and a generalised pruritic macular rash; just prior to presentation her lamotrigine dosage had been increased to 50 mg/day. She had a total bilirubin level of 0.4 mg/dL and AST, ALT and ALP levels of 2764, 2490 and 93 IU/L, respectively. The woman was instructed to cease all medication and was discharged on an antihistamine. Two days later, she presented again with fatigue, chills and persistent nausea. Repeat tests showed a total bilirubin level of 3.9 mg/dL and AST, ALT and ALP levels of 6079, 6900 and 149 IU/L, respectively. She also had an INR of 1.9 and a prothrombin time of 21.5 seconds. Only a diffuse erythematous pruritic macular rash and very mild jaundice were observed during clinical examination. She was hospitalised for observation and received IV hydration, supportive care and diphenhydramine, as well as prophylactic treatment with oral vitamin K and pantoprazole. By day 3, her liver enzymes had markedly improved and she was discharged. She discontinued all medications following discharge; after 1 month, her liver enzymes had normalised. Author comment: "We hypothesize that lamotrigine was directly responsible for the patient’s rash and liver impairment given the time sequence of drug introduction and resolution of symptoms and liver enzyme abnormality once the drug was withdrawn." Su-Yin AN, et al. Lamotrigine-associated reversible severe hepatitis: a case report. Journal of Medical Toxicology - official journal of the American College of 801126042 Medical Toxicology 4: 258-260, No. 4, Dec 2008 - Singapore
0114-9954/10/1232-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 13 Dec 2008 No. 1232
Data Loading...
