Case report: Carbamazepine Dependent Antiplatelet Antibody and
Antiepipeptic drug hypersensitivity syndrome
Liao JX1, Xiao YH1,
Yi BH1, Wang LH2, Li CR1
1Epilepsy Centre, Shenzhen Children’s Hospital, Shenzhen
518026, China
2Blood Transfusion
Institute
Introduction:
Carbamazepine induced severe concomitant thrombocytopenia and rashes are
uncommon. The mechanism underlying antiepipeptic
drug hypersensitivity syndrome of carbamazepine has not been elucidated.
Case Report: The female
patient was nine years old, she was prescribed carbamazepine as an
antiepileptic drug for epilepsy, 0.4 grams daily. Ten days later she had
fever, measles-like rashes and petechial rashes, and thrombocytopenia
simultaneously. Her peripheral blood platelet was 35,000-40,000
counts/Liter. She was treated with steroids, and the carbamazepine
discontinued. On the fifth day, the platelet was increased to 90,000
counts/Liter, fever was gone and rashes decreased, on the ninth day, the
platelet count was normal and the rashes were disappeared, and she was
discharged. Very interestingly, with flow cytometry technique and ELISA we
detected carbamazepine dependendent antiplaetlet antibodies in the
patient’s serum extracted on the second day after the rashes occurred, but
no homogeneous and autoimmune antiplatelet antibodies were detected.
Conclusion: The
carbamazepine dependent antiplatelet antibodies may be responsible for the
drug induced thrombocytopenia,fever and rashes. The exact immunological
mechamism of antiepipeptic drug hypersensitivity syndrome of carbamazepine
are being investigated further.