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Liver dysfunction induced by systemic hypersensitivity reaction to lamotrigine: case report.

Im SG, Yoo SH, Park YM, Lee SJ, Jang SK, Jeon DO, Cho HJ, Oh MJ - Clin Mol Hepatol (2015)

Bottom Line: Hypersensitivity to lamotrigine usually causes mild symptoms such as fever, rash, and slight invasion of internal organs.However, a 33-year-old male patient who was admitted with Stevens-Johnson syndrome after taking lamotrigine for 15 days experienced hepatic failure and died 5 days after admission.This case demonstrates the importance of realizing that lamotrigine can lead to fatal hepatic failure, and that tests for the normal liver function should be performed when administering lamotrigine.

View Article: PubMed Central - PubMed

Affiliation: Hepatology Center, Bundang Jesaeng General Hospital, Seongnam, Korea.

ABSTRACT
Lamotrigine is an anticonvulsant drug used to treat partial and generalized seizure disorders. Hypersensitivity to lamotrigine usually causes mild symptoms such as fever, rash, and slight invasion of internal organs. However, a 33-year-old male patient who was admitted with Stevens-Johnson syndrome after taking lamotrigine for 15 days experienced hepatic failure and died 5 days after admission. This case demonstrates the importance of realizing that lamotrigine can lead to fatal hepatic failure, and that tests for the normal liver function should be performed when administering lamotrigine.

No MeSH data available.


Related in: MedlinePlus

Time course of serum liver enzyme (AST, ALT), and prothrombin time (INR) level. AST, aspartate aminotransferase; ALT, alanine aminotransferase; INR, international normalized ratio.
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Figure 1: Time course of serum liver enzyme (AST, ALT), and prothrombin time (INR) level. AST, aspartate aminotransferase; ALT, alanine aminotransferase; INR, international normalized ratio.

Mentions: Lamotrigine was immediately discontinued, and levetiracetam was tried in monotherapy for epilepsy. Dexamethasone and antihistamine were applied. The skin lesion appeared improved, however the liver function did not improve. On the 3rd day, he had suffered from consciousness degradation. On the 5th day of admission, he was comatose and his laboratory results were: total bilirubin 1.83 mg/dL, alanine aminotransferase 15,975 IU/L, aspartate aminotransferase 4,730 IU/L, alkaline phosphatase 3,333 IU/L, γ-glutamyl transpeptidase 147 IU/L, prothrombin time 0%, serum albumin 3.3 g/dL, and creatinine 1.80 mg/dL (Fig. 1). Hepatic encephalopathy and coagulopathy had progressed and the patient died 5days after admission due to hepatic failure.


Liver dysfunction induced by systemic hypersensitivity reaction to lamotrigine: case report.

Im SG, Yoo SH, Park YM, Lee SJ, Jang SK, Jeon DO, Cho HJ, Oh MJ - Clin Mol Hepatol (2015)

Time course of serum liver enzyme (AST, ALT), and prothrombin time (INR) level. AST, aspartate aminotransferase; ALT, alanine aminotransferase; INR, international normalized ratio.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493362&req=5

Figure 1: Time course of serum liver enzyme (AST, ALT), and prothrombin time (INR) level. AST, aspartate aminotransferase; ALT, alanine aminotransferase; INR, international normalized ratio.
Mentions: Lamotrigine was immediately discontinued, and levetiracetam was tried in monotherapy for epilepsy. Dexamethasone and antihistamine were applied. The skin lesion appeared improved, however the liver function did not improve. On the 3rd day, he had suffered from consciousness degradation. On the 5th day of admission, he was comatose and his laboratory results were: total bilirubin 1.83 mg/dL, alanine aminotransferase 15,975 IU/L, aspartate aminotransferase 4,730 IU/L, alkaline phosphatase 3,333 IU/L, γ-glutamyl transpeptidase 147 IU/L, prothrombin time 0%, serum albumin 3.3 g/dL, and creatinine 1.80 mg/dL (Fig. 1). Hepatic encephalopathy and coagulopathy had progressed and the patient died 5days after admission due to hepatic failure.

Bottom Line: Hypersensitivity to lamotrigine usually causes mild symptoms such as fever, rash, and slight invasion of internal organs.However, a 33-year-old male patient who was admitted with Stevens-Johnson syndrome after taking lamotrigine for 15 days experienced hepatic failure and died 5 days after admission.This case demonstrates the importance of realizing that lamotrigine can lead to fatal hepatic failure, and that tests for the normal liver function should be performed when administering lamotrigine.

View Article: PubMed Central - PubMed

Affiliation: Hepatology Center, Bundang Jesaeng General Hospital, Seongnam, Korea.

ABSTRACT
Lamotrigine is an anticonvulsant drug used to treat partial and generalized seizure disorders. Hypersensitivity to lamotrigine usually causes mild symptoms such as fever, rash, and slight invasion of internal organs. However, a 33-year-old male patient who was admitted with Stevens-Johnson syndrome after taking lamotrigine for 15 days experienced hepatic failure and died 5 days after admission. This case demonstrates the importance of realizing that lamotrigine can lead to fatal hepatic failure, and that tests for the normal liver function should be performed when administering lamotrigine.

No MeSH data available.


Related in: MedlinePlus