Lamotrigine hypersensitivity in childhood epilepsy.
OBJECTIVE
To evaluate the effect of lamotrigine (LTG) on several humoral and cellular immune functions in children with epilepsy and the change in immunological status in patients with LTG-induced rash.


METHODS
Sixteen children with epilepsy of unknown origin or secondary to various etiologies undergoing treatment with LTG participated in the humoral and cellular immunological study. Of these, 2 patients developed a rash during LTG treatment and are described in detail.


RESULTS
No modifications of humoral or cellular immunity (measured at 1 and 3 months) were noted in 14 of the 16 patients during this treatment. In the 2 children who manifested rash, basal immune function was normal. In both, immediately after the skin rash appeared, there was a high increase in the percentage of activated T-helper lymphocytes (CD4-DR) and activated T-suppressor lymphocytes (CD8-DR), a slight increase in percentage of B lymphocytes (CD19), and a greater increase in serum concentration of IgE. In 1 of the 2 patients, reevaluation of immunity 20 days after the rash appeared and after LTG suspension showed normal percentages of CD4-DR, CD8-DR, and CD19, whereas the serum concentration of IgE had decreased.


CONCLUSIONS
The observed immunological results indicate that LTG-induced rash may be considered an immune-mediated hypersensitivity reaction.
Iannetti
P
P
Chair of Pediatrics (VII), La Sapienza University, Rome, Italy.
Raucci
U
U
Zuccaro
P
P
Pacifici
R
R
D000917:Antibody Formation / Q000187:drug effects / Q000276:immunology; D000927:Anticonvulsants / Q000009:adverse effects*; D002648:Child; D003875:Drug Eruptions / Q000209:etiology*; D004827:Epilepsy / Q000188:drug therapy*; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects; D000077213:Lamotrigine; D008213:Lymphocyte Activation / Q000187:drug effects; D018655:Lymphocyte Count / Q000187:drug effects; D014227:Triazines / Q000009:adverse effects*
D000927:Anticonvulsants; D014227:Triazines; D000077213:Lamotrigine