title: Lamotrigine hypersensitivity in childhood epilepsy.
abstract: 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.
authors.affiliation: Chair of Pediatrics (VII), La Sapienza University, Rome, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Iannetti
authors.forename: U
authors.initials: U
authors.lastname: Raucci
authors.forename: P
authors.initials: P
authors.lastname: Zuccaro
authors.forename: R
authors.initials: R
authors.lastname: Pacifici
mesh_terms: 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*
chemical_list: D000927:Anticonvulsants; D014227:Triazines; D000077213:Lamotrigine