Severe, isolated thrombocytopenia under polytherapy with carbamazepine and valproate.
It is not known whether polytherapy with carbamazepine (CBZ) and valproate (VPA) increases the risk of thrombocytopenia. A 67-year-old woman with symptomatic epilepsy since age 6 years, classified as Lennox-Gasteau syndrome, developed severe, isolated thrombocytopenia of 5 GIGA/L (normal: 150-360 GIGA/L) after being on CBZ (1200 mg/day) for 15 days and additional VPA (300 mg/day) for 5 days in combination. After discontinuation of CBZ and VPA and two thrombocyte transfusions, the thrombocyte count normalized within 3 days. Because she had been taking VPA for only 5 days in addition to CBZ, it could not be confirmed whether it was CBZ alone or the combination of CBZ and VPA that was responsible for the severe thrombocytopenia.
Finsterer
J
J
Ludwig Boltzmann Institute for Research in Epilepsy and Neuromuscular Disorders, Postfach 348, 1180 Vienna, Austria. fij@2hr.hkr.magwien.gu.at
Pelzl
G
G
Hess
B
B
D000368:Aged; D000927:Anticonvulsants / Q000009:adverse effects*; D001792:Blood Platelets / Q000187:drug effects; D002220:Carbamazepine / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D004827:Epilepsy / Q000188:drug therapy; D005260:Female; D006801:Humans; D010976:Platelet Count; D013921:Thrombocytopenia / Q000097:blood / Q000139:chemically induced*; D016896:Treatment Outcome; D014635:Valproic Acid / Q000009:adverse effects*
D000927:Anticonvulsants; D002220:Carbamazepine; D014635:Valproic Acid