Carbamazepine induced transient monoclonal gammopathy and immunodeficiency.
Immune abnormalities have been found in many patients receiving anti-epileptic drugs. However, the effects of carbamazepine are still conflicting. We report the case of a 31-year-old woman who began carbamazepine treatment because of idiopathic epilepsy of adulthood. After three years of treatment she developed arthralgias and malaise. Complete immunologic evaluation showed a total absence of immunoglobulin M with decreased levels of immunoglobulin A, positive antinuclear antibodies and monoclonal paraproteinemia type IgG-kappa. The possibility of B cell lymphoma or myeloma was ruled out. Skin testing was negative. Bone marrow examination was normal. After carbamazepine discontinuation, levels of IgA and IgM increased until reaching normal values over 3 years. The monoclonal gammopathy of undetermined significance also disappeared over this period. During this period of immunodeficiency, the patient did not complain of any infectious complications.
Moreno-Ancillo
A
A
Unidad de Alergología, Hospital Virgen del Puerto, Plasencia, Cáceres, España. alanaro@telefonica.net
Cosmes Martín
P M
PM
Domínguez-Noche
C
C
Martín-Núñez
G
G
Fernández-Galán
M A
MA
López-López
R
R
González-Hurtado
J A
JA
Gil-Adrados
A C
AC
D000328:Adult; D000361:Agammaglobulinemia / Q000139:chemically induced*; D000927:Anticonvulsants / Q000009:adverse effects*; D001853:Bone Marrow / Q000473:pathology; D002220:Carbamazepine / Q000009:adverse effects*; D003937:Diagnosis, Differential; D004827:Epilepsy / Q000150:complications / Q000188:drug therapy; D005260:Female; D006801:Humans; D017098:IgA Deficiency / Q000139:chemically induced*; D007075:Immunoglobulin M / Q000172:deficiency*; D007145:Immunoglobulin kappa-Chains / Q000097:blood; D007153:Immunologic Deficiency Syndromes / Q000139:chemically induced*; D016393:Lymphoma, B-Cell / Q000175:diagnosis; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000139:chemically induced* / Q000175:diagnosis; D009101:Multiple Myeloma / Q000175:diagnosis
D000927:Anticonvulsants; D007075:Immunoglobulin M; D007145:Immunoglobulin kappa-Chains; D002220:Carbamazepine