[Chest pain, reduced physical activity, and polyserositis in a 35-year old patient with anticonvulsive medication].
We report on a rare case of a late-onset drug-induced lupus erythematosus. A 35 year old male patient complained about dyspnea, chest pain and reduced physical activity for three months. His medical history consisted of epilepsy treated with carbamazepine for 20 years. After diagnosis of a large pericardial effusion and percardiocentesis (1200 ml) the diagnosis of viral perimyocarditis was suspected. Under antiphlogistic treatment the symptoms vanished initially. Four weeks later the pericardial effusion recurred and a livedo reticularis became evident. A structural or infectious heart disease, in particular viral myocarditis, was ruled out invasively. Serologic testing revealed antinuclear antibodies and antibodies against histones without presence of antibody against ds-DNA, thereby confirming the diagnosis of carbamazepine-induced lupus erythematodes. After discontinuation of carbamazepine and immunosuppressive medication the patient recovered completely.
Wittchen
F
F
Medizinische Klinik II--Kardiologie und Pulmologie, Campus Benjamin Franklin der Charité Universitätsmedizin, Hindenburgdamm 30, 12200 Berlin.
Spencker
S
S
Zinke
S
S
Coban
N
N
Schultheiss
H P
HP
Witzenbichler
B
B
D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects; D002220:Carbamazepine / Q000009:adverse effects*; D002637:Chest Pain / Q000139:chemically induced* / Q000175:diagnosis; D005221:Fatigue / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000139:chemically induced* / Q000175:diagnosis* / Q000517:prevention & control; D008297:Male; D009043:Motor Activity / Q000187:drug effects*; D012700:Serositis / Q000139:chemically induced* / Q000175:diagnosis
D000927:Anticonvulsants; D002220:Carbamazepine