title: [Carbamazepine-induced systemic lupus erythematosus--a case report].
abstract: Epileptic seizures may be an early symptom of systemic lupus erythematosus, while at the same time some of the epileptic drugs, namely carbamazepine (CBZ), phenytoin (PHT), valproic acid (VPA), ethosuximide (ETM), primidone (PRM), lamotrigine (LTG), zonisamide (ZNS) can cause lupus. A separate clinical problem is the fact that few cases of systemic lupus have as yet been identified by giving antiepileptic drug. We present the case of a 30-year-old woman with frequent simple partial seizures and few secondarily generalized seizures since the age of 18. She was treated with VPA for three years. Then, because of side effects the drug had to be withdrawn and was replaced by CBZ. After eight months duration of the treatment with CBZ, the dose was increased because a secondarily generalized seizure occurred again. After another two months, painful swelling of all joints and leucopenia were observed. During additional studies, LE cells and high titer of ANA antibodies were found. Systemic lupus erythematosus was diagnosed and prednisone therapy was introduced. In spite of the withdrawal of CBZ, the increased titer of ANA antibodies persisted for several years and skin and muscle biopsy performed five years from the onset of clinical symptoms disclosed inflammatory infiltration and presence of IgG and IgM deposits in skin and vessel walls. Control serological examinations, skin and muscle biopsy carried out after eight years of observation and lack of clinical manifestations permitted to exclude a connective tissue disease in our patient.
authors.affiliation: Katedra i Klinika Neurologii w Katowicach Ochojcu, Slaska Akademia Medyczna, ul. Ziołowa 45/47, 40-635 Katowice. neurologia@gcm.pl
authors.forename: Ewa
authors.initials: E
authors.lastname: Motta
authors.forename: Zofia
authors.initials: Z
authors.lastname: Kazibutowska
authors.forename: Andrzej
authors.initials: A
authors.lastname: Lorek
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Januszewski
authors.forename: Anna
authors.initials: A
authors.lastname: Gołba
authors.forename: Aldona
authors.initials: A
authors.lastname: Wianecka
mesh_terms: D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects*; D002220:Carbamazepine / Q000008:administration & dosage / Q000009:adverse effects*; D004828:Epilepsies, Partial / Q000188:drug therapy; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis* / Q000188:drug therapy; D011241:Prednisone / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D000974:Antibodies, Antinuclear; D000927:Anticonvulsants; D005938:Glucocorticoids; D002220:Carbamazepine; D011241:Prednisone