Life-threatening organ failure after lamotrigine therapy.
We describe an 11-year-old girl with a seizure disorder who developed fever, rash, rhabdomyolysis, and multiorgan failure 2 weeks after commencing a transition from sodium valproate to lamotrigine therapy. To our knowledge, this patient represents the most severe life-threatening hypersensitivity lamotrigine reaction described in the pediatric literature. We recommend caution when prescribing lamotrigine to children on concomitant sodium valproate, and immediate discontinuation of lamotrigine and the provision of aggressive supportive care in patients with features of lamotrigine hypersensitivity.
Ferguson
Lee P
LP
Department of Pediatric Intensive Care, Evelina Children's Hospital, Guy's and Saint Thomas' National Health Service Foundation Trust, London, United Kingdom. lee.ferguson@childrens.harvard.edu
Dargan
Paul I
PI
Hood
Joanne L
JL
Tibby
Shane M
SM
D000927:Anticonvulsants; D002648:Child; D000075202:Contraindications; D004359:Drug Therapy, Combination; D005076:Exanthema / Q000139:chemically induced; D005260:Female; D005334:Fever / Q000139:chemically induced; D006801:Humans; D000077213:Lamotrigine; D009102:Multiple Organ Failure / Q000139:chemically induced* / Q000628:therapy; D012206:Rhabdomyolysis / Q000139:chemically induced; D012640:Seizures / Q000188:drug therapy; D016896:Treatment Outcome; D014227:Triazines; D014635:Valproic Acid / Q000627:therapeutic use
D000927:Anticonvulsants; D014227:Triazines; D014635:Valproic Acid; D000077213:Lamotrigine