title: Comorbidity of Stevens-Johnson syndrome and neutropenia associated with lamotrigine: a case report.
abstract: A 19-year-old woman with a medical history of depressive mood arrived and was treated with lamotrigine at 25 mg/day. On day 10, a high fever of 39.3 °C and a diffuse, erythematous, pruritic full-body rash involving the palms of her hands and the soles of her feet developed, and she was diagnosed with Stevens-Johnson syndrome (SJS). On day 17, white blood cell count (WBC) result was 1,240/μl with 54.1% neutrophils (670/μl), and the WBC decreased to 840/μl with 60.7% neutrophils (510/μl) on day 18. The trend toward improvement included skin symptoms after steroid pulse therapy using 1000 mg/day. Based on the clinical course, we concluded that the SJS and leukopenia and/or neutropenia are associated with lamotrigine. Monitoring of WBC should be kept in mind when administering lamotrigine.
authors.affiliation: Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki 036-8562, Japan. Electronic address: yasufuru@cc.hirosaki-u.ac.jp.
authors.forename: Norio
authors.initials: N
authors.lastname: Yasui-Furukori
authors.affiliation: Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki 036-8562, Japan.
authors.forename: Kojiro
authors.initials: K
authors.lastname: Hashimoto
authors.affiliation: Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki 036-8562, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Tsuruga
authors.affiliation: Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki 036-8562, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakamura
mesh_terms: D000328:Adult; D015897:Comorbidity; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D009503:Neutropenia / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D013262:Stevens-Johnson Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D014227:Triazines / Q000009:adverse effects*; D061567:Voltage-Gated Sodium Channel Blockers / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D014227:Triazines; D061567:Voltage-Gated Sodium Channel Blockers; D000077213:Lamotrigine
keywords: Bipolar disorder; Comorbidity; Lamotrigine; Neutropenia; Stevens–Johnson syndrome