title: Bronchiolitis obliterans organising pneumonia associated with anticonvulsant hypersensitivity syndrome induced by lamotrigine.
abstract: A 14-year-old girl who was known to have a seizure disorder and on lamotrigine treatment was admitted to the hospital, with a history of rash, fever and cough. Her condition deteriorated with clinical features suggestive of anticonvulsant hypersensitivity syndrome (ACHS) complicated with bronchiolitis obliterans organising pneumonia (BOOP). Her chest CT showed multifocal parenchymal opacities and lung biopsy was typical for BOOP. Initially, the lamotrigine was discontinued since the onset of the rash, then she was treated for pneumonia with antibiotics, which may have delayed the diagnosis. Eventually, BOOP was considered and she was treated with a high dose of corticosteroid. She improved clinically and her repeated chest CT showed a marked resolution of the lesions. This case illustrates the possible occurrence of BOOP as a complication of ACHS secondary to lamotrigine treatment.
authors.affiliation: Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Hasan
authors.initials: H
authors.lastname: Ghandourah
authors.affiliation: Alberta Children's Hospital, Calgary, Alberta, Canada.
authors.forename: Samarjeet
authors.initials: S
authors.lastname: Bhandal
authors.affiliation: Department of Pathology & Laboratory Medicine and Paediatrics, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Marie-Anne
authors.initials: MA
authors.lastname: Brundler
authors.affiliation: Alberta Children's Hospital, Calgary, Alberta, Canada.
authors.forename: Mary
authors.initials: M
authors.lastname: Noseworthy
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects*; D018549:Cryptogenic Organizing Pneumonia / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000503:physiopathology; D063926:Drug Hypersensitivity Syndrome / Q000209:etiology*; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D008168:Lung / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014227:Triazines / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D000900:Anti-Bacterial Agents; D000927:Anticonvulsants; D014227:Triazines; D000077213:Lamotrigine
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