title: Immunoglobulin A deficiency following treatment with lamotrigine.
abstract: Lamotrigine (LTG) is an anti-epileptic drug and mood-stabilizing agent, whose adverse effects include skin rash and dizziness. Interactions with the immune system are rare, and only a few cases linking hypogammaglobulinemia to LTG treatment have been previously described. In this report, we describe a case in which a patient developed hypogammaglobulinemia, and a subsequent immunoglobulin A (IgA) deficiency, following LTG treatment. As a result of her immunodeficiency, the patient presented with a severe urinary tract infection and required intravenous immunoglobulin. Serum levels of immunoglobulin G and M had recovered by seven months and one month after the discontinuation of LTG, respectively; however, IgA levels remained low (less than 4mg/dL) two years post-treatment. While previous reports have demonstrated IgA deficiencies in patients prescribed other antiepileptic drugs, this is the first case of an IgA deficiency following LTG administration.
authors.affiliation: Department of Pediatrics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Epilepsy Center, Kagoshima University Hospital, Japan. Electronic address: s-maru@m.kufm.kagoshima-u.ac.jp.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Maruyama
authors.affiliation: Department of Pediatrics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Okamoto
authors.affiliation: Department of Pediatrics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Toyoshima
authors.affiliation: Epilepsy Center, Kagoshima University Hospital, Japan; Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Hanaya
authors.affiliation: Department of Pediatrics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Kawano
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D017074:Common Variable Immunodeficiency / Q000097:blood / Q000139:chemically induced*; D004827:Epilepsy / Q000097:blood / Q000188:drug therapy; D005260:Female; D006801:Humans; D017098:IgA Deficiency / Q000097:blood / Q000139:chemically induced*; D007070:Immunoglobulin A / Q000097:blood; D000077213:Lamotrigine; D014227:Triazines / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D007070:Immunoglobulin A; D014227:Triazines; D000077213:Lamotrigine
keywords: Hypogammaglobulinemia; IgA deficiency; Lamotrigine; Secondary