卡马西平致红斑狼疮样综合征

Carbamazepine-induced lupus erythematosus-like syndrome

1例女性患者,14岁时因癫痫口服卡马西平,由初始剂量300 mg/d逐渐增至600 g/d。服药10年后,患者出现腹腔积液和血小板减少。其血小板计数5×109/L。停用卡马西平,改用左乙拉西坦。实验室检查示抗核抗体1∶320,抗双链DNA抗体261 IU/ml。考虑红斑狼疮样综合征和卡马西平有关,给予泼尼松治疗,患者的腹腔积液逐渐消退。停用卡马西平50 d后血小板计数103×109/L,检测抗核抗体和抗双链DNA抗体均为阴性,红斑狼疮样综合征症状未再出现。

A women at the age of 14 started receiving an initial dose of carbamazepine 300 mg/d and then the dosage was gradually increased to 600 g/d for epilepsy. After ten years treatment, the patient developed seroperitoneum, thrombocytopenia. She had a platelet level of 5×10^9/L, The drug was discontinued and switched to levetiracetam. Laboratory examination revealed an antinuclear antibody （ANA） titre of 1：320, and anti-double stranded DNA（ anti ds-DNA） antibodies 261 IU/ml. Drug-induced lupus erythematosus-like syndrome was considered to be associated with carbamazepine, the patient was given prednisone, and her seroperitoneum significantly improved. Fifth days after carbamazepine withdrawal, her platelet count was 103×10^9/L, ANA and anti ds-DNA test results were negative, lupus erythematosus-like syndrome did not recur.