Oxcarbazepine-Induced Leukopenia

摘要

To the Editor. Leukopenia is a well known adverse effect in epileptic patients treated with carbamaze-pine, but it has rarely been described with oxcarbazepine, particularly in adults. We describe a patient who developed reversible leukopenia with hyponatremia taking oxcarbazepine at high dosages.Case ReportA 38-year-old man with partial epilepsy was admitted to our institute 1 year after starting treatment with oxcarbazepine in adjunctive therapy (previously he only assumed leve-tiracetam, 3000 mg/day, and clonazepam, 4 mg/day). Up to 1 week before admission, the patient had been taking a stable regimen of oxcarbazepine, 1800 mg/day, levetira-cetam, 2000 mg/day, and clonazepam, 4 mg/day. Due to the occurrence of new partial seizures with secondary generalization, oxcarbazepine was quickly increased to 2400 mg/day. Except for epilepsy, the patient's clinical history and physical examination were normal. At the admission, routine laboratory tests showed no relevant abnormalities except for hyponatremia (125 mmol/liter) and leukopenia (2800/mm~3, 50% neutrophils). Laboratory tests for infectious diseases were negative. We proceeded with a scheduled tapering of oxcarbazepine, decreasing the dosage to 1800 mg/day and infusing lorazepam, 8 mg/day.