Case report: Progressive skin rash and lymphadenopathy associated with lamotrigine-valproic acid combination in a bipolar adolescent

作者全名："Duan, Yingxu; Qiu, Fangxinrui; Zhou, Jingyuan; Liu, Shiyu; Zhao, Die; Qiu, Changjian"

作者地址："[Duan, Yingxu; Zhou, Jingyuan; Liu, Shiyu; Zhao, Die; Qiu, Changjian] Sichuan Univ, Mental Hlth Ctr, Sichuan Clin Med Res Ctr Mental Disorders, West China Hosp, Chengdu, Sichuan, Peoples R China; [Qiu, Fangxinrui] Chongqing Med Univ, Int Med Coll, Chongqing, Peoples R China"

通信作者："Qiu, CJ (通讯作者)，Sichuan Univ, Mental Hlth Ctr, Sichuan Clin Med Res Ctr Mental Disorders, West China Hosp, Chengdu, Sichuan, Peoples R China."

来源：FRONTIERS IN PHARMACOLOGY

ESI学科分类：PHARMACOLOGY & TOXICOLOGY

WOS号：WOS:000962128400001

JCR分区：Q1

影响因子：4.4

年份：2023

卷号：14

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：lamotrigine; valproate; lymphadenopathy; bipolar disorder; case report

摘要："Background: Lamotrigine may cause severe skin reactions. There is a known interaction between lamotrigine and valproic acid with an increase in lamotrigine levels and lamotrigine toxicity risk. Few cases of severe rash and systemic reactions in bipolar patients using lamotrigine and valproate have been reported. Here, we report a rare case of severe skin rash and lymphadenopathy associated with lamotrigine-valproic acid combination. Case presentation: An 18-year-old female adolescent with bipolar disorder type I was treated with lamotrigine, magnesium valproate, and perospirone for 12 days. After the last dose of lamotrigine, she abruptly developed generalized rash and swollen lymph nodes, which continued to progress over the next 3 days. This finally subsided after stopping valproate and with glucocorticoid treatment. Conclusion: This case suggests that lamotrigine-valproic acid combination may cause not only rash but also lymphadenopathy. Even though the aforementioned reactions appear after the last dose of lamotrigine, it cannot be ruled out as suspicious. We recommend caution during titration of lamotrigine and valproate and early withdrawal of both when signs of hypersensitivity appear."

基金机构："1.3.5 Project for Disciplines of Excellence-Clinical Research Incubation Project, West China Hospital, Sichuan University [ZYJC21083, 2022YFS0345]; Department of Science and Technology of Sichuan provincial government [2022HXFH029]"

基金资助正文："This work was partly funded by the 1.3.5 Project for Disciplines of Excellence-Clinical Research Incubation Project, West China Hospital, Sichuan University (Grant No. ZYJC21083) (CQ), the Department of Science and Technology of Sichuan provincial government (Grant No. 2022YFS0345) (CQ), and the 1.3.5 Project for Disciplines of Excellence-Clinical Research Incubation Project, West China Hospital, Sichuan University (Grant No. 2022HXFH029) (CQ). The funding sources had no role in the design, execution, interpretation, analysis, or publication of the study."