A case of rhabdomyolysis in which levetiracetam was suspected as the cause

Akiyama, Hisanao; Haga, Yoshiteru; Sasaki, Naoshi; Yanagisawa, Toshiyuki; Hasegawa, Yasuhiro

doi:10.1016/j.ebcr.2014.08.001

Cited by 25 publications

(31 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Rhabdomyolysis is not a well-documented or listed adverse effect on this drug's profile but rare case reports have implicated levetiracetam as a cause of rhabdomyolysis [11, 12]. …”

Section: Discussionmentioning

confidence: 99%

Rhabdomyolysis in a Hospitalized 16-Year-Old Boy: A Rarely Reported Underlying Cause

Singh

Patel

Pejka

2016

Case Reports in Pediatrics

View full text Add to dashboard Cite

Rhabdomyolysis can occur because of multiple causes and account for 7% of all cases of acute kidney injury annually in the United States. Identification of specific cause can be difficult in many cases where multiple factors could potentially cause rhabdomyolysis. We present a case of 16-year-old male who had seizures and was given levetiracetam that resulted in rhabdomyolysis. This side effect has been rarely reported previously and like in our case diagnosis may be delayed.

show abstract

“…Rhabdomyolysis is not a well-documented or listed adverse effect on this drug's profile but rare case reports have implicated levetiracetam as a cause of rhabdomyolysis [11, 12]. …”

Section: Discussionmentioning

confidence: 99%

Rhabdomyolysis in a Hospitalized 16-Year-Old Boy: A Rarely Reported Underlying Cause

Singh

Patel

Pejka

2016

Case Reports in Pediatrics

View full text Add to dashboard Cite

show abstract

“…In the literature, few adult patients have been reported, but there have been no reports in children [4,5]. Akiyama et al [4] reported a 29-year-old woman with epilepsy in whom rhabdomyolysis was induced by LEV. The other case, a 19-year-old man, was described by Isaacson et al [5].…”

Section: Sirmentioning

confidence: 97%

Acute rhabdomyolysis associated with levetiracetam therapy in a child

et al. 2015

View full text Add to dashboard Cite

Levetiracetam (LEV) is a new antiepileptic drug (AED)that is effective in adults and children with partial-onset seizures or idiopathic or symptomatic generalized seizures. LEV does not bind to plasma proteins, and is eliminated by the kidneys. It has been argued that LEV can act on the N-type Ca 2? channel and can reverse the gammaaminobutyric acid (GABA) and glycine-gated currents [1]. Side effects include fatigue, somnolence, infection, headache, behavioral changes and skin rashes [2]. Herein, we present the first case of rhabdomyolysis in a child treated with LEV.A 13-year-old girl presented with a history of myalgia (mainly in her lower extremities) since last 2-3 days to our hospital. She was born of an uneventful full-term pregnancy. Developmental milestones were normal. On medical history, she had partial onset of secondarily generalized seizures during sleep since 2 months. The seizure activity consisted of twitching of the right face, tonic deviation of the mouth involving the lips, tongue, and pharyngeal and laryngeal muscles, resulting in speech arrest and drooling and progressing into bilateral tonic stiffening of the arms and legs. The EEG revealed left centrotemporal spikes and was subsequently diagnosed with benign epilepsy with centrotemporal spikes. The patient was administered LEV monotherapy. LEV had started 10 mg/kg/day, but her brief partial seizures continued. The dose was increased to 20 mg/kg/day (500 mg/day), and her seizures were ceased. One week after starting LEV therapy, she experienced mild myalgia. On her examination, the vital signs, including the blood pressure were normal. Her height and weight were in normal limit for her age. The physical and neurological examinations were normal. There was no evidence of trauma, exercise or infection.On laboratory examination, blood urea was 29 mg/dL (normal range 17-43), creatinine 1.0 mg/dL (normal range 0.6-1.2), myoglobin 78 ng/mL (normal range 14.3-65.8), and creatinine phospho kinase (CPK) was 986 U/L (normal range 27-168). Plasma carnitine (42 lmol/L; reference range 19-59 lmol/L) and free carnitine levels (35 lmol/L; reference range 12-46 lmol/L) were normal as acylcarnitine profile. Brain MRI showed no abnormal findings.Rhabdomyolysis was diagnosed with clinical and biochemical findings. We thought LEV may be the cause of her complaints and ceased LEV therapy. Hydration therapy were started to avoid potential complications. After stopping LEV, serum CPK and myoglobin levels gradually decreased and returned into normal values. Muscle biopsy was not performed.

show abstract

“…L evetiracetam is a commonly used medication for the treatment of partial‐onset and primary generalized epilepsy due to its favorable pharmacokinetics, lack of drug interactions, and availability of bioequivalent oral and intravenous forms . Commonly reported adverse effects of levetiracetam are somnolence, asthenia, headache, and irritability …”

mentioning

confidence: 99%

“…There have been 4 reports of levetiracetam‐associated rhabdomyolysis . All occurred in the setting of epilepsy treatment and involved young patients aged 13 to 29 years, with resulting CK levels ranging from 986 to 29,136 U/L . Myalgia was reported in 2 patients and muscle weakness in 1 .…”

mentioning

confidence: 99%

“…All occurred in the setting of epilepsy treatment and involved young patients aged 13 to 29 years, with resulting CK levels ranging from 986 to 29,136 U/L . Myalgia was reported in 2 patients and muscle weakness in 1 . Three of 4 patients received other medications which could have contributed to the occurrence of rhabdomyolysis, including valproate and phenytoin, oxcarbamazepine, clobazam, and propofol .…”

mentioning

confidence: 99%

See 1 more Smart Citation