Bronchiolitis obliterans organising pneumonia associated with anticonvulsant hypersensitivity syndrome induced by lamotrigine

Abstract

A 14-year-old girl who was known to have a seizure disorder and on lamotrigine treatment was admitted to the hospital, with a history of rash, fever and cough. Her condition deteriorated with clinical features suggestive of anticonvulsant hypersensitivity syndrome (ACHS) complicated with bronchiolitis obliterans organising pneumonia (BOOP). Her chest CT showed multifocal parenchymal opacities and lung biopsy was typical for BOOP. Initially, the lamotrigine was discontinued since the onset of the rash, then she was treated for pneumonia with antibiotics, which may have delayed the diagnosis. Eventually, BOOP was considered and she was treated with a high dose of corticosteroid. She improved clinically and her repeated chest CT showed a marked resolution of the lesions. This case illustrates the possible occurrence of BOOP as a complication of ACHS secondary to lamotrigine treatment.

Levetiracetam-induced interstitial lung disease in a patient with advanced lung cancer

“…Although the number of cases is small, phenytoin, carbamazepine, zonisamide, and lamotrigine have been reported as AEDs that can cause drug-induced ILD [ [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] ]. CT findings in those cases have been reported to be mostly consolidation suggesting eosinophilic pneumonia or organizing pneumonia [ [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] ] and GGO or reticular shadows in a small number of cases [ 20 , 21 ]. From the CT findings which are mainly based on GGO, Pneumocystis jirovecii pneumonia, viral pneumonia, pulmonary edema including neurogenic pulmonary edema, Mendelson syndrome, drug reaction with eosinophilia and systemic symptom (DRESS) syndrome were considered as differential diseases in addition to drug-induced pneumonia.…”

Comparison of different sustained‐release opioids and acute respiratory conditions in patients with cancer and chronic kidney disease

“…Antidepressants, antipsychotics, and anticonvulsants were not screened in this study. Although rare, these medications can cause acute respiratory conditions [20][21][22] ; thus, we considered the risk of respiratory conditions caused by these medications to be generally low.…”