Carbamazepine induced leukopenia: A case series

Abstract

This is a case series of 4 patients who developed leukopenia on, controlled-release carbamazepine (CBZ-CR) monotherapy for focal seizure prophylaxis. All 4 cases (2 males and 2 females), presented to the neurology department with history of episodes of sudden onset, abnormal body movements. Patients were diagnosed as cases of focal seizures and were prescribed tablet CBZ-CR 300 mg twice a day for seizure prophylaxis. One month later patients presented for follow-up and were continuing with the treatment. Blood biochemistry parameters indicated leukopenia with total leukocyte count less than 4000 per mm 3 . According to World Health Organization Uppsala monitoring Centre (WHO-UMC) causality assessment, all 4 cases were classified as 'probable/likely' for carbamazepine-induced leukopenia. Carbamazepine was continued and total leukocyte count gradually recovered on 3-months follow-up. Conclusion:Total leukocyte count should be documented before initiating carbamazepine therapy. Patients with pre-existing leukopenia should not receive carbamazepine. All patients receiving carbamazepine should be monitored for leukocyte count in addition to other blood biochemistry parameters.

A comparative study of the safety, efficacy, quality of life and pharmacoeconomics of levetiracetam with controlled-release carbamazepine in patients of new onset focal seizures: A randomized controlled academic trial

“…3 However, the decrease in TLC was transient and this recovered gradually at 3-months follow-up on continuing the treatment. 11 Study by Consoli D. et al, 18 reported that 1 out of 54 patients in CBZ group developed leukopenia.…”

“…In CBZ-CR group 4 patients developed leukopenia, which was transient and reversed on continuing the treatment. 11 Table 1 shows the TLC levels observed in two groups.…”