Effects of antiepileptic drugs on concentration of serum proteins and immunoglobulins of epileptic patients

Garzón, Pedro Javier Rojas; González-Cornejo, Salvador; Hernández-Hernández, Guillermo; Aguirre-Portillo, Leonardo; Almodovar-Cuevas, C.; Navarro-Ruíz, A.

doi:10.1016/0306-3623(86)90010-8

Cited by 7 publications

(3 citation statements)

References 24 publications

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“…There have been occasional reports of lower serum IgA levels in patients treated with phenobarbital (Garzon et al 1986;Sinues et al 1982), valproic acid (Joubert et al 1977) or valpromide, a close derivative of valproic acid (Musolino et al 1980).…”

Section: Other Drugsmentioning

confidence: 96%

Immunological Adverse Effects of Anticonvulsants

et al. 1993

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Long term administration of anticonvulsants is sometimes associated with impairment of the humoral and/or cellular immune response. Furthermore, certain well known adverse reactions to antiepileptics may have an immunotoxicological origin e.g. lymphadenopathy, pseudolymphoma and systemic lupus erythematosus. However, two important questions remain unresolved. First, the possibility that epilepsy per se might be primarily associated with immune alterations makes it difficult to assess the pathogenetic role of a specific drug, especially in a patient population usually on multiple drug therapy. Secondly, the clinical relevance of some of the observed immunological abnormalities is still highly controversial. This review is intended to give an outline of the present state of knowledge on the effects of anticonvulsants on humoral, cellular and nonspecific immunity, with particular regard to some of the major clinical conditions that have been ascribed to drug-induced immune dysregulation, such as pseudolymphoma and systemic autoimmune diseases. The immunotoxic potential of anticonvulsants appears to be low, and immunological monitoring is not usually required except in patients with known immune defects.

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Section: Other Drugsmentioning

confidence: 96%

Immunological Adverse Effects of Anticonvulsants

et al. 1993

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“…Although this is known to be a rare adverse reaction to various pharmacologics (1,4,5), including the anticonvulsant carbamazepine (3, 6, 10, 11), it has not been previously described with oxcarbazepine.A 49-year-old white female was referred for further investigation of low serum immunoglobulins found as part of an evaluation for chronic bacterial vaginitis and suspected immune deficiency. Her infectious history was significant for one episode of pneumonia, several episodes of sinusitis, and chronic bladder infections.…”

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confidence: 99%

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confidence: 99%

Oxcarbazepine-Induced Immunoglobulin Deficiency

Knight

Cunningham‐Rundles

2005

Clin Vaccine Immunol

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We are reporting the first case of oxcarbazepine-induced immunoglobulin deficiency. Although this is known to be a rare adverse reaction to various pharmacologics (1,4,5), including the anticonvulsant carbamazepine (3, 6, 10, 11), it has not been previously described with oxcarbazepine.A 49-year-old white female was referred for further investigation of low serum immunoglobulins found as part of an evaluation for chronic bacterial vaginitis and suspected immune deficiency. Her infectious history was significant for one episode of pneumonia, several episodes of sinusitis, and chronic bladder infections.As a part of her immunologic evaluation, causes of secondary hypogammaglobulinemia were considered. She had no evidence of gastrointestinal protein loss and no evidence of malignancy and was not taking any immunosuppressive medications. She had been given oxcarbazepine (1,800-mg total daily dose), a derivative of the anticonvulsant carbamazepine, for chronic pain.At referral, immunoglobulin levels were low (immunoglobulin G [IgG], 576 mg/dl; IgA, Ͻ11 mg/dl; IgM, Ͻ4 mg/dl) and she had a B-cell deficiency (1%, 18 B cells/mm 3 [normal, 5 to 15%, 75 to 375 B cells/mm 3 ]). She maintained positive (immune) IgG responses to measles, rubella, mumps, tetanus, and diphtheria. Antibody responses 1 month after pneumococcal vaccination were poor (protective antibody, 1.3 g/ml, to only 2 out of 12 serotypes tested).Suspecting a potential adverse reaction to oxcarbazepine, this medication was discontinued; immunoglobulin levels and B-cell numbers remained low for at least 2 months. Her IgG and IgM levels returned to normal after 8 months (IgG, 977 mg/dl; IgA, Ͻ7 mg/dl; IgM, 62 mg/dl), with normalized B-cell numbers (5%; 85 B cells/mm 3 ), and remained normal at 12 months (IgG, 1,065 mg/dl; IgA, Ͻ15 mg/dl; IgM, 64 mg/dl; 113 B cells/mm 3 [7%]), with protective antibody responses to 5 out of 12 pneumococcal serotypes ( Fig. 1 and 2). She continued to have IgA deficiency. Her chronic pain returned with the discontinuation of oxcarbazepine.

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Serum Immunoglobulins and Risk of Infection: How Low Can You Go?

Fürst

2009

Seminars in Arthritis and Rheumatism

121

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Effects of antiepileptic drugs on concentration of serum proteins and immunoglobulins of epileptic patients

Cited by 7 publications

References 24 publications

Immunological Adverse Effects of Anticonvulsants

Immunological Adverse Effects of Anticonvulsants

Oxcarbazepine-Induced Immunoglobulin Deficiency

Serum Immunoglobulins and Risk of Infection: How Low Can You Go?

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