TY - JOUR
T1 - Rash and multiorgan dysfunction following lamotrigine
T2 - could genetic be involved?
AU - Provenzani, Alessio
AU - Labbozzetta, Manuela
AU - Notarbartolo, Monica
AU - Poma, Paola
AU - Polidori, Piera
AU - Vizzini, Giovanni
AU - D’Alessandro, Natale
PY - 2015/10/1
Y1 - 2015/10/1
N2 - Case (description): We report the case of a 38-year-old woman treated with lamotrigine who experienced multi-organ dysfunction. The patient received the drug at the dose of 100 mg per day. One week later, the treatment was suspended because of an extensive body rash. Twenty-four hours later, the patient appeared drowsy and stuporous and was hospitalized. On the fifth day, the patient was admitted with a clinical picture of acute multi-organ failure in our Institute, where, she, despite the support of vital functions with vasoactive drugs, continuous hemofiltration and ventilation with oxygen, died. Serum lamotrigine concentration was measured 110 h after its last dose and the drug resulted to be still present at 1 mg/L. The patient was homozygous for the UGT1A4-70C and UGT2B7-161C alleles and heterozygous for the UGT2B7-372A>G polymorphism. Regarding ABCB1 the patient showed the 3435CC, 2677GT and 1236CT genotypes. Conclusion: Our results may suggest a role of the UGT2B7-372A>G polymorphism in this reaction.
AB - Case (description): We report the case of a 38-year-old woman treated with lamotrigine who experienced multi-organ dysfunction. The patient received the drug at the dose of 100 mg per day. One week later, the treatment was suspended because of an extensive body rash. Twenty-four hours later, the patient appeared drowsy and stuporous and was hospitalized. On the fifth day, the patient was admitted with a clinical picture of acute multi-organ failure in our Institute, where, she, despite the support of vital functions with vasoactive drugs, continuous hemofiltration and ventilation with oxygen, died. Serum lamotrigine concentration was measured 110 h after its last dose and the drug resulted to be still present at 1 mg/L. The patient was homozygous for the UGT1A4-70C and UGT2B7-161C alleles and heterozygous for the UGT2B7-372A>G polymorphism. Regarding ABCB1 the patient showed the 3435CC, 2677GT and 1236CT genotypes. Conclusion: Our results may suggest a role of the UGT2B7-372A>G polymorphism in this reaction.
KW - ABCB1
KW - Antiepileptic drugs
KW - HLA
KW - Lamotrigine
KW - Multi-organ dysfunction
KW - Pharmacogenetics
KW - Rash
KW - SNPs
KW - UGT1A4
KW - UGT2B7
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UR - http://www.scopus.com/inward/citedby.url?scp=84943170676&partnerID=8YFLogxK
U2 - 10.1007/s11096-015-0158-4
DO - 10.1007/s11096-015-0158-4
M3 - Article
C2 - 26173940
AN - SCOPUS:84943170676
VL - 37
SP - 682
EP - 686
JO - International Journal of Clinical Pharmacy
JF - International Journal of Clinical Pharmacy
SN - 2210-7703
IS - 5
ER -