Multiple organ system damage caused by carbamazepine
10.3760/cma.j.issn.1008-5734.2016.04.017
- VernacularTitle:卡马西平致多系统损害
- Author:
Xiaofei TANG
1
;
Bing TAN
;
Yan ZHANG
;
Hongjun LIU
;
Meng YANG
;
Lijuan CHEN
;
Zhixiang YANG
Author Information
1. 408200,重庆市丰都县人民医院药剂科
- Publication Type:Journal Article
- Keywords:
Carbamazepine;
Drug toxicity
- From:
Adverse Drug Reactions Journal
2016;18(4):303-305
- CountryChina
- Language:Chinese
-
Abstract:
A 79-years-old male patient took carbamazepine 100 mg thrice daily for the trigeminal neuralgia and added the dose of carbamazepine to 200 mg thrice daily by himself because the pain could not be controlled.One month later,the patient developed shortness of breath,heart palpitations,dizziness,and limbs numbness.Laboratory tests showed the following results:white blood cell (WBC) 3.0 × 109/L,red blood cell (RBC) 3.1 × 1012/L,hemoglobin (Hb) 100 g/L,serum sodium 127 mmol/L,chloride 95 mmol/L,total thyroxine 58 nmol/L,free thyroxine 10.6 pmol/L,thyroid-stimulating hormone (TSH) 4.5 mU/L.Dynamic electrocardiogram showed average heart rate 59 beats/min and 326 times of cardiac arrest exceeding 2.0 s.He was diagnosed with sick sinus syndrome and hypothyroidism.The patient was discharged after symptomatic treatments.About 3 months later,shortness of breath,dizziness and heart palpitations appeared again,accompanied by syncope 2 times (about 1 minute each time and relieved spontaneously).Laboratory tests showed the following results:WBC 3.1 × 109/L,RBC 3.0 × 1012/L,Hb 99 g/L,serum sodium 127 mmol/L,chloride 95 mmol/L,total thyroxine 63 nmol/L,free thyroxine 11.8 pmol/L,TSH 7.9 mU/L.Dynamic electrocardiogram showed arrhythmia,atrioventricular block,and R-R interval prolongation.Carbamazepine was stopped.Ten days later,dizziness,heart palpitations,and syncope disappeared.The laboratory revealed the following results:WBC 5.6 × 109/L,RBC 4.4 × 1012/L,Hb 120 g/L,serum sodium 139 mmol/L,chloride 102 mmol/L,total thyroxine 67 nmol/L,free thyroxine 15.0 pmol/L,TSH 3.8 mU/L.Dynamic electrocardiogram showed sinus heart rate and heart rate 75 beats/ min.Carbamazepine 100 mg thrice daily was administered again for trigeminal neuralgia.The above mentioned symptoms did not recur during a half year of follow-up.
