カルバマゼピンを服用中に急性リンパ性白血病を発症した3小児例(<特集>小児科学教室大澤真木子教授開講5周年記念)

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Three epileptic children who had been treated with antiepileptic drugs (AED) including carbamazepine (CBZ) were eventually found to be suffering from acute lymphoblastic leukemia (ALL). Case 1, a boy, had been healthy until age 8, when generalized tonic-clonic seizures first occurred. Seizures persisted despite treatment with phenobarbital sodium (PB), phenytoin (PHT) and valproate sodium (VPA). At the age of 9, complex partial seizures (CPS) developed in this boy. CBZ was therefore added to the treatment regimen, and the previous prescription was stopped. Five months later, it was found that the boy was suffering from ALL. Case 2, also a boy, was born with complicating intraventricular hemorrhage in the neonatal period. An epileptiform EEG abnormality was noticed at age 2, when VPA administration was started. Despite this, an episode of CPS occurred at the age of 4, which prompted us to switch the treatment from VPA to CBZ. His later course was uneventful until the age of 8, when hematological problems became evident, and a diagnosis of ALL was made. Case 3, a boy, was initially treated with CBZ because of autism and EEG abnormality at 12 years of age. In addition to CBZ, haloperidol and promethazine hydrochloride were given at the age of 13 years. ALL developed at the age of 14 years 2 months. In summary, ALL was noticed in three epileptic boys on AED therapy, all of whom were receiving CBZ. No causal relationship between AED (especially CBZ) and ALL has been established. While these three cases may represent mere coincidence, they may also suggest that we should keep ALL in mind when treating children with AED therapy.
2000-06-25

カルバマゼピンを服用中に急性リンパ性白血病を発症した3小児例(<特集>小児科学教室大澤真木子教授開講5周年記念)

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