levetiracetam and Neutropenia

Topics: Adrenal Cortex Hormones; Adult; Aged; Antibodies, Monoclonal, Humanized; Biological Products; Biomarkers; Cyclophosphamide; Cytokine Release Syndrome; Drug Therapy, Combination; Female; Humans; Immunotherapy, Adoptive; Leukapheresis; Levetiracetam; Lymphoma, Large B-Cell, Diffuse; Male; Middle Aged; Nervous System Diseases; Neutropenia; Propensity Score; Vidarabine; Young Adult

Topics: Adult; Anticonvulsants; Humans; Levetiracetam; Male; Neutropenia; Piracetam; Steroids; Stevens-Johnson Syndrome

Levetiracetam is being increasingly utilized for post-traumatic brain injury seizure prophylaxis, in part because of its more favourable adverse effect profile compared to other anti-epileptics. This report highlights an unusual, clinically significant adverse drug reaction attributed to levetiracetam use in a patient with blunt traumatic brain injury.. This study describes a case of isolated neutropenia associated with levetiracetam in a 52-year-old man with traumatic brain injury.. The patient developed neutropenia on day 3 of therapy with levetiracetam, with an absolute neutrophil count nadir of 200. There were no other medications that may have been implicated in the development of this haematological toxicity. Neutropenia rapidly resolved upon cessation of levetiracetam therapy.. Clinicians should be aware of potentially serious adverse reactions associated with levetiracetam in patients with neurological injury.

Topics: Anticonvulsants; Brain Injuries; Humans; Levetiracetam; Male; Middle Aged; Neutropenia; Piracetam

Brain metastases occur in about 30% of patients with non-small-cell lung carcinoma; seizures occur in approximately 20% of them. Antiepileptic drugs are commonly given for postoperative prophylaxis after brain or metastasis tumor surgery. The incidence of seizures following supratentorial craniotomy is estimated to be 15%-20%. Postoperative seizures are more common in the first month after cranial surgery. However, the use of antiepileptic drugs postoperatively has been investigated in randomized controlled trials. In case of seizures, the recommendations are continuing antiepileptic drugs after a 1- to 4-year seizure-free interval. This decision must weigh the risk of seizure recurrence against the possible benefits of the drug. Some antiepileptic drugs have been known to cause blood dyscrasias, including neutropenia, but this is a rare occurrence.. We report a case of neutropenia related to the use of levetiracetam at first exposure. After drug administration, neutropenia was detected. Additional tests were performed.. By exclusion, it was decided to withdraw the drug, and the patient had a reversal of neutropenia.. Levetiracetam-induced neutropenia is infrequent but possible. It is an exclusion diagnosis.

Topics: Adenocarcinoma; Anticonvulsants; Brain Neoplasms; Craniotomy; Drug Administration Schedule; Humans; Levetiracetam; Lung Neoplasms; Male; Middle Aged; Neutropenia; Piracetam; Seizures

Mitochondrial cytopathy is a multisystemic disease that requires different pharmacological and specialist approaches; although most therapies are usually of scarce effectiveness. We describe a clinical management of a very young girl with Pearson's syndrome that developed the symptoms of Kearns-Sayre syndrome. Many of symptoms were temporarily improved by the replacement therapy with hydrocortisone introduced to treat the partial adrenal insufficiency. During her life, she showed an ample clinical spectrum of symptoms because of multiple organs involvements: firstly bone marrow and, thereafter, brain, retina, inner ear, and kidney. Partial adrenal insufficiency, rarely described in mitochondrial disorders, was a distinctive characteristic of this case. When our patient was treated with hydrocortisone, in addition to ubiquinone and carnitine, the episodes of decompensation regressed and an improvement of the adrenal insufficiency, but only temporary reversion of the weakness of muscle, ophthalmoplegia and of the fatigue, were testified. Nevertheless, after a brief period of recovery, she developed the de Toni-Debré-Fanconi syndrome and the reappearance of the neurological symptoms.

Topics: Acidosis, Lactic; Bone Marrow Diseases; Calcium; Child, Preschool; Disease Progression; DNA, Mitochondrial; Ergocalciferols; Fanconi Syndrome; Female; Humans; Kearns-Sayre Syndrome; Levetiracetam; Neutropenia; Nootropic Agents; Pancreas, Exocrine; Pancreatic Diseases; Piracetam; Sodium Bicarbonate; Thrombocytopenia