levetiracetam and Pancreatitis

We report a 25-year-old woman with new onset convulsive episodes. The patient initially failed to respond to phenytoin and was switched to levetiracetam (LEV) which was rapidly titrated to 3000 mg daily over 1 week. At initiation of LEV therapy, she developed mild nausea and decrease in appetite. This was rapidly followed by severe digestive symptoms consistent with acute pancreatitis. She was also found to have elevated liver transaminases. An extensive work-up failed to reveal an organic cause for her symptoms, suggesting a direct relationship to LEV. Clinical symptoms and laboratory abnormalities normalized after LEV discontinuation, along with supportive therapy.

Topics: Administration, Oral; Adult; Anticonvulsants; Female; Humans; Levetiracetam; Liver; Pancreatitis; Piracetam; Time Factors; Transaminases

Topics: Acute Disease; Adolescent; Anticonvulsants; Autistic Disorder; Epilepsy; Humans; Levetiracetam; Male; Pancreatitis; Piracetam; Tomography, X-Ray Computed

Octreotide is a synthetic somatostatin analogue which has been suggested for use in the management of acute pancreatitis, though its safety and effectiveness in the pediatric setting has not been extensively studied.. we present a rare case of a 6.5-year-old female with acute lymphoblastic leukemia (ALL) and L-asparaginase (L-asp) induced pancreatitis, who developed epileptic seizures, possibly associated with octreotide administration. Her imaging and laboratory findings ruled out a leukemic involvement or infection of CNS. The EEG revealed repetitive sharp waves maximal on the frontal and temporal areas of the right hemisphere. The child was treated with diazepam and she continued with systemic anticonvulsant treatment with levetiracetam. After 2 weeks of conservative treatment, pancreatitis resolved and she continued her chemotherapy protocol. Levetiracetam treatment lasted 8 months. 7 months after the first episode, EEG was reported as normal, and the child completed the chemotherapy protocol without any further severe complications.. Larger and well designed studies are needed to warrant the safety of octreotide in pediatric population.

Topics: Acute Disease; Anticonvulsants; Asparaginase; Child; Diagnosis, Differential; Drug Interactions; Electroencephalography; Epilepsy; Female; Humans; Levetiracetam; Octreotide; Pancreatitis; Piracetam; Precursor Cell Lymphoblastic Leukemia-Lymphoma