PMID- 35810379
OWN - NLM
STAT- MEDLINE
DCOM- 20220712
LR  - 20220712
IS  - 2795-4552 (Electronic)
IS  - 2795-4552 (Linking)
VI  - 1
IP  - 2
DP  - 2022 Apr-Jun
TI  - Juvenile systemic lupus erythematosus triggered by Lamotrigine.
PG  - 181-182
AB  - Several drugs can unmask clinically silent systemic lupus erythematosus (SLE), 
      induce flares in patients with already known SLE diagnosis or lead to the 
      development of lupus-like syndromes. We describe a rare case of juvenile SLE 
      triggered by lamotrigine. A 17-year-old female, who was recently medicated with 
      lamotrigine, presented with a 3 week history of daily fever, fatigue, 
      odynophagia, arthralgia, myalgia, diffuse erythematous maculopapular rash, 
      vasculitic rash of the fingers, and lips and vulvar edema. Leukopenia, 
      lymphopenia, elevated C-reactive protein, low serum C3 and C4 levels, 
      antinuclear, anti-double stranded DNA (anti-dsDNA) and anti-Ro (SSA) antibodies 
      were identified. Lamotrigine was stopped and an immediate clinical improvement 
      occurred. The patient was afebrile in less than 24h and all the other symptoms 
      rapidly disappeared. C3 and C4 levels remained below normal ranges and anti-dsDNA 
      antibodies persisted elevated. Treatment with hydroxychloroquine was started and 
      the patient remained asymptomatic for two years. She later developed vasculitic 
      rash, which responded well to treatment with steroids. A drug as a trigger for 
      SLE should always be considered, since drug withdrawal is an important step for a 
      favourable outcome.
FAU - Barbosa Rodrigues, Ana
AU  - Barbosa Rodrigues A
AD  - Pediatric Rheumatology Unit, Hospital de Santa Maria, Lisbon, Portugal, CHULN.
FAU - Oliveira-Ramos, Filipa
AU  - Oliveira-Ramos F
AD  - Pediatric Rheumatology Unit, Hospital de Santa Maria, Lisbon, Portugal, CHULN.
FAU - Costa-Reis, Patricia
AU  - Costa-Reis P
AD  - Pediatric Rheumatology Unit, Hospital de Santa Maria, Lisbon, Portugal, CHULN.
LA  - eng
PT  - Case Reports
PT  - Journal Article
TT  - Juvenile systemic lupus erythematosus triggered by Lamotrigine.
PL  - Portugal
TA  - ARP Rheumatol
JT  - ARP rheumatology
JID - 9918402287906676
RN  - 0 (Antibodies, Antinuclear)
RN  - 0 (Anticonvulsants)
RN  - 0 (anti-dsDNA autoantibody)
RN  - U3H27498KS (Lamotrigine)
SB  - IM
MH  - Adolescent
MH  - Antibodies, Antinuclear
MH  - Anticonvulsants/therapeutic use
MH  - *Exanthema
MH  - Female
MH  - Humans
MH  - Lamotrigine/adverse effects
MH  - *Lupus Erythematosus, Systemic/chemically induced
EDAT- 2022/07/11 06:00
MHDA- 2022/07/14 06:00
CRDT- 2022/07/10 07:32
PHST- 2022/07/10 07:32 [entrez]
PHST- 2022/07/11 06:00 [pubmed]
PHST- 2022/07/14 06:00 [medline]
AID - CE210455 [pii]
PST - ppublish
SO  - ARP Rheumatol. 2022 Apr-Jun;1(2):181-182.