3142 Case Report: Hypogammaglobulinemia Induced by Oxcarbazepine

Tuesday, 6 December 2011
Poster Hall (Cancún Center)

Maria Angelica Marinovic, MD , Servicio de Alergia e Inmunologia, Hospital Clinico Universidad de Chile, Santiago, Chile

Rosario Rojas, MD , Servicio de Alergia e Inmunologia, Hospital Clinico Universidad de Chile, Santiago, Chile

Background: case report

Methods: case report

Results: case report

Conclusions:

A 6 years old girl with history of motor learning disability of unknown cause in treatment with Oxcarbazepine since December 2008 for epilepsy. No previous infection history, on July 2009 presents a septic shock secondary to Haemophilus influenzae pneumonia. During hospitalization blood exams reveal; low IgG (356mg/dl) with normal IgA/IgM levels.  T cell populations in normal range LTCD3: 74.9% (2476 cells/mm3), LTCD4: 47% (1562 cells/mm3), LTCD8: 28% (930 cells/mm3), CD56: 22.9% (758 cells/mm3) and B cell number frankly diminished CD19: 1.1% (38 cells/mm3 (normal values range 200-1600 cells/mm3)). IVIG treatment was indicated.

The diagnosis of common variable immunodeficiency (CVID) induced by Oxcarbazepine was proposed.

According to literature reports this cases should be controlled by immunoglobulin monthly quantification, and they recover between 3-9 months after drug suspension.

After IGIV therapy immunoglobulin quantification show: IgG 1041mg/dl, IgA 78mg/dl, IgM 103mg/dl, with frankly IgG elevation. A second control after 2 months IGIV infusion shows IgG 834mg/dl, IgA 54mg/dl, IgM 75mg/dl. The patient remains in good health with no infections after drug suspension. Her IgG levels and B cell (CD19) number returned to normal after three months (10.7% (271cells/mm3)). Posterior IgG controls are in normal range which shows a resolution of hypogammaglobulinemia.