Journal article
Evaluation of the Mechanisms of Antiepileptic Drug‐Related Chronic Leukopenia
Epilepsia (Copenhagen), v 35(1), pp 149-154
Jan 1994
PMID: 8112238
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Antiepileptic drug (AED)‐related chronic leukopenia [white blood cell (WBC) count <4,000/μl] is a dilemma, especially when the AED is effective in controlling seizures. We evaluated the possible mechanisms of leukopenia in 7 patients. Mean WBC count was 3,000/μ1 with a mean of 42% polymorphonuclear leukocytes (PMN). The AEDs were carbamazepine (CBZ) alone in 1 patient or CBZ combined with phenytoin (PHT), primidone (PRM), phenobarbital (PB) and/or valproate (VPA) in 5 patients; one patient was receiving PHT only. Bone marrow (BM) aspirates and PMN antibody studies using chemiluminescence were normal. Two liver‐spleen scans showed mild relative splenomegaly. After exercise, WBC count (n = 7) increased by 54% (SEM 12%), while the WBC counts in controls (n = 5) increased by 52 ±16%. Antinuclear antibodies (Hep‐2) were absent in 6 patients and positive (1:160) in 1. PMN adhesion to nylon wool was decreased (54 ±10% in patients vs. 80 ± 5% in controls: n = 13, p < 0.00s). Our data, particularly the appropriate WBC response to the stress of exercise, and normal BM examinations suggest that continuation of AED therapy when leukopenia is stable and the percentage of PMN is normal is probably safe. Caution should be used if the absolute PMN count is consistently <1,000/μl. BM examinations need not be performed routinely for every patient with neutropenia due to AEDs, especially if the leukopenia fluctuates in the range of 2,000–4,000 cells/μ1.
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Details
- Title
- Evaluation of the Mechanisms of Antiepileptic Drug‐Related Chronic Leukopenia
- Creators
- Carolyn Riester O'ConnorPaul L. Schraeder - Cooper University HospitalAlan H. Kurland - Rutgers, The State University of New JerseyWilliam H. O'Connor - Rutgers, The State University of New Jersey
- Publication Details
- Epilepsia (Copenhagen), v 35(1), pp 149-154
- Publisher
- Blackwell Publishing Ltd
- Number of pages
- 6
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Rheumatology; [Retired Faculty]
- Web of Science ID
- WOS:A1994MX30800021
- Scopus ID
- 2-s2.0-0028215249
- Other Identifier
- 991021955153504721
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- Web of Science research areas
- Clinical Neurology