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International Journal of Clinical Pharmacy

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01-10-2015 | Case Report

Rash and multiorgan dysfunction following lamotrigine: could genetic be involved?

Authors: Alessio Provenzani, Manuela Labbozzetta, Monica Notarbartolo, Paola Poma, Piera Polidori, Giovanni Vizzini, Natale D’Alessandro

Published in: International Journal of Clinical Pharmacy | Issue 5/2015

Abstract

Case (description)

We report the case of a 38-year-old woman treated with lamotrigine who experienced multi-organ dysfunction. The patient received the drug at the dose of 100 mg per day. One week later, the treatment was suspended because of an extensive body rash. Twenty-four hours later, the patient appeared drowsy and stuporous and was hospitalized. On the fifth day, the patient was admitted with a clinical picture of acute multi-organ failure in our Institute, where, she, despite the support of vital functions with vasoactive drugs, continuous hemofiltration and ventilation with oxygen, died. Serum lamotrigine concentration was measured 110 h after its last dose and the drug resulted to be still present at 1 mg/L. The patient was homozygous for the UGT1A4-70C and UGT2B7-161C alleles and heterozygous for the UGT2B7-372A>G polymorphism. Regarding ABCB1 the patient showed the 3435CC, 2677GT and 1236CT genotypes.

Conclusion

Our results may suggest a role of the UGT2B7-372A>G polymorphism in this reaction.

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Title: Rash and multiorgan dysfunction following lamotrigine: could genetic be involved?
Authors: Alessio Provenzani
Manuela Labbozzetta
Monica Notarbartolo
Paola Poma
Piera Polidori
Giovanni Vizzini
Natale D’Alessandro
Publication date: 01-10-2015
Publisher: Springer Netherlands
Published in: International Journal of Clinical Pharmacy / Issue 5/2015
Print ISSN: 2210-7703
Electronic ISSN: 2210-7711
DOI: https://doi.org/10.1007/s11096-015-0158-4

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