Ethosuximide induced lymphadenopathy--a case report

Area of Science:

• Neurology
• Pharmacology
• Pediatrics

Background:

• Anticonvulsant drugs are widely used for seizure disorders.
• Prolonged use of certain anticonvulsants, such as ethosuximide, is associated with various adverse effects.
• Commonly reported side effects of ethosuximide include gastrointestinal issues, psychiatric changes, and Systemic Lupus Erythematosus (SLE), with rare occurrences of hematological abnormalities like leukopenia and pancytopenia.

Observation:

• A 12-year-old female patient with simple absence seizures was treated with ethosuximide.
• The patient developed generalized lymphadenopathy, progressive weight loss, and leukopenia during prolonged ethosuximide therapy.
• Lymph node enlargement regressed upon ethosuximide withdrawal and reappeared upon its reintroduction.

Findings:

• The case demonstrates a potential link between ethosuximide use and drug-induced lymphadenopathy with leukopenia.
• Histopathological examination of lymph node biopsy revealed marked reactive hyperplasia.
• Discontinuation of ethosuximide and substitution with sodium valproate successfully controlled seizures and resolved lymphadenopathy and leukopenia.

Implications:

• This case highlights the importance of considering drug-induced adverse effects in patients presenting with unexplained lymphadenopathy and hematological changes.
• Clinicians should be vigilant for rare side effects of ethosuximide, including lymphoproliferative responses.
• Further investigation into the mechanisms of ethosuximide-induced lymphadenopathy may be warranted.