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Acute hepatic failure in a child treated with lamotrigine
R Arnon1, D DeVivo, A R Defelice
1Department of Pediatrics, Columbia University School of Medicine, New York, New York 10032, USA.
Insights
Lamotrigine, an epilepsy medication, may cause acute liver failure in children. Careful liver function monitoring is recommended during treatment to prevent severe adverse events.
Area of Science:
- Pediatric Neurology
- Hepatology
- Clinical Pharmacology
Background:
- Epilepsy is a common neurological disorder in children requiring long-term medication.
- Lamotrigine is a widely prescribed antiepileptic drug.
- Drug-induced liver injury is a significant concern in pediatric pharmacotherapy.
Observation:
- An 8-year-old boy with a seizure disorder treated with lamotrigine presented with acute hepatic failure.
- Clinical signs included jaundice, elevated liver enzymes, and coagulopathy.
- The patient had no prior history of liver disease.
Findings:
- Discontinuation of lamotrigine and supportive care led to an uneventful recovery.
- The acute hepatic failure was strongly suspected to be secondary to lamotrigine administration.
- This case highlights a rare but serious adverse effect of lamotrigine.
Implications:
- Clinicians should maintain a high index of suspicion for drug-induced liver injury in children on lamotrigine.
- Regular monitoring of liver function tests is crucial for early detection of hepatotoxicity.
- This case underscores the importance of pharmacovigilance in identifying potential drug safety issues in pediatric populations.
Abstract:
An 8-year-old boy with a known seizure disorder that was being treated with lamotrigine developed acute hepatic failure. The patient, who had been well previously, presented with jaundice, elevated liver enzymes, and a coagulopathy. After discontinuation of lamotrigine and aggressive resuscitation, the patient made an uneventful recovery. We believe that the hepatic failure in our patient was secondary to the use of lamotrigine. We recommend careful monitoring of liver function when lamotrigine is administered.