LAMOTRIGINE HYPERSENSITIVITY IN CHILDHOOD EPILEPSY

Purpose: To evaluate the effect of lamotrigine (LTG) on several humora l and cellular immune functions in children with epilepsy and the chan ge in immunological status in patients with LTG-induced rash. Methods. Sixteen children with epilepsy of unknown origin or secondary to vari ous etiologies undergoing treatment with LTG participated in the humor al and cellular immunological study. Of these, 2 patients development a rash during LTG treatment and are described in detail. Results: No m odifications of humoral or cellular immunity (measured at 1 and 3 mont hs) were noted in 14 of the 16 patients during this treatment. In the 2 children who manifested rash, basal immune function was normal. In b oth, immediately after the skin rash appeared, there was a high increa se in the percentage of activated T-helper lymphocytes (CD4-DR) and ac tivated T-suppressor lymphocytes (CD8-DR), a slight increase in percen tage B lymphocytes (CD19), and a greater increase in serum concentrati on of IgE. In 1 of the 2 patients, reevaluation of immunity 20 days af ter the rash appeared and after LTG suspension showed normal percentag es of CD4-DR, CD8-DR, and CD19, whereas the serum concentration of IgE had decreased. Conclusions: The observed immunological results indica te the LTG-induced rash may be considered an immune-mediated hypersens itivity reaction.