PURE RED-CELL APLASIA DURING CARBAMAZEPINE MONOTHERAPY

A 7-year-old girl developed pure red cell aplasia during carbamazepine (CBZ) monotherapy for epilepsy. She developed generalized clonic conv ulsions at the age of 7 years and 8 months. Treatment with CBZ was beg un. Two months later she was admitted to our hospital because of sever e anemia. Bone marrow examination revealed the almost complete absence of erythroblasts, with normal myelopoiesis and megakaryocytopoiesis, indicating pure red cell aplasia. Following the discontinuation of CBZ , she developed brisk reticulocytosis within 1 week and her hemoglobin level rose to a normal one within 1 month. Although the hematological toxicity of CBZ is well documented, isolated cessation of red cell pr oduction is uncommon. A patient who is undergoing treatment with CBZ s hould be carefully monitored, especially for serious adverse reactions including pure red cell aplasia. (C) 1997 Elsevier Science B.V.