Lamotrigine-induced lupus

A 57-year-old woman was under treatment for epilepsy with lamotrigine 2 mg/ kg/d since 1996. In April 1998 she was admitted to the Rheumatology Unit fo r arthralgias affecting the small joints of the hands, wrists and knees, er ythematosus skin rash and myalgias. She referred a vascular abnormality at the hands exposed to cold, compatible with Raynaud's phenomenon. Serum anti nuclear antibodies (ANA) were positive (1:320, speckled pattern); moreover, a positivity for anti-Ro/SSA was observed. Rheumatoid factor was negative, serum complement was normal. LAC and anticardiolipin antibodies were negat ive. Drug-related lupus diagnosis was made with resolution of symptoms and gradual normalisation of positivity of ANA and anti-Ro/SSA upon lamotrigine withdrawal. To our knowledge, this is the first case report of an associat ion between lamotrigine and the onset of SLE (systemic lupus erythematosus) .