Acute granulomatous interstitial nephritis and colitis in anticonvulsant hypersensitivity syndrome associated with lamotrigine treatment

We present the case of a 17-year-old woman with a history of bipolar disord er, who developed a clinical syndrome manifested by fever, lymphadenopathy, skin rash, diarrhea, and acute renal failure requiring dialysis after the use of lamotrigine. Renal biopsy showed acute interstitial nephritis (AIN) with focal granulomas, Similarly, colonic biopsy specimens showed colitis a nd ileitis with non-necrotizing epithelioid granulomas, The patient had a c omplete recovery after withdrawal of the medication and steroid treatment. Although lamotrigine has been previously implicated in the development of a nticonvulsant hypersensitivity syndrome, there have been no previous report s of acute granulomatous interstitial nephritis or colitis associated with the use of this drug. (C) 2000 by the National Kidney Foundation, Inc.