Abstract
Lamotrigine (LTG), a wide spectrum antiepileptic drug, is considered effective in partial or generalized seizure disorders. Usually LTG is well tolerated in children and adults. The most frequent adverse events include somnolence, rash and episodes of transitory diplopia. There have been only a few sporadic reports on haematological side effects, including agranulocytosis, neutropenia, thrombocytopenia and asymptomatic disseminated intravascular coagulation. We report on a 4-year-old girl developing severe thrombocytopenia (22/nl) without fever or rash within two weeks after administration of LTG as add-on therapy with valproic acid (VPA) and levetiracetam for treatment of partial seizures in another hospital. Shortly after discontinuation of VPA and LTG platelets rose to normal values. Since the patient was already receiving VPA for 7 months with normal platelet values, we believe LTG primarly responsible for this rare side effect – maybe due to the high starting dose of 0.5mg/kg LTG and the combination with VPA.
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