A RARE IDIOSYNCRATIC REACTION TO PHENYTOIN AND CARBAMAZEPINE – CASE REPORT

Abstract

Phenytoin and carbamazepine are the most widely used antiepileptics. This case report is about
rare idiosyncratic complication of long term use of phenytoin and carbamazepine induced
myelosuppression in tertiary care hospital, Vijayapur, Karnataka. We report a case of an 18-yearold female patient, known case of seizure disorder for 6years for which she was on phenytoin and
carbamazepine. The patient presented with complaints of nasal bleeding and fever. Peripheral
smear showing Pancytopenia (severe normocytic normochromic anemia with neutropenic
leucopenia). Bone tissue biopsy report showed Hypo cellular marrow suggestive of Aplastic
anemia. CT brain showing Leptomeningeal enhancement in parasagittal region of left parietal
lobe – suggestive of focal meningitis the patient was treated with broad-spectrum antibiotics,
antifungal, granulocyte colony stimulating factor, cyclosporine, and blood transfusion. Even after
best efforts the patient’s condition worsened and collapsed. So the life-threatening complication
like myelosuppression should be diagnosed early and appropriate management is the key in such
complications. Reporting of such cases is necessary to create awareness among the clinicians.