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A Case of Pure Red Cell Anemia Complicated by Antiepileptic Drugs

Journal of the Korean Pediatric Society 1999;42(2):264-267.
Published online February 15, 1999.
A Case of Pure Red Cell Anemia Complicated by Antiepileptic Drugs
Hyunmi Kim1, Sang Gyu Park1, Sung Ryeul Kim2
1Department of Pediatrics, Ulsan University Hospital, Ulsan, Korea
2Department of Clinical Pathology, Ulsan University Hospital, Ulsan, Korea
복잡부분간질 소아에서 항경련제 병합요법중 합병된 진성적혈구계 빈혈(Pure Red Cell Anemia) 1례
김현미1, 박상규1, 김성률2
1울산대학교 의과대학 소아과학교실
2울산대학교 의과대학 임상병리학교실
A 12-year-old boy developed pure red cell anemia(PRCA) during a combination therapy of antiepileptic drugs(AEDs) for epilepsy. His complex partial seizure was intractable to monotherapy. During 7 months of treatment, he was treated with Vigabatrin, Carbamazepine and Valproate. While switching from Carbamazepine to Valproate, he presented anemia but with no jaundice. His hemoglobin was 4.1g/dl bone-marrow biopsy revealed erythroid hypoplasia with normal myelopoiesis and megakaryocytopoiesis, indicating PRCA. Rapid recovery from PRCA was observed 1 month after discontinuation of Valproate, without immunosuppressive therapy. Although the hematologic toxicity of AEDs is well documented, isolated cessation of red cell production is uncommon. Our observation suggests that the synergistic toxicity caused by Valproate and Carbamazepine may induce PRCA through the inhibitory effect beyond the differentiation stage of BFU-E and CFU-E.
Key Words: Valproate, Carbamazepine, Pure red cell anemia

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