Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0019158 (hepatitis)
 30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Carbamazepine is widely used in the treatment of epilepsy and various neuralgias. Its most common side-effects are leukopenia and skin rash. Hepatic side-effects are rare, but serious and occasionally even fatal. A 72-year-old woman with toxic hepatitis due to carbamazepine is presented. We recommend monitoring liver function tests in every patient receiving this drug.
 ...
PMID:[Carbamazepine-associated hepatitis]. 207 67

Carbamazepine (CBZ) can produce serious side-effects such as hepatitis, LES, agranulocytosis, aplastic anaemia and skin eruptions. The latter, of polymorphous appearance (morbilliform, orticorioid and vesicular) depend on the levels of CBZ and retreat rapidly with the administration of prednisone. 2 cases of rash following introduction of the drug quickly resolved with its suspension are reported.
 ...
PMID:[Skin rash induced by carbamazepine. Description of 2 clinical cases]. 214 28

Carbamazepine is the drug of first choice in the treatment of simple and complex partial seizures and trigeminal and glossopharyngeal neuralgias. It is usually preferred to phenobarbitone or phenytoin because of its powerful antiepileptic activity combined with a relative lack of adverse effects. In this article the mechanisms of action and pharmacological properties of carbamazepine are outlined in order to explain the pathogenesis of most side and toxic effects. Most of these effects, namely those affecting the nervous or cardiovascular systems, correlate well with an increased concentration of the drug in plasma and disappear spontaneously upon discontinuation of therapy. Other, less frequent toxic effects, namely aplastic anaemia or fatal hepatitis, may be ascribed to unforeseeable idiosyncratic reactions. Carbamazepine poisoning, usually accidental and sometimes secondary to the coadministration of other drugs, yields a clinical picture with neurological and cardiovascular signs. The outcome is usually favourable, sometimes with spontaneous improvement, and death is a distinct rarity. No specific antidotes are available. The oral administration of activated charcoal has been shown to be an effective therapeutic measure significantly reducing the plasma half-life of the drug.
 ...
PMID:Carbamazepine toxicity and poisoning. Incidence, clinical features and management. 265 45

Carbamazepine is one of the drugs most widely prescribed for the treatment of trigeminal neuralgia and psychomotor seizures. Coincidentally with its use, hypersensitivity reactions to this agent have ben reported with increasing frequency. This report documents our recent encounter with 2 patients who developed hepatitis within one month of beginning carbamazepine therapy for temporal-lobe epilepsy. The occurrence of fever, skin rash and arthralgias suggest immunologic hypersensitivity as does eosinophilia and raised level of IgE, as seen in our patients. After withdrawal of the drug, symptoms and signs disappeared rapidly. We also describe a patient with psychomotor seizures who had ingested carbamazepine for less than 2 months before presenting with a febrile illness characterized by rash, arthritis, lymphadenopathy, epatosplenomegaly and diffuse pulmonary infiltrates with eosinophilia. The reaction cleared on cessation of the drug. Besides showing antinuclear antibody without DNA-precipitating antibody, this patient had an increased helper-T-cell count as well as a decreased number of T lymphocytes with suppressor activity. Taken together, these observations make it reasonable to speculate that carbamazepine may have interfered with lymphocyte triggering, thereby favouring the emergence of B cells with autoimmune propensities.
 ...
PMID:[Immuno-allergic side effects induced by the administration of carbamazepine. Case contribution]. 646 8

Three cases of carbamazepine-induced granulomatous hepatitis are reported. Each patient had ingested carbamazepine for less than 1 month before presenting with a febrile illness suggestive of biliary tract infection. After withdrawal of carbamazepine, symptoms disappeared rapidly. Histologically, all patients had granulomatous hepatitis. Two patients also had acute cholangitis. Carbamazepine-induced liver injury can be confused clinically and pathologically with biliary tract infection.
 ...
PMID:Granulomatous hepatitis secondary to carbamazepine. 724 30

Carbamazepine therapy is occasionally complicated by hypersensitivity reactions, the mechanism of which is poorly understood. It has been suggested that affected individuals may have a genetically-determined defect of microsomal epoxide hydrolase. The aim of this study was to determine whether a single genetic mutation or pattern of mutations could be used to predict individual susceptibility to carbamazepine-hypersensitivity. DNA was isolated from 10 carbamazepine-hypersensitive patients and 10 healthy volunteers. The patients had developed various forms of toxicity with carbamazepine, including toxic epidermal necrolysis, Stevens-Johnson syndrome, hepatitis and pneumonitis. The technique of polymerase chain reaction single-strand conformation polymorphism analysis (PCR-SSCP) was used to screen for mutations in all nine exons of the microsomal epoxide hydrolase gene. Any new mutations detected by this method were characterised by direct sequencing of the DNA. In addition, in the most severely affected patient, we sequenced all nine exons of the gene. There was a higher frequency of mutations in the hypersensitive group when compared with the controls, but there was no consistent mutation (or pattern of mutations) in the microsomal epoxide hydrolase gene which was common to the hypersensitive group. DNA sequencing of all nine exons of the microsomal epoxide hydrolase gene from the most severely affected patient showed the sequence to be "wild-type," when compared to the previously published sequences. The results of this study suggest that a single mutation within the coding region of the microsomal epoxide hydrolase gene cannot be the sole determinant of the predisposition to carbamazepine hypersensitivity.
 ...
PMID:Genetic analysis of microsomal epoxide hydrolase in patients with carbamazepine hypersensitivity. 750 83

Carbamazepine is a drug commonly used in the treatment of neuropathic pain. It is an iminostilbene derivative that is extensively metabolized by the liver. We describe a 66-year-old man with dysesthetic pain from cervical myelopathy who developed cholestatic hepatitis, skin rash, and eosinophilia after carbamazepine was administered for 5 weeks (total dose of 18.9gm). Withdrawal of carbamazepine led to complete resolution of both clinical and biochemical abnormalities within 3 weeks. Clinicians should be alert to this rare complication because it can be confused clinically with biliary tract sepsis and viral hepatitis.
 ...
PMID:Carbamazepine-induced hepatitis in a patient with cervical myelopathy. 860 Aug 77

Carbamazepine is a potent anticonvulsant agent with proven efficacy in the treatment of partial and tonic-clonic seizures. An epileptic child treated with therapeutic dosages of carbamazepine developed severe hepatitis and hepatic insufficiency. She had a positive response to withdrawal of the drug and administration of corticosteroids. The Roussel UCLAF method for estimating causality of the adverse event was applied for an acute hepatocellular problem, with a final score of 8. This method has advantages over other tools because it involves many clinical factors that give additional guides to clinicians in patients with liver injury, but it must be adapted for adverse events in the pediatric population.
 ...
PMID:Suspected carbamazepine-induced hepatotoxicity. 1003 Jul 80

(1) The reference treatment for mania is lithium. Lithium can be combined with a neuroleptic in patients who also have psychotic disorders (especially with aggressiveness). Carbamazepine is a second-line alternative. (2) Marketing authorisation has now been granted in France for disodium valproate (divalproate). (3) Disodium valproate is a complex composed of one molecule of sodium valproate and one molecule of valproic acid. Its effects are identical to those of valproate sodium. (4) The clinical file on disodium valproate mainly comprises two double-blind trials. In one trial involving 43 patients in whom lithium was ineffective or poorly tolerated, the efficacy of divalproate, measured using a validated scale, was significantly superior to that of the placebo. (5) The other trial, involving 179 patients, confirmed the efficacy of divalproate versus a placebo, and showed that divalproate was roughly as effective as lithium. (6) The efficacy of divalproate has not been compared with that of carbamazepine. It has not yet been demonstrated that carbamazepine remains effective when lithium is inadequate. (7) The adverse effect profile of divalproate mainly comprises gastrointestinal and neuropsychological disorders. A few cases of severe hepatitis and pancreatitis have also been reported. (8) In practice, in cases of lithium intolerance or inefficacy, divalproate is worth trying for patients with acute mania, before trying carbamazepine.
 ...
PMID:Disodium valproate: new preparation. An alternative for acute mania after lithium failure or intolerance. 1171 80

Some studies have suggested an ethnic susceptibility to Hypersensitivity Syndrome. We did a 7-year-prospective study in Guadeloupe whose population is mainly of African ancestry, and has free access to modern care facilities. Most patients included were Afro-Caribbeans (26/28), and females (20/28). However, ethnic distribution did not reach significant conclusions. Annual incidence rate was estimated at 0.9/100,000. Medium incubation and duration were 33 and 66 days respectively. Two patients with grade 4 hepatitis died from the syndrome. Two thirds of the patients were given prednisone, which usually alleviated the systemic symptoms, but did not prevent their development (in 5 patients) nor death. Carbamazepine, allopurinol, and minocycline accounted for 2/3 of the cases. Sixty four percent of the causative prescriptions were judged inappropriate. DHS appeared as the most frequent type of severe systemic drug reaction in this population, and may largely be prevented by rational prescribing.
 ...
PMID:Drug Hypersensitivity Syndrome in a West-Indian population. 1469 94


1 2 Next >>