Abstracts

Lamotrigine (LTG) is an effective and widely used treatment for epilepsy. It is FDA approved as adjunctive therapy for partial seizures and for conversion to monotherapy. Commonly occurring adverse events (AEs) associated with the use of LTG include dizziness, somnolence, diplopia and headache. There is little in the literature discussing the development of SLE following exposure to LTG.
Two female patients in the Adult Epilepsy Clinic of the Penn State Milton S. Hershey Medical Center were exposed to LTG and subsequently developed SLE. The average duration of exposure was 10 weeks and the average dose of LTG was 200 mg/day. Both patients were under age 32. A third female patient, age 36, also developed a lupus-like syndrome, but her serology was borderline.
Both patients presented with complaints of arthralgias, edema and malaise. LTG was tapered. Serological studies were positive for ANA titers and antihistone antibody. Treatment with Prednisone was instituted with resolution of symptoms. Follow up titers demonstrated no persistence of an autoimmune disorder.
LTG, a widely used and effective therapy for epilepsy, caused SLE in two female patients and produced symptoms with borderline serology in a third. Two patients developed their symptoms within eight weeks of exposure to LTG. Careful monitoring of patients for symptoms consistent with autoimmune disease is crucial.