Lacosamide-induced sinus node dysfunction followed by severe agranulocytosis
Open Access
- 8 June 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Neurology
- Vol. 21 (1), 1-5
- https://doi.org/10.1186/s12883-021-02253-1
Abstract
Background Lacosamide (LCM) is the antiepileptic drug approved by the U.S. Food and Drug Administration in 2008 that facilitates slow activation of the voltage-gated sodium channels. Neutropenia and cardiac events including sinus node dysfunction (SND) and atrioventricular block have been previously reported as adverse effects of LCM. To date, there have been no reports of severe agranulocytosis resulting in death associated with LCM. Additionally, there have been no reports of concomitant SND and agranulocytosis after LCM administration. Herein we report the first case of LCM-induced severe SND followed by agranulocytosis. Case presentation The patient with focal epilepsy was initiated on LCM 100 mg/day and the dose was increased to 200 mg/day on the 9th hospital day. Severe SND developed on the 10th hospital day and LCM was discontinued. Thereafter agranulocytosis appeared on the 11th hospital day, and the patient died from septic shock on the 15th hospital day. Conclusions This case illustrates the need for careful follow-up of the electrocardiogram and the complete blood cell counts when initiating LCM. Moreover, it should be noticed that various side effects may occur simultaneously in the early period of LCM use, even for a short time and at low dosages.This publication has 22 references indexed in Scilit:
- Long-term retention of lacosamide in a large cohort of people with medically refractory epilepsy: A single centre evaluationEpilepsy Research, 2013
- Long‐term safety and efficacy in patients with uncontrolled partial‐onset seizures treated with adjunctive lacosamide: Results from a phase III open‐label extension trialEpilepsia, 2012
- Lacosamide-induced second-degree atrioventricular block in a patient with partial epilepsyEpilepsia, 2011
- Atrioventricular block following lacosamide intoxicationEpilepsy & Behavior, 2011
- Idiosyncratic drug-induced agranulocytosis or acute neutropeniaCurrent Opinion in Hematology, 2008
- The Investigational Anticonvulsant Lacosamide Selectively Enhances Slow Inactivation of Voltage-Gated Sodium ChannelsMolecular Pharmacology, 2007
- Efficacy and Safety of Oral Lacosamide as Adjunctive Therapy in Adults with Partial‐Onset SeizuresEpilepsia, 2007
- The Ictal Bradycardia Syndrome: Localization and LateralizationEpilepsia, 2006
- Population-Based Drug-Induced AgranulocytosisArchives of Internal Medicine, 2005
- Neutropenia and agranulocytosis in England and Wales: Incidence and risk factorsAmerican Journal of Hematology, 2003