INTRODUCTION The widespread use of carbamazepine in multiple neurological disorders makes it a drug whose most frequent side effects are well-known and controlled. Aplastic anaemia is a very rare side effect, although it is the most serious since it presents a high mortality rate.
CASE REPORT We report the case of a 51-year-old male patient who suffered brain injury that required daily treatment with 600 mg of carbamazepine. In the sixth month of treatment he was found to have a decrease in the number of platelets, which was confirmed a month later. He was admitted to hospital and diagnosed as having a medullar aplasia. Despite therapy with immunosuppressants, he died 12 weeks later.
DISCUSSION The appearance of aplastic anaemia does not seem to be related to age, the disease treated or to be dose-dependent. Most cases are seen 3-4 months after treatment and the risk period is the first year. The choice treatment is a bone marrow transplant in patients under the age of 50; in older patients the recommended treatment is immunosuppressant therapy. The early diagnosis of aplastic anaemia is essential, although the difficulty lies in determining how often haematological controls are to be performed, since some cases have appeared a few days after beginning treatment. The frequency of the controls must be based on the clinical judgement of the doctor with regular check-ups to detect haematological problems (infections, high temperature, ecchymosis) and to warn the patient and relatives should any of the symptoms appear.
KeywordsAnticonvulsive drugsAplastic anaemiaBone marrow transplantCarbamazepineColony-stimulating factorsImmunosuppressant drugs
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