Oligohydrosis and fever in pediatric patients treated with zonisamide

Knudsen, James; Thambi, Lopa R.; Kapcala, Leonard P.; Racoosin, Judith A.

doi:10.1016/s0887-8994(02)00511-8

Cited by 46 publications

(20 citation statements)

References 8 publications

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“…The functional decrease of sweat glands may have resulted from complex intrinsic regulatory mechanisms triggered by the administration of topiramate, rather than by changes in nerve supply and periglandular neurotransimitters [41]. Here, we found that the absence of obvious structural defects in the size of the secretory coil suggesting that glands from hypohidrotic individuals, induced by topiramate, were not morphologically abnormal, but purely hypoactive, and further suggested that hypohidrosis resulted from metabolic conditions, such as neurohumoural or secretory cell metabolic abnormalities [42]. The decline of sweating after topiramate treatment may have resulted from a reduced responsiveness of mice induced by topiramate stimulation.…”

Section: Discussionmentioning

confidence: 56%

Effects of Topiramate on Mouse Eccrine Sweat Gland Responsiveness to Heat Exposure

Jiyu¹,

Huang²,

Deng³

et al. 2007

Basic Clin Pharma Tox

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Young mice (2 weeks old) were given topiramate daily for 1 month, and sudomotor function was evaluated utilizing impression mould techniques to determine the number of sweat glands reactive to heat exposure and sweat output per gland on the plantar surface of mice hind-paws. Immunohistochemical quantitation of protein gene product 9.5, choline acetyltransferase and tyrosine hydroxylase in footpads was determined after topiramate treatment. While a 25% decrease in the number of secreting sweat glands and a 42% decline in sweat output per gland were observed following topiramate treatment, no significant differences were noted in sudomotor innervation, expressed as length of choline acetyltransferase, tyrosine hydroxylase and protein gene product 9.5 immunoreactive nerve profiles in single secretory coils or in sweat gland sizes within the secretory coil area. Long-term topiramate stimulation resulted in a reduction in the number of reactive sweat glands, without changes in sweat gland innervation, suggesting that the diminished responsiveness of the glands to heat exposure induced by topiramate might have resulted from a decrease in the intrinsic regulatory activity of sweat glands, as opposed to the loss of periglandular neurotransmitters or the impairment of the structure of the glands. [12][13][14][15][16][17]. While the effect was reversible, and disappeared with the cessation of the treatment, the mechanism underlying this effect on sweating has not been fully elucidated. The ability of human beings to dissipate heat during exercise and in hot environments depends mainly on the evaporation of sweat secreted by eccrine sweat glands. Consequently, sweat production is essential for heat tolerance, preventing hyperthermia, and influences performance during physical activity [18]. Sweat glands are innervated by sympathetic postganglionic axons, which, in contrast to the ordinary sympathetic innervation, use acetylcholine as the principal neurotransmitter [19][20][21].In the current study, we investigated the effects of topiramate on the responsiveness of mouse eccrine sweat glands to heat exposure and evaluated sudomotor function utilizing silicone imprints, a method that allows accurate quantitation of sweat gland secretion repeatedly over time, and following different types of nerve lesions or treatments [22][23][24][25][26][27]. Additionally, immunolabelling was used to examine the effects of topiramate on choline acetyltransferase (ChAT) in cholinergic sudomotor nerves, tyrosine hydroxylase (TH) in noradrenalinergic nerves, as well as total innervation of sweat glands (protein gene product 9.5, PGP9.5) and sweat gland acinar size. The aim of this study was to investigate whether topiramate reduced the responsiveness of the glands to heat exposure in mice, and whether the effects on the eccrine sweat glands were related to changes in periglandular neurotransmitters and/or sweat gland structure. Materials and MethodsExperimental design. Animals were housed under standard conditions with water and foo...

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Section: Discussionmentioning

confidence: 56%

Effects of Topiramate on Mouse Eccrine Sweat Gland Responsiveness to Heat Exposure

Jiyu¹,

Huang²,

Deng³

et al. 2007

Basic Clin Pharma Tox

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“…Zonisamide, another anticonvulsant that also inhibits CA, has been shown to cause oligohidrosis and fever in pediatric patients (Okumura et al, 1996;Shimizu et al, 1997;Knudsen et al, 2003;Low et al, 2004). Topiramate decreased CA activity in mouse lung and tumor microvessel endothelial cells as well as expression of aquaporin (AQP)-1, a member of the aquaporin family of waterselective membrane pores (Ma et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

Topiramate reduced sweat secretion and aquaporin-5 expression in sweat glands of mice

Huang

Deng

et al. 2007

Life Sciences

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“…[379] The FDA's surveillance programme estimated the US incidence to be 13 cases per 10 000 paediatric-years of exposure, which is >10-fold the Japanese incidence of 1 case per 10 000 paediatric-years of exposure. [388,389] The FDA's surveillance programme has also been shown to significantly underestimate the true incidence of adverse events, suggesting a higher actual incidence in the US.…”

Section: Skinmentioning

confidence: 99%

The Safety and Tolerability of Newer Antiepileptic Drugs in Children and Adolescents

Sarco

Bourgeois

2010

CNS Drugs

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The newer antiepileptic drugs (AEDs) provide more therapeutic options and overall improved safety and tolerability for patients. To provide the best care, physicians must be familiar with the latest tolerability and safety data. This is particularly true in children, given there are relatively fewer studies examining the effects of AEDs in children compared with adults. Since we now have significant paediatric literature on each of these agents, we provide a comprehensive and current literature review of the newer AEDs, focusing on safety and tolerability data in children and adolescents. Because the safety profiles in children differ from those in adults, familiarity with this literature is important for child neurologists and other paediatric caregivers. We have organized the data by organ system for each AED for easier reference.

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Oligohydrosis and fever in pediatric patients treated with zonisamide

Cited by 46 publications

References 8 publications

Effects of Topiramate on Mouse Eccrine Sweat Gland Responsiveness to Heat Exposure

Effects of Topiramate on Mouse Eccrine Sweat Gland Responsiveness to Heat Exposure

Topiramate reduced sweat secretion and aquaporin-5 expression in sweat glands of mice

The Safety and Tolerability of Newer Antiepileptic Drugs in Children and Adolescents

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