Pregabalin‐associated rhabdomyolysis

Gunathilake, Roshan; Boyce, Laura; Knight, Anne

doi:10.5694/mja13.10769

Cited by 16 publications

(15 citation statements)

References 5 publications

(7 reference statements)

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“…Several studies have reported that various AEDs may induce rhabdomyolysis [2,3]. In the literature, few adult patients have been reported, but there have been no reports in children [4,5].…”

Section: Sirmentioning

confidence: 97%

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Acute rhabdomyolysis associated with levetiracetam therapy in a child

et al. 2015

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Levetiracetam (LEV) is a new antiepileptic drug (AED)that is effective in adults and children with partial-onset seizures or idiopathic or symptomatic generalized seizures. LEV does not bind to plasma proteins, and is eliminated by the kidneys. It has been argued that LEV can act on the N-type Ca 2? channel and can reverse the gammaaminobutyric acid (GABA) and glycine-gated currents [1]. Side effects include fatigue, somnolence, infection, headache, behavioral changes and skin rashes [2]. Herein, we present the first case of rhabdomyolysis in a child treated with LEV.A 13-year-old girl presented with a history of myalgia (mainly in her lower extremities) since last 2-3 days to our hospital. She was born of an uneventful full-term pregnancy. Developmental milestones were normal. On medical history, she had partial onset of secondarily generalized seizures during sleep since 2 months. The seizure activity consisted of twitching of the right face, tonic deviation of the mouth involving the lips, tongue, and pharyngeal and laryngeal muscles, resulting in speech arrest and drooling and progressing into bilateral tonic stiffening of the arms and legs. The EEG revealed left centrotemporal spikes and was subsequently diagnosed with benign epilepsy with centrotemporal spikes. The patient was administered LEV monotherapy. LEV had started 10 mg/kg/day, but her brief partial seizures continued. The dose was increased to 20 mg/kg/day (500 mg/day), and her seizures were ceased. One week after starting LEV therapy, she experienced mild myalgia. On her examination, the vital signs, including the blood pressure were normal. Her height and weight were in normal limit for her age. The physical and neurological examinations were normal. There was no evidence of trauma, exercise or infection.On laboratory examination, blood urea was 29 mg/dL (normal range 17-43), creatinine 1.0 mg/dL (normal range 0.6-1.2), myoglobin 78 ng/mL (normal range 14.3-65.8), and creatinine phospho kinase (CPK) was 986 U/L (normal range 27-168). Plasma carnitine (42 lmol/L; reference range 19-59 lmol/L) and free carnitine levels (35 lmol/L; reference range 12-46 lmol/L) were normal as acylcarnitine profile. Brain MRI showed no abnormal findings.Rhabdomyolysis was diagnosed with clinical and biochemical findings. We thought LEV may be the cause of her complaints and ceased LEV therapy. Hydration therapy were started to avoid potential complications. After stopping LEV, serum CPK and myoglobin levels gradually decreased and returned into normal values. Muscle biopsy was not performed.

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Section: Sirmentioning

confidence: 97%

“…channel and can reverse the gammaaminobutyric acid (GABA) and glycine-gated currents [1]. Side effects include fatigue, somnolence, infection, headache, behavioral changes and skin rashes [2]. Herein, we present the first case of rhabdomyolysis in a child treated with LEV.…”

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confidence: 99%

Acute rhabdomyolysis associated with levetiracetam therapy in a child

et al. 2015

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“…1,2 Rhabdomyolysis has been reported with various antiepileptic drugs. 3,4 Overall, levetiracetam is considered a safe and well-tolerable antiepileptic commonly used for focal and generalized seizures. In recent years, there has been an increase in the reported cases of levetiracetam-associated rhabdomyolysis.…”

Section: Introductionmentioning

confidence: 99%

Levetiracetam Treatment-Associated Acute Rhabdomyolysis in an Adolescent

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et al. 2020

J Pediatr Intensive Care

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Etiology of rhabdomyolysis includes hereditary muscle enzyme deficiencies, trauma, viral infections, excessive exercise, hypothyroidism, and medications such as colchicine, lithium, and statins. Several studies have reported that various antiepileptic drugs may induce rhabdomyolysis. Levetiracetam is one of the antiepileptic drugs implicated in the etiology of rhabdomyolysis. Herein, we present a case of rhabdomyolysis in an adolescent treated with levetiracetam. We wanted to draw attention to the increasing trend of levetiracetam-associated rhabdomyolysis frequency in pediatric patients.

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“…These therefore tended to express more frequently in the elderly, which is consistent with previous reports. Indeed, in reports of pregabalin‐associated rhabdomyolysis (age 66, 75 and 70 years) and heart failure (age 84, 69 and 72 years), only elderly patients were affected. Thus, although the expression age of ADEs caused by pregabalin was almost similar, we identified a difference in that for the presence of some ADEs.…”

Section: Discussionmentioning

confidence: 99%