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Perampanel-Induced, New-Onset Thrombocytopenia in a Patient With Refractory Seizures: A Case Report

Perampanel (Fycompa) is a glutamate receptor antagonist known to be a safe, effective, and well-tolerated medication; nevertheless, adverse effects are possible. This case report aims to raise the suspicion of perampanel-induced thrombocytopenia and discuss its possible pathways implicated. Here, we...

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Autores principales: Almuhanna, Rakan A, Muddassir, Rabia, Almaghrabi, Murouj, Bokhari, Gadir, Al-Ghamdi, Abdulazuiz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10195002/
https://www.ncbi.nlm.nih.gov/pubmed/37213988
http://dx.doi.org/10.7759/cureus.37781
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author Almuhanna, Rakan A
Muddassir, Rabia
Almaghrabi, Murouj
Bokhari, Gadir
Al-Ghamdi, Abdulazuiz
author_facet Almuhanna, Rakan A
Muddassir, Rabia
Almaghrabi, Murouj
Bokhari, Gadir
Al-Ghamdi, Abdulazuiz
author_sort Almuhanna, Rakan A
collection PubMed
description Perampanel (Fycompa) is a glutamate receptor antagonist known to be a safe, effective, and well-tolerated medication; nevertheless, adverse effects are possible. This case report aims to raise the suspicion of perampanel-induced thrombocytopenia and discuss its possible pathways implicated. Here, we present the case of a 66-year-old female patient with a generalized tonic-clonic seizure initially managed with levetiracetam, valproic acid, and lacosamide; however, the patient continued to have seizures clinically as well as on the electroencephalogram. The patient was initiated on 2 mg of perampanel and reached up to 12 mg within a week, after which the seizure was controlled. Nevertheless, after perampanel initiation, a gradual platelet count reduction was observed. Upon withdrawal of perampanel, the platelet count dramatically improved reaching up to her baseline. Although perampanel is known to be a safe medication, a hematological complication such as thrombocytopenia is possible. The exact mechanism remains unclear. Further studies are required to understand the association between thrombocytopenia and perampanel to identify high-risk populations and prevent this condition sequentially.
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spelling pubmed-101950022023-05-19 Perampanel-Induced, New-Onset Thrombocytopenia in a Patient With Refractory Seizures: A Case Report Almuhanna, Rakan A Muddassir, Rabia Almaghrabi, Murouj Bokhari, Gadir Al-Ghamdi, Abdulazuiz Cureus Internal Medicine Perampanel (Fycompa) is a glutamate receptor antagonist known to be a safe, effective, and well-tolerated medication; nevertheless, adverse effects are possible. This case report aims to raise the suspicion of perampanel-induced thrombocytopenia and discuss its possible pathways implicated. Here, we present the case of a 66-year-old female patient with a generalized tonic-clonic seizure initially managed with levetiracetam, valproic acid, and lacosamide; however, the patient continued to have seizures clinically as well as on the electroencephalogram. The patient was initiated on 2 mg of perampanel and reached up to 12 mg within a week, after which the seizure was controlled. Nevertheless, after perampanel initiation, a gradual platelet count reduction was observed. Upon withdrawal of perampanel, the platelet count dramatically improved reaching up to her baseline. Although perampanel is known to be a safe medication, a hematological complication such as thrombocytopenia is possible. The exact mechanism remains unclear. Further studies are required to understand the association between thrombocytopenia and perampanel to identify high-risk populations and prevent this condition sequentially. Cureus 2023-04-18 /pmc/articles/PMC10195002/ /pubmed/37213988 http://dx.doi.org/10.7759/cureus.37781 Text en Copyright © 2023, Almuhanna et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Almuhanna, Rakan A
Muddassir, Rabia
Almaghrabi, Murouj
Bokhari, Gadir
Al-Ghamdi, Abdulazuiz
Perampanel-Induced, New-Onset Thrombocytopenia in a Patient With Refractory Seizures: A Case Report
title Perampanel-Induced, New-Onset Thrombocytopenia in a Patient With Refractory Seizures: A Case Report
title_full Perampanel-Induced, New-Onset Thrombocytopenia in a Patient With Refractory Seizures: A Case Report
title_fullStr Perampanel-Induced, New-Onset Thrombocytopenia in a Patient With Refractory Seizures: A Case Report
title_full_unstemmed Perampanel-Induced, New-Onset Thrombocytopenia in a Patient With Refractory Seizures: A Case Report
title_short Perampanel-Induced, New-Onset Thrombocytopenia in a Patient With Refractory Seizures: A Case Report
title_sort perampanel-induced, new-onset thrombocytopenia in a patient with refractory seizures: a case report
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10195002/
https://www.ncbi.nlm.nih.gov/pubmed/37213988
http://dx.doi.org/10.7759/cureus.37781
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