606 Case Report: Hypogammaglobulinemia Induced by Oxcarbazepine

BACKGROUND: Case report: A 6 year old girl with history of motor learning disability of unknown cause in treatment with Oxcarbazepine since December 2008 for epilepsy. CONCLUSIONS: No previous infection history, on July 2009 presents a septic shock secondary to Haemophilus influenzae pneumonia. During hospitalization blood exams reveal; low IgG (356 mg/dL) with normal IgA/IgM levels. T cell populations in normal range LTCD3: 74.9% (2476 cells/mm(3)), LTCD4: 47% (1562 cells/mm(3)), LTCD8: 28% (930 cells/mm(3)), CD56: 22.9% (758 cells/mm(3)) and B cell number frankly diminished CD19:1.1% (38 cells/mm(3) (normal values range 200–1600 cells/mm(3))). IVIG treatment was indicated. The diagnosis of common variable immunodeficiency (CVID) induced by Oxcarbazepine was proposed. According to literature reports this cases should be controlled by immunoglobulin monthly quantification, and they recover between 3 and 9 months after drug suspension. After IGIV therapy immunoglobulin quantification show: IgG 1041 mg/dL, IgA 78 mg/dL, IgM 103 mg/dL, with frankly IgG elevation. A second control after 2 months IGIV infusion shows IgG 834 mg/dL, IgA 54 mg/dL, IgM 75 mg/dL. The patient remains in good health with no infections after drug suspension. Her IgG levels and B cell (CD19) number returned to normal after 3 months (10.7% (271 cells/mm(3))). Posterior IgG controls are in normal range which shows a resolution of hypogammaglobulinemia.