Turk Kardiyol Dern Ars. 2012; 40(4): 358-360 | DOI: 10.5543/tkda.2012.70268

Lamotrigine related myocarditis: case report

Turan Bayhan¹, Murat Şahin², Işıl Yıldırım², Tevfik Karagöz^2
1Department of Pediatrics, Hacettepe University, Ankara, Turkey
²Department of Pediatric Cardiology, Hacettepe University, Ankara, Turkey

Myocarditis can develop secondary to several medications. Here, we report a case of myocarditis related to the use of lamotrigine. A 15-year-old boy was admitted to another hospital because of a chest pain that was sustained for 30 minutes. He was transferred to our hospital after detection of cardiac enzyme elevation. He was evaluated in our center, where electrocardiography revealed non-specific ST elevation at inferior derivations, and the level of troponin T was found to be 0.47 ng/ml (0-0.1), while creatinin kinase MB was found to be 38 ng/ml (0-4.97). Systolic cardiac functions were normal via echocardiography. Cardiac magnetic resonance imaging showed minimal pericardial effusion and a minimal decrease in left ventricular function. He was hospitalized with the diagnosis of myocarditis. Viral and bacterial agents that can cause myocarditis were excluded via serological tests. He had been on a lamotrigine treatment due to epilepsy, and after cessation of lamotrigine, his cardiac enzyme levels returned to normal. Therefore, we diagnosed him with drug related myocarditis due to lamotrigine. If an etiology cannot be found during the evaluation of a myocarditis case, drug hypersensitivity should be considered. Changing the responsible drug for hypersensitivity may be beneficial for these patients.

Keywords: Acute disease, cardiomyopathy/etiology, child, diagnostic imaging; heart failure; myocarditis/complications/diagnosis/etiology/therapy; troponin T

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