Organizing Pneumonia Associated With Anticonvulsant...

Bronchiolitis obliterans organizing pneumonia associated with anticonvulsant hypersensitivity syndrome induced by Lamotrigine Case Summary: A 14-year-old-girl known to have seizure disorder on Lamotrigine treatment admitted to the hospital with history of rash, fever and cough. Her condition deteriorated initially with typical clinical features of anticonvulsant hypersensitivity syndrome (ACHS) complicated with bronchiolitis obliterans organizing pneumonia (BOOP). Her chest computed tomography showed multifocal parenchymal opacities and the lung biopsy was typical for BOOP. The Lamotrigine was discontinued when she first developed the skin rash and she was treated with high dose of corticosteroid. She improved clinically and her repeated chest computed tomography showed marked resolution of the lesions. In the initial presentation she was treated for pneumonia with antibiotics which may have delayed the diagnosis. This case illustrates the possible occurrence of BOOP as a complication of ACHS secondary to Lamotrigine treatment. Background: BOOP is a rare lung condition in which the small airways (bronchioles and alveoli) become inflamed with connective tissue. BOOP can be secondary to infections, various drugs, and other medical conditions. In many cases, the underlying cause of BOOP is unknown. Anticonvulsant medications are widely used in pediatrics for different seizure disorders. ACHS is characterized by fever, rash and internal organ involvement. It is a rare, but