Pancytopenia and Stevens-Johnson syndrome induced by oxcarbazepine: A case report

Abstract

Oxcarbazepine (OXC), a commonly prescribed medication for focal and secondarily generalized seizure, has been associated with the development of pancytopenia in approximately 1% of patients. The incidence of Stevens-Johnson syndrome (SJS) in Han Chinese patients receiving OXC has been reported as 8 cases per 100,000 individuals annually. However, the simultaneous occurrence of both conditions is relatively rare. We report a case of pancytopenia and SJS induced by OXC. An 8-year-old Chinese female developed SJS after 9 days of initiating OXC therapy. On the 13th day of treatment, a complete blood count revealed pancytopenia. Prompt withdrawal of OXC, along with the administration of immunoglobulin, methylprednisolone, and supportive care, resulted in a favorable outcome with full recovery and restoration of normal hematological parameters. This case highlights the rare coexistence of pancytopenia and SJS induced by OXC in a single patient. Early diagnosis through heightened vigilance is crucial for achieving favorable outcomes. Prompt drug withdrawal and initiation of immunosuppressive treatments during the early phase can contribute to a good prognosis. Additionally, pre-exposure genetic testing and regular evaluation of the hematologic profile should be considered for patients undergoing OXC therapy.