Periportal necrosis and successful liver transplantation following Lamotrigine drug-induced liver injury in a child.

Autor:	Couper MR; Liver unit, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK., Brown RM; Histopathology, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK., Nath S; Paediatric division, Royal Cornwall Hospitals NHS Trust, Truro, UK., Parida A; Neurology, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK., Kelgeri C; Liver unit, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK chayarani.kelgeri@nhs.net.
Jazyk:	angličtina
Zdroj:	BMJ case reports [BMJ Case Rep] 2023 Nov 24; Vol. 16 (11). Date of Electronic Publication: 2023 Nov 24.
DOI:	10.1136/bcr-2023-255787
Abstrakt:	Lamotrigine is one of the most prescribed antiepileptics in children and a well-known cause of drug-induced liver injury (DILI). The typical presentation usually includes a drug rash with eosinophilia and systemic symptoms (DRESS syndrome). Cases are typically mild and self-limiting, requiring supportive care only. We report a severe Lamotrigine-induced DILI with a non-typical presentation with hyperammonaemia and rapid clinical deterioration. We present a literature review exploring contributing factors, transplant considerations and liver histology. Histology showed periportal necrosis, which is recognised as a pattern of DILI but has not been previously described with Lamotrigine. Our patient proceeded to transplant and is the first reported liver transplant for Lamotrigine DILI in a child. A directed and rapid diagnostic approach is crucial to avoid delays and rule out multisystemic metabolic and genetic conditions that preclude liver transplantation. Competing Interests: Competing interests: None declared. (© BMJ Publishing Group Limited 2023. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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