Background

There are no prior cases in the literature that report immunoglobulins dropping secondary to oxcarbazepine use in an adolescent patient.

Case

This patient was an adolescent female taking buspirone, mirtazapine, and oxcarbazepine for mood stabilization. She was admitted to an inpatient disordered eating program for malnutrition. During her malnutrition evaluation, the patient was found to have low serum IgA, low IgM, and low-normal IgG. A slow wean of oxcarbazepine was initiated, and all immunoglobulins showed an increasing trend after stopping oxcarbazepine.

Discussion

Gabapentin was an added medication during hospitalization but is not known to affect immunoglobulins. Malnutrition is the only other significant factor that changed during the patient's hospital stay. With malnutrition alone, immunoglobulins are normal and IgA could be increased; this essentially rules out malnutrition and disordered eating as the cause of this patient's hypogammaglobulinemia, implicating oxcarbazepine as the cause.

Conclusion

Chronic oxcarbazepine use was the most likely cause of the hypogammaglobulinemia seen in this patient; this is not currently a reported side effect of oxcarbazepine. This case highlights the importance of judicious use of all medications given the risk of even rare potential side effects.

中文翻译：

---

青少年使用奥卡西平相关的低丙种球蛋白血症

背景

文献中没有报道青少年患者使用奥卡西平继发免疫球蛋白下降的病例。

案子

该患者是一名服用丁螺环酮、米氮平和奥卡西平以稳定情绪的青春期女性。她因营养不良而被送入住院饮食失调计划。在她的营养不良评估期间，发现患者血清 IgA 低、IgM 低和 IgG 低正常。奥卡西平开始缓慢撤药，停奥卡西平后所有免疫球蛋白均呈上升趋势。

讨论

加巴喷丁是住院期间添加的药物，但不知道会影响免疫球蛋白。营养不良是患者住院期间唯一改变的其他重要因素。仅营养不良，免疫球蛋白正常，IgA可能升高；这基本上排除了营养不良和饮食失调是该患者低丙种球蛋白血症的原因，暗示奥卡西平是原因。

结论

长期使用奥卡西平是该患者出现低丙种球蛋白血症的最可能原因；这不是目前报告的奥卡西平的副作用。考虑到甚至罕见的潜在副作用的风险，这个案例强调了明智使用所有药物的重要性。