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. 2015 Jul 24:4:45-7.
doi: 10.1016/j.ebcr.2015.06.001. eCollection 2015.

Levetiracetam-induced pancytopenia

Talal Alzahrani  1 , Dana Kay  2 , Saeed A Alqahtani  3 , Yamane Makke  3 , Linda Lesky  2 , Mohamad Z Koubeissi  3
Affiliations

Levetiracetam-induced pancytopenia

Talal Alzahrani et al. Epilepsy Behav Case Rep. .

Abstract

Pancytopenia is a rare side effect of levetiracetam (LEV) that is associated with severe morbidity that requires hospitalization. Here, we report a patient with a right temporoparietal tumor who underwent a temporal craniotomy with resection of the mass and was started on LEV for seizure prophylaxis per the neurosurgery local protocol. The patient developed LEV-induced pancytopenia, which was successfully managed by discontinuation of this medication. Our report aims to increase awareness of this rare cause of pancytopenia among clinicians.

Keywords: Adverse effects; Glioblastoma multiforme; Levetiracetam; Pancytopenia.

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Figures

Fig. 1
Fig. 1
Blood smear showing lack of schistocytes and immature cell lines. Findings on blood smear correlate with absence of disseminated intravascular coagulation and thrombotic thrombocytopenic purpura and are suggestive of bone marrow suppression.
Fig. 2
Fig. 2
Graph depicting relationship between red blood cell count and hemoglobin and number of days postoperatively (POD). LEV was started on postoperative day 0 and was discontinued on postoperative day 10. The patient experienced an acute bleed requiring transfusion of 2 units of RBC on POD 5, followed by a steady decline in Hgb and RBC. Improvement in anemia was observed with discontinuation of the medication.
Fig. 3
Fig. 3
Graph depicting relationship between white blood cell count and number of days postoperatively (POD). LEV was started on postoperative day 0 and was discontinued on postoperative day 10. Development of leukopenia was witnessed with start of LEV, and improvement in leukopenia was observed with discontinuation of the medication.
Fig. 4
Fig. 4
Graph depicting relationship between platelet count and number of days postoperatively (POD). LEV was started on postoperative day 0 and was discontinued on postoperative day 10. Development of thrombocytopenia was witnessed with the start of LEV, and improvement in thrombocytopenia was observed with discontinuation of the medication.
See this image and copyright information in PMC

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