Scientific Poster Session IV - Original Research

Original Research
  Tuesday, October 15, 2024
  08:30 AM–10:00 AM

Abstract

Introduction: Drug-induced leukocytosis is a potential adverse effect associated with the use of anticonvulsant medications. It is crucial to differentiate drug-induced leukocytosis from other potential causes, including infections or other underlying medical conditions, in order to promptly manage the underlying reaction. Several anticonvulsant medications have been associated with drug-induced leukocytosis, although the incidence and severity may vary among individuals.

Research Question or Hypothesis: To determine the incidence of leukocytosis associated with carbamazepine, lamotrigine, and phenobarbital.

Study Design: A comprehensive literature review was conducted with the assistance of a medical reference librarian on PubMed, MEDLINE, Embase, and Google Scholar through June 2023. Application of inclusion and exclusion criteria identified relevant reports to include in the review.

Methods: The following search terminology was applied: "leukocytosis/chemically induced"[MeSH Terms] AND ("Anticonvulsants"[MeSH Terms] OR ("Anticonvulsants"[Pharmacological Action] OR "Anticonvulsants"[MeSH Terms] OR "Anticonvulsants"[All Fields] OR "anticonvulsant"[All Fields] OR "anticonvulsion"[All Fields] OR "anticonvulsive"[All Fields] OR "anticonvulsives"[All Fields]) OR ("Anticonvulsants"[Pharmacological Action] OR "Anticonvulsants"[MeSH Terms] OR "Anticonvulsants"[All Fields] OR "antiepileptic"[All Fields] OR "antiepileptics"[All Fields])).

Results: Thirteen reports were included from 64 potential results of our literature review following the application of inclusion and exclusion criteria: seven of the reports involved carbamazepine, four of the reports involved lamotrigine, and two of the reports involved phenobarbital. Five of our studies presented patients with drug-induced hypersensitivity syndrome (DIHS), six of our studies presented patients with drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome, one study presented patients with pseudolymphoma syndrome (PLS), and one study presented a patient from lamotrigine overdose. The most common presenting diagnosis was DIHS and DRESS seen within 5-6 weeks of initiation of the offending agent. The final outcome after treatment included improvement in symptoms and resolution of leukocytosis in each report.

Conclusion: Clinicians should be judicious when evaluating leukocytosis in patients on potentially precipitating medications, including carbamazepine, lamotrigine, and phenobarbital.

Presenting Author

Samantha Sutton BSPS
University of Toledo

Authors

Lauren Csurgo BSPS
University of Toledo

Justin Reinert Pharm.D., MBA, BCCCP
University of Toledo