Arsenovic Nebojsa, Sheehan Loraine, Clark David, Moreira Ricardo
Cellular Pathology Department, PathLinks Pathology Services, Lincoln County Hospital, Greetwell Road, Lincoln LN2 5QY, UK.
J Forensic Leg Med. 2010 Feb;17(2):57-61. doi: 10.1016/j.jflm.2009.07.021. Epub 2009 Aug 15.
The most severe adverse reactions to carbamazepine have been observed in the haemopoietic system, the liver and the cardiovascular system. A frequently fatal, although exceptionally rare side effect of carbamazepine is necrotizing eosinophilic (hypersensitivity) myocarditis. We report a case of hypersensitivity myocarditis secondary to administration of carbamazepine. Acute hypersensitivity myocarditis was not suspected clinically, and the diagnosis was made post-mortem. Histology revealed diffuse infiltration of the myocardium by eosinophils and lymphocytes with myocyte damage. Clinically, death was due to cardiogenic shock. To best of our knowledge this is the second case of fatal carbamazepine induced myocarditis reported in English literature.
卡马西平最严重的不良反应出现在造血系统、肝脏和心血管系统。卡马西平有一种虽极为罕见但常致命的副作用，即坏死性嗜酸性粒细胞性（超敏性）心肌炎。我们报告一例因服用卡马西平继发的超敏性心肌炎病例。临床上未怀疑有急性超敏性心肌炎，诊断是在尸检后做出的。组织学检查显示心肌有嗜酸性粒细胞和淋巴细胞弥漫性浸润，并伴有心肌细胞损伤。临床上，死亡原因是心源性休克。据我们所知，这是英文文献中报道的第二例卡马西平诱发的致命性心肌炎病例。
