Jung Gu Hyun, You Su Jeong
Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea.
Korean J Pediatr. 2019 Aug;62(8):312-316. doi: 10.3345/kjp.2019.00017. Epub 2019 Apr 11.
The major side effects of treatment with oxcarbazepine (OXC) are skin rash and hyponatremia. Hematologic side effects are reported rarely. The aim of this study was to investigate the rate and types of the hematologic side effects of OXC.
The medical records of 184 patients diagnosed with epilepsy or movement disorder and on OXC monotherapy, at the Department of Pediatrics of Inje University Sanggye Paik Hospital from July 2001 to July 2018, were retrospectively reviewed.
Of the 184 patients, 10 (5.4%) developed leukopenia in addition to pancytopenia and 2 (1.0%) developed pancytopenia. Leukopenia developed in 11 days to 14 years after OXC administration and was more frequent in males than in females (male vs. female, 9 vs. 1; Fisher exact test, P<0.05). Of the eight patients with leukopenia alone, 7 continued OXC treatment; 6 improved without intervention; 1 was lost to follow-up; and 1 received a reduced OXC dose, who improved after intervention. Pancytopenia developed within 2 months of initiation of OXC treatment. Both patients initially continued OXC. One improved within 1 month and continued treatment with OXC, but the other showed progression of the side effect, leading to the discontinuation of OXC and subsequent improvement within 1 month. There were no significant differences in the ages of the patients, OXC dose, and duration of OXC treatment between patients with and without these side effects of OXC (P >0.05, t -test).
OXC-induced leukopenia is not rare and may result in pancytopenia. Patients being treated with OXC should be regularly monitored for abnormal complete blood count profiles.
奥卡西平（OXC）治疗的主要副作用是皮疹和低钠血症。血液学副作用报道较少。本研究的目的是调查奥卡西平血液学副作用的发生率和类型。
回顾性分析2001年7月至2018年7月在仁济大学圣心白医院儿科诊断为癫痫或运动障碍且接受奥卡西平单药治疗的184例患者的病历。
184例患者中，10例（5.4%）除全血细胞减少外还出现白细胞减少，2例（1.0%）出现全血细胞减少。白细胞减少发生在奥卡西平给药后11天至14年，男性比女性更常见（男性对女性，9例对1例；Fisher精确检验，P<0.05）。仅白细胞减少的8例患者中，7例继续奥卡西平治疗；6例未经干预改善；1例失访；1例减少奥卡西平剂量，干预后改善。全血细胞减少发生在奥卡西平治疗开始后2个月内。两名患者最初均继续使用奥卡西平。1例在1个月内改善并继续使用奥卡西平治疗，但另1例副作用进展，导致停用奥卡西平，随后在1个月内改善。有或无奥卡西平这些副作用的患者在年龄、奥卡西平剂量和奥卡西平治疗持续时间方面无显著差异（P>0.05，t检验）。
奥卡西平引起的白细胞减少并不罕见，可能导致全血细胞减少。接受奥卡西平治疗的患者应定期监测全血细胞计数异常情况。
