Tor J, Rey C, Fernández-Sevilla T, Martí Vilalta J L
Med Clin (Barc). 1979 Dec 15;73(10):443-6.
A 20-year-old patient with previous history since 9 years of age of epileptic crises, was followed since then by anticonvulsivant therapy. Eight months before her admittance to the hospital ethosuximide was added to the anticonvulsivant treatment with good results. The development of fever, pain in the joints, and pleuropericarditis decided her admittance, being the clinical evaluation analytically and immunologically compatible with a systemic lupus erythematosus. The discontinuance of the anticonvulsivant medication determined at the end of the 3rd week the clinical and analytical recovery of the patient. The immunological study was normal after 3 months. The addition of other anticonvulsivant drugs, without having modified the normal condition of the patient, establishes a cause-effect relationship after the administration of ethosuximide. The infrequency of this observation is commented on, and the present knowledge of the possible mechanisms implicated in the drug-induction of a systemic lupus erythematosus is discussed.
一名20岁患者自9岁起就有癫痫发作史，此后一直接受抗惊厥治疗。入院前八个月，在抗惊厥治疗中加用了乙琥胺，效果良好。发热、关节疼痛和胸膜心包炎促使她入院，临床评估在分析和免疫方面与系统性红斑狼疮相符。在第3周末停用抗惊厥药物后，患者临床和分析指标恢复。3个月后免疫学研究结果正常。加用其他抗惊厥药物后患者情况未改变，而加用乙琥胺后出现上述情况，由此确立了因果关系。文中对该观察结果的罕见性进行了评论，并讨论了目前关于药物诱发系统性红斑狼疮可能机制的认识。
