Iannetti P, Raucci U, Zuccaro P, Pacifici R
Chair of Pediatrics (VII), La Sapienza University, Rome, Italy.
Epilepsia. 1998 May;39(5):502-7. doi: 10.1111/j.1528-1157.1998.tb01412.x.
To evaluate the effect of lamotrigine (LTG) on several humoral and cellular immune functions in children with epilepsy and the change in immunological status in patients with LTG-induced rash.
Sixteen children with epilepsy of unknown origin or secondary to various etiologies undergoing treatment with LTG participated in the humoral and cellular immunological study. Of these, 2 patients developed a rash during LTG treatment and are described in detail.
No modifications of humoral or cellular immunity (measured at 1 and 3 months) were noted in 14 of the 16 patients during this treatment. In the 2 children who manifested rash, basal immune function was normal. In both, immediately after the skin rash appeared, there was a high increase in the percentage of activated T-helper lymphocytes (CD4-DR) and activated T-suppressor lymphocytes (CD8-DR), a slight increase in percentage of B lymphocytes (CD19), and a greater increase in serum concentration of IgE. In 1 of the 2 patients, reevaluation of immunity 20 days after the rash appeared and after LTG suspension showed normal percentages of CD4-DR, CD8-DR, and CD19, whereas the serum concentration of IgE had decreased.
The observed immunological results indicate that LTG-induced rash may be considered an immune-mediated hypersensitivity reaction.
评估拉莫三嗪（LTG）对癫痫患儿多种体液免疫和细胞免疫功能的影响，以及LTG诱发皮疹患者免疫状态的变化。
16例病因不明或继发于各种病因的癫痫患儿接受LTG治疗，参与体液免疫和细胞免疫研究。其中，2例患者在LTG治疗期间出现皮疹，并进行详细描述。
16例患者中有14例在治疗期间（1个月和3个月时测量）体液免疫或细胞免疫无改变。在出现皮疹的2例患儿中，基础免疫功能正常。在这2例患儿中，皮疹出现后，活化辅助性T淋巴细胞（CD4-DR）和活化抑制性T淋巴细胞（CD8-DR）百分比均大幅升高，B淋巴细胞（CD19）百分比略有升高，血清IgE浓度升高更明显。在这2例患者中的1例，皮疹出现20天后且停用LTG后重新评估免疫功能，结果显示CD4-DR、CD8-DR和CD19百分比正常，而血清IgE浓度已下降。
观察到的免疫学结果表明，LTG诱发的皮疹可能被视为免疫介导的超敏反应。
