Drug-induced pseudolymphoma secondary to lamotrigine

Abstract

Pseudolymphoma is a drug-induced syndrome that can be confused with true lymphoma. Lamotrigine is a phenyltriazine derivative used as a broad-spectrum antiepileptic drug for both partial and generalized seizures. It is generally well tolerated, but a skin rash can occur in at least 3% of patients. We report a patient with pseudolymphoma induced by lamotrigine. A 35-year-old man with Lennox-Gastaut syndrome, which began at age 4 years, had multiple seizure types, including generalized tonic clonic, tonic, myoclonic, and atypical absence. He had no history of allergy or drug reaction. Because seizures were intractable on a combination of valproic acid 2,000 mg, carbamazepine 1,200 mg, and clobazam 60 mg daily, lamotrigine was started at 25 mg per day as replacement for carbamazepine. The dose was increased to 200 mg per day over 12 weeks, with a modest reduction in seizures. Fourteen weeks after lamotrigine was introduced and 2 weeks after the last dose increase of 25 mg, the …