Abstracts

Levetiracetam (LEV) is a broad spectrum antiepileptic drug with a favourable safety profile. Haematological side effects including leucopenia and thrombocytopenia are rare, but are potentially serious. This is the first report of a patient who developed reversible trombocytopathia secondary to LEV use., A 57 year-old female with generalized tonic-clonic seizures of unknown etiology since the age of 31 developed marked ecchymoses 1 month after initiation of LEV. The ecchymoses remained as long as she was taking LEV (13 months), but disappeared immediately after cessation of the drug. The patient did not use any other drugs, was otherwise healthy, had never had any haematological diseases or bleeding predisposition before, and there was no family history of such., The platelet count was unchanged during LEV treatment with 244, 276 and 275 x 10⁹/l before, during and after LEV treatment. Bleeding time on LEV treatment, however, was pathologically increased to 12 min (normal value 3-10), compared to 7.5 min without drug. Screening for other haematological parameters including coagulation factors VIII, IX, Von Willebrand factor, Ristocetin Co., white blood cell count, and general haematology was normal., This is the first report of LEV induced thrombocytopathia with increased bleeding time and ecchymoses without thrombocytopenia. Most likely, there has been a direct effect of the drug on trombocyte function. Alternatively, an effect on endothelial cells or vessel wall fragility can not be ruled out.,