International Journal of Clinical Pharmacy

, Volume 37, Issue 5, pp 682–686 | Cite as

Rash and multiorgan dysfunction following lamotrigine: could genetic be involved?

  • Alessio ProvenzaniEmail author
  • Manuela Labbozzetta
  • Monica Notarbartolo
  • Paola Poma
  • Piera Polidori
  • Giovanni Vizzini
  • Natale D’Alessandro
Case Report


Case (description)

We report the case of a 38-year-old woman treated with lamotrigine who experienced multi-organ dysfunction. The patient received the drug at the dose of 100 mg per day. One week later, the treatment was suspended because of an extensive body rash. Twenty-four hours later, the patient appeared drowsy and stuporous and was hospitalized. On the fifth day, the patient was admitted with a clinical picture of acute multi-organ failure in our Institute, where, she, despite the support of vital functions with vasoactive drugs, continuous hemofiltration and ventilation with oxygen, died. Serum lamotrigine concentration was measured 110 h after its last dose and the drug resulted to be still present at 1 mg/L. The patient was homozygous for the UGT1A4-70C and UGT2B7-161C alleles and heterozygous for the UGT2B7-372A>G polymorphism. Regarding ABCB1 the patient showed the 3435CC, 2677GT and 1236CT genotypes.


Our results may suggest a role of the UGT2B7-372A>G polymorphism in this reaction.


ABCB1 Antiepileptic drugs HLA Lamotrigine Multi-organ dysfunction Pharmacogenetics Rash SNPs UGT1A4 UGT2B7 




Conflicts of interest

None to declare.


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Copyright information

© Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2015

Authors and Affiliations

  • Alessio Provenzani
    • 1
    Email author
  • Manuela Labbozzetta
    • 2
  • Monica Notarbartolo
    • 2
  • Paola Poma
    • 2
  • Piera Polidori
    • 1
  • Giovanni Vizzini
    • 3
  • Natale D’Alessandro
    • 2
  1. 1.Clinical Pharmacy ServiceMediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT)PalermoItaly
  2. 2.Area of Pharmacology, Department of Sciences for Health Promotion and Mother-Child Care “G. D’Alessandro”University of PalermoPalermoItaly
  3. 3.Department of MedicineMediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT)PalermoItaly

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