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"Late" Withdrawal Syndrome after Carbamazepine In Utero Exposure in a CYP2C9 Slow Metabolizer Newborn.


ABSTRACT: We report a case of carbamazepine withdrawal syndrome following in utero exposure to carbamazepine related to a pharmacogenetic predisposition factor. The infant was born at 37 1/7 weeks' gestation by cesarean section to a mother treated for epilepsy with carbamazepine. One hour and thirty minutes after birth, the infant presented a respiratory distress with severe oxygen desaturation requiring intubation 5 h after birth. On the third day of life the infant developed clinical signs of a withdrawal syndrome which resolved progressively after 16 days and symptomatic treatment. The infant genotype analysis showed two low activity CYP2C9 allelic variants (2/3 heterozygote) predicting a CYP2C9 slow metabolizer phenotype which could explain reduced carbamazepine elimination and a late and long-lasting withdrawal symptoms observed 3 days after birth. The association of a withdrawal syndrome with carbamazepine exposure has not been previously reported and pharmacogenetic tests might therefore be useful in identifying patients at risk.

SUBMITTER: Passia E 

PROVIDER: S-EPMC5399605 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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"Late" Withdrawal Syndrome after Carbamazepine <i>In Utero</i> Exposure in a CYP2C9 Slow Metabolizer Newborn.

Passia Evangelia E   Rock Nathalie N   Pfister Riccardo E RE   Ing Lorenzini Kuntheavy R KR   Desmeules Jules J   Samer Caroline F CF  

Frontiers in pharmacology 20170421


We report a case of carbamazepine withdrawal syndrome following <i>in utero</i> exposure to carbamazepine related to a pharmacogenetic predisposition factor. The infant was born at 37 1/7 weeks' gestation by cesarean section to a mother treated for epilepsy with carbamazepine. One hour and thirty minutes after birth, the infant presented a respiratory distress with severe oxygen desaturation requiring intubation 5 h after birth. On the third day of life the infant developed clinical signs of a w  ...[more]

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