Mina MISIRLIGİL, Melike ARSLAN, Necati BALAM

Levetirasetam Kullanan Epilepsili Bir Çocuk Hastada Hipertransaminaseminin Nadir Bir Nedeni: Salmonella Hepatiti

Salmonella hepatiti, salmonella enteritinin karaciğeri tutmasıyla oluşan bir enfeksiyon hastalığı olup akut gastroenterit bulguları ve hipertransaminazemi ile seyreder. Levetirasetam, GABA-glisin sistemini aktive ederek antiepileptik etki gösteren yeni nesil bir antiepileptik ajandır ve nadiren hipertransaminazemiye yol açabilmektedir. Epilepsi tanısıyla 15 aydır levetirasetam kullanmakta olan 11 yaşında bir kız hasta, bulantı-kusma, ateş, karın ağrısı şikayetleriyle birlikte hipertransaminazemi olması nedeniyle başvurdu. Salmonella hepatiti tanısı konulan hastada uygun antibiyoterapi ile klinik bulgular gerilemesine rağmen hipertransaminazeminin 12 hafta sürdüğü gözlendi. Persistan hipertransaminazemi etiyolojisi araştırıldı. Sonuç olarak, levetirasetam kullanan, akut gastroenterit ve hepatit bulgularıyla getirilen hastalarda ilaç tedavisi kesilmeden önce salmonella hepatitinin de ayırıcı tanıda düşünülmesi gerektiği değerlendirilmektedir.

Anahtar Kelimeler:

levetirasetam, Salmonella, Hipertransaminazemi

A Rare Cause of Hypertransaminasemia in a Child with Epilepsy Taking Levetiracetam: Salmonella Hepatitis

Salmonella hepatitis is an infectious disease caused by liver involvement of salmonella enteritis and characterized by acute gastroenteritis and hypertransaminasemia. Levetiracetam is a new generation antiepileptic agent that activates the GABA-glycine system and may rarely cause hypertransaminasemia. An 11-year-old girl with epilepsy who had been taking levetiracetam for 15 months was consulted because of hypertransaminasemia with nausea-vomiting, fever and abdominal pain. The patient was diagnosed with salmonella enteritis. The clinical findings regressed with appropriate antibiotherapy but hypertransaminasemia lasted. The etiology of persistent hypertransaminasemia has been investigated. In addition to salmonella hepatitis, the use of levetiracetam was seen as causes but the drug was not discontinued. Normal liver enzyme levels were reached in the 12th weeks following Salmonella infection. Consequently, it is considered that before discontinuation of medication, salmonella hepatitis may be in differential diagnosis in patients who have acute gastroenteritis and hepatitis findings and also receiving levetiracetam.

Keywords:

Hypertransaminasemia, Levetiracetam, Salmonella,

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