Pulmonary Edema and Simultaneous Cardiac Dysfunction After Epileptic Seizures

V. Pelliccia, C. Pizzanelli, S. Pini, P. Malacarne, U. Bonuccelli
2013 Canadian Journal of Neurological Sciences  
It is reported that at least 25% of people with epilepsy are women of child-bearing age. Levetiracetam, a second generation antiepileptic drug, has been preferred in pregnancy and lactation due to promising safety in pregnancy 1,2 . Herein, we report a pregnant case of levetiracetam induced pancreatitis. Twenty-five year old pregnant woman at 27 weeks gestation was consulted to gastroenterology department due to abdominal pain, nausea and hyperamilasemia of 396 u/L (normal range in our
more » ... y: 28-128). Her lipase level was also high 264 u/L (N: <60 u/L). ultrasound showed enlarged, edematous pancreas but no gallstones. Serological analysis was normal. Blood count disclosed anemia (Hb: 9.1 g/dl). Serum calcium and lipid levels were within normal limits. Her past medical history was unremarkable except levetiracetam monotherapy start due to epileptic seizure at 12 weeks gestation. Levetiracetam was discontinued. Supportive measures such as fluid-electrolyte therapy was given. Her amylase level declined to normal level in a week. Abdominal pain was over. Antiepileptic drug was not recommended by the neurology department until the delivery. Pancreatitis in pregnancy had been associated in the past with a high maternal and fetal morbidity rate or preterm labor 3 . Earlier diagnosis and greater treatment options improve the prognosis of pancreatitis in pregnancy. Pancreatitis in pregnancy is mostly related with gallstones. Although levetiracetam has been known to be a safe drug in pregnancy, pancreatitis should be considered in patients with epilepsy on levetiracetam.
doi:10.1017/s0317167100022630 fatcat:q55o6wqpejdqtbot5vorvnu7si