Abstract
A 39-year-old man was found to have hyperproteinemia after being treated with zonisamide for 10 years. Laboratory examination revealed a serum M-protein which consisted of IgG (lambda) and an increased number of plasma cells in the bone marrow, resulting in a diagnosis of smoldering myeloma. Considering his age, zonisamide was suspected to play an etiologic role in the occurrence of smoldering myeloma. Zonisamide was changed to sodium valproate. Subsequently the M-protein did not increase over 13 months. When zonisamide is used, the monitoring of serum levels of M-protein and patterns of gammaglobulin is warranted.
MeSH terms
-
Adult
-
Agammaglobulinemia / blood
-
Agammaglobulinemia / chemically induced*
-
Anticonvulsants / adverse effects*
-
Anticonvulsants / therapeutic use
-
Epilepsy, Generalized / drug therapy*
-
Epilepsy, Generalized / etiology
-
Humans
-
Immunoglobulin lambda-Chains / blood*
-
Intracranial Arteriovenous Malformations / complications
-
Isoxazoles / adverse effects*
-
Isoxazoles / therapeutic use
-
Male
-
Multiple Myeloma / blood
-
Multiple Myeloma / chemically induced*
-
Multiple Myeloma / diagnosis
-
Myeloma Proteins / analysis*
-
Subarachnoid Hemorrhage / complications
-
Valproic Acid / therapeutic use
-
Zonisamide
Substances
-
Anticonvulsants
-
Immunoglobulin lambda-Chains
-
Isoxazoles
-
Myeloma Proteins
-
Zonisamide
-
Valproic Acid