PEDIATRICS Vol. 80 No. 6 December 1987, pp. 951-953
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Heart Block Secondary to Erythromycin-Induced Carbamazepine Toxicity

ANDREW J. MACNAB MD1, JOAN L. ROBINSON BSc, MD1, ROBERT J. ADDERLY MD1, and LUIGI D'ORSOGNA MB, BS1

1 Department of Paediatrics, University of British Columbia, British Columbia's Children's Hospital, Vancouver

Toxic elevations of serum levels of carbamazepine have been reported recently in children treated concurrently with erythromycin.1-3 Similar toxic interaction has been recognized longer in adults.4 The toxic effects described are confusion, somnolence, ataxia, vertigo, and nystagmus, sometimes associated with vomiting and hyponatremia. We report the case of a 10-year-old boy with sinus arrest and atrioventricular (A-V) block. The potential azepine to depress A-V conduction and ventricular automaticity is recognized in adults,5-10 particularly those with preexisting A-V conduction defects6,10 However, this is the first reported case of serious conduction disturbances occurring with carbamazepine toxicity in a child.

CASE REPORT