Sir, -Antiepileptic drugs account for about 4.7%-11.5% of the cases of secondary aplastic anaemia [1,3, 6]. However, all of these cases involved oral administration and there have been heretofore no reports of aplastic anaemia following parenteral administration of antiepileptic drugs. Here we report a case of aplastic anaemia induced by intravenous administration of phenytoin and lidocaine. The patient was a 13year-old Japanese girl who had had an acute encephalopathy at the age of 10. She had epilepsy and moderate mental retardation with a right hemiplegia since that time and was first seen at Kyushu University Hospital at the age of 11, in 1980.
Her seizures had been well controlled with carbamazepine, primidone and valproic acid, up to the age of 12 years, when she experienced status epilepticus, twice, because of irregular ingestion of drugs and a concomitant fever. During a third attack of status epilepticus, she was admitted to Kyushu University Hospital, on March 21, 1983. On admission, she was stuporous and there was anisocoria and right hemiplegia. Laboratory findings were red blood cell count (RBC) 2.79 โข 106/cmm, haemoglobin (Hb) 11.1 g/dl, haematocrit 30.6% and white blood cell count (WBC) 6000/cmm (segment 81%, filament 2%, lymphocyte 15% and monocyte 22%), platelet count 194 x 103/ cmm and mean corpuscular volume 110 bt3; revealing macrocytic anaemia (Fig, l). Intravenous infusion of lidocaine 30 gg/kg per rain in addition to