{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T01:25:38Z","timestamp":1777339538432,"version":"3.51.4"},"reference-count":13,"publisher":"SMC Media","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Blood dyscrasias associated with levetiracetam use can be difficult to identify, especially when other potential differential diagnoses are concurrently present. Here we present a 57-year-old man with metastatic adenocarcinoma of unknown primary origin on levetiracetam who initially presented with an in-stent thrombosis of the right external iliac vein and then developed worsening thrombocytopenia followed by pancytopenia. Levetiracetam was not identified as the culprit until other causes like platelet consumption, heparin-induced thrombocytopenia, idiopathic immune thrombocytopenic purpura, and bone marrow involvement by metastatic disease were ruled out.<\/jats:p>","DOI":"10.12890\/2021_002449","type":"journal-article","created":{"date-parts":[[2021,5,25]],"date-time":"2021-05-25T09:52:37Z","timestamp":1621936357000},"source":"Crossref","is-referenced-by-count":4,"title":["Delayed Recognition of Levetiracetam-induced Pancytopenia"],"prefix":"10.12890","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9083-636X","authenticated-orcid":false,"given":"Mohammad","family":"Ammad Ud Din","sequence":"additional","affiliation":[{"name":"Internal Medicine, Rochester General Hospital, Rochester, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Syed","family":"Ather Hussain","sequence":"additional","affiliation":[{"name":"Internal Medicine, Rochester General Hospital, Rochester, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Bodrog","sequence":"additional","affiliation":[{"name":"Hematology\/Oncology, Rochester General Hospital, Rochester, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10397","published-online":{"date-parts":[[2021,3,30]]},"reference":[{"key":"10.12890\/2021_002449_ref1","doi-asserted-by":"crossref","unstructured":"<li>Bangash O, Simonin A, Tsimiklis C, Ramakonar H, Honeybul S. Prophylactic levetiracetam-induced pancytopenia with traumatic extra-dural hematoma: case report. <em>J Clin Neurosci<\/em> 2020;<strong>80<\/strong>:264\u2013266. doi: 10.1016\/j.jocn.2020.08.004<\/li>","DOI":"10.1016\/j.jocn.2020.08.004"},{"key":"10.12890\/2021_002449_ref2","doi-asserted-by":"crossref","unstructured":"<li>Alzahrani T, Kay D, Alqahtani SA, Makke Y, Lesky L, Koubeissi MZ. Levetiracetam-induced pancytopenia. <em>Epilepsy Behav Case Rep<\/em> 2015;<strong>4<\/strong>:45\u201347. doi: 10.1016\/j.ebcr.2015.06.001<\/li>","DOI":"10.1016\/j.ebcr.2015.06.001"},{"key":"10.12890\/2021_002449_ref3","doi-asserted-by":"crossref","unstructured":"<li>Gohil JR, Agarwal TS. Levetiracetam adverse drug reaction: pancytopenia. <em>J Pediatr Neurosci<\/em> 2018;<strong>13<\/strong>(1):116\u2013117. doi: 10.4103\/JPN.JPN_139_17<\/li>","DOI":"10.4103\/JPN.JPN_139_17"},{"key":"10.12890\/2021_002449_ref4","doi-asserted-by":"crossref","unstructured":"<li>Mohamed B Peer, Prabhakar P. Thrombocytopenia as an adverse effect of levetiracetam therapy in a child [published correction appears in Neuropediatrics 2009;40(5):244. Mohamed, B P [corrected to Peer Mohamed, B]. <em>Neuropediatrics<\/em> 2009;<strong>40<\/strong>(5):243\u2013244. doi: 10.1055\/s-0030-1247524<\/li>","DOI":"10.1055\/s-0030-1247524"},{"key":"10.12890\/2021_002449_ref5","doi-asserted-by":"crossref","unstructured":"<li>Garc\u00eda Carretero R, Romero Brugera M, Olid-Velilla M, Salamanca-Ramirez I. Pancytopenia associated with levetiracetam in an epileptic woman. <em>BMJ Case Rep<\/em> 2016;<strong>2016<\/strong>:bcr2016217407. doi: 10.1136\/bcr-2016-217407<\/li>","DOI":"10.1136\/bcr-2016-217407"},{"key":"10.12890\/2021_002449_ref6","doi-asserted-by":"crossref","unstructured":"<li>Aydo?an Harun, Yal\u00e7n ?aban, Karahan Mahmut Alp, B\u00fcy\u00fckfrat Evren. Pancytopenia associated with levetiracetam treatment in Lafora's disease. <em>Blood Coagul Fibrinolysis<\/em> 2012;<strong>23<\/strong>(2):175. doi: 10.1097\/MBC.0b013e32834bdb5f<\/li>","DOI":"10.1097\/MBC.0b013e32834bdb5f"},{"key":"10.12890\/2021_002449_ref7","doi-asserted-by":"crossref","unstructured":"<li>Elouni B, Ben Salem C, Biour M. Levetiracetam-induced pancytopenia. <em>Ann Pharmacother<\/em> 2009;<strong>43<\/strong>(5):985. doi: 10.1345\/aph.1L727<\/li>","DOI":"10.1345\/aph.1L727"},{"key":"10.12890\/2021_002449_ref8","doi-asserted-by":"crossref","unstructured":"<li>Oghlakian R, Nock C, Koubeissi M. A case of levetiracetam-induced thrombocytopenia. <em>Epileptic Disord<\/em> 2010;<strong>12<\/strong>(4):335\u2013337. doi:10.1684\/epd.2010.0343<\/li>","DOI":"10.1684\/epd.2010.0343"},{"key":"10.12890\/2021_002449_ref9","doi-asserted-by":"crossref","unstructured":"<li>Sahaya K, Goyal MK, Sarwal A, Singh NN. Levetiracetam-induced thrombocytopenia among inpatients: a retrospective study. <em>Epilepsia<\/em> 2010;<strong>51<\/strong>(12):2492\u20132495. doi: 10.1111\/j.1528-1167.2010.02788.x<\/li>","DOI":"10.1111\/j.1528-1167.2010.02788.x"},{"key":"10.12890\/2021_002449_ref10","doi-asserted-by":"crossref","unstructured":"<li>Kimland E, H\u00f6jeberg B, von Euler M. Levetiracetam-induced thrombocytopenia. <em>Epilepsia<\/em> 2004;<strong>45<\/strong>(7):877\u2013878. doi: 10.1111\/j.0013-9580.2004.64903.x<\/li>","DOI":"10.1111\/j.0013-9580.2004.64903.x"},{"key":"10.12890\/2021_002449_ref11","doi-asserted-by":"crossref","unstructured":"Meschede A, Runge U, Sabolek M. Thrombocytopenia during levetiracetam therapy.<em>Epilepsy Res<\/em> 2008;<strong>80<\/strong>(1):91\u201392. doi: 10.1016\/j.eplepsyres.2008.03.002<\/li>","DOI":"10.1016\/j.eplepsyres.2008.03.002"},{"key":"10.12890\/2021_002449_ref12","doi-asserted-by":"crossref","unstructured":"<li>Kim Jonguk, Jung-Won Shin. Levetiracetam-induced thrombocytopenia in a patient with status epilepticus. <em>Epileptic Disord<\/em> 2017;<strong>19<\/strong>(1):104\u2013108. doi: 10.1684\/epd.2017.0889<\/li>","DOI":"10.1684\/epd.2017.0889"},{"key":"10.12890\/2021_002449_ref13","doi-asserted-by":"crossref","unstructured":"<li>Gallerani M, Mari E, Boari B, Carletti R, Marra A, Cavallo M. Pancytopenia associated with levetiracetam treatment. <em>Clin Drug Investig<\/em> 2009;<strong>29<\/strong>(11):747\u2013751. doi: 10.2165\/11319450-000000000-00000 <\/li>","DOI":"10.2165\/11319450-000000000-00000"}],"container-title":["European Journal of Case Reports in Internal Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/2449\/2622","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/2449\/2623","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/2449\/2623","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:11:22Z","timestamp":1756372282000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/view\/2449"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,30]]},"references-count":13,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.12890\/2021_002449","relation":{"has-manifestation":[{"id-type":"other","id":"1-69-2449-g2622","asserted-by":"subject"},{"id-type":"other","id":"1-69-2449-g2623","asserted-by":"subject"}],"is-part-of":[{"id-type":"other","id":"1-69","asserted-by":"subject"}]},"ISSN":["2284-2594"],"issn-type":[{"value":"2284-2594","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,30]]},"article-number":"8"}}