Suspected Lamotrigine-Associated Haematological Adverse Reaction in the Context of Polypharmacy, Alcohol Use, HIV, and Recent Medication Changes

This is a case report of an adult male with well-controlled HIV infection who developed fever, malaise, myalgia and headache within 24-48 hours of commencing lamotrigine. Laboratory investigations demonstrated acute leukopenia, neutropenia and thrombocytopenia, accompanied by elevated inflammatory markers. Following withdrawal of lamotrigine, constitutional symptoms improved rapidly, while haematological and inflammatory markers demonstrated an overall trend towards recovery over subsequent days, although some laboratory abnormalities transiently persisted or worsened before normalising. This case highlights the importance of considering drug-induced haematological toxicity in patients presenting with fever and constitutional symptoms shortly after initiating lamotrigine, as prompt recognition and discontinuation may facilitate rapid recovery.