Valproic acid-induced neutropenia

Valproik asit, önemli antikonvülzan ajanlardan biri olmakla beraber ciddi yan etkilere sa-hiptir. Nötropeni bunlardan biridir. Bir yaşında kız hastanın, kontrol muayenesi için başvurduğu sırada yapılan tam kan sayımında, nötropeni saptandı. Yapılan bazı spesifik tanı testlerinden sonra hastanın nötropenisinin valproik aside bağlı olduğu saptandı. VaI-poik asit tedavisi sonlandırılan hastanın kan değerleri hızla düzeldi. Valproik aside bağlı nötropeni, bu olguda nötropenik ateşe neden olduğu için yayınlamak istedik.

Valproik aside bağlı nötropeni

Valproic acid is an important anticonvulsant agent but it has some serious side effects. Neutropenia is one of them. A one-year old female patient applied to our hospital for control. Neutropenia was determined in her complete blood count. She was given some specific diagnostic tests to explain the cause of neutropenia. At the end of the evaluation,it was thought that neutropenia was due to valproate. The patient's hematological parameters improved after stopping drug apply. This case was found interesting enough to be presented since VPA-induced neutropenia had caused fever.

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1. Watts RG, Emanuel PD. Zuckerman KS. et al. Valproic acid-Induced cytopenias:Evidence for a dose-related suppression of hematopoesis. J Pediatr 1990; 117: 495-499. 2. Acharya S, Bussel JB. Hematologic toxicity of sodium valproate. J Pediatr Hematol Oncol 2000; 22: 62-65. 3. Dreifuss FE, Langer DH. Side effects of valproate. Am J Med 1988;84: 34-41. 4. Blackburn SC, Oliart AD, Garcia Rodriguez LA et al. Antiepileptic^ and blood dyscrasias: a cohort study, Pharmacotherapy. 1998; 18: 1277-1283. 5. Barr RD, Copeland SA, Stockwell MC et al. Valproic acid and immune thrombocytopenia. Arch Dis Child 1982; 57: 681-684. 6. Jaeken J, van Goethem C, Casaer P et al. Letter: Neutropenia during sodium valproate treatment. Arch Dis Child 1979; 54: 986-987. 7. Symon DN, Russel G. Letter: Sodium valproate and neutropenia. Arch Dis Child 1983; 58: 235. 8. Coulter DL, Wu H, Allen RJ. Valproic acid therapy in childhood epilepsy. JAMA 1980; 244: 785-788.