Systemic lupus erythematosus associated with use of valproate.
A 30-year-old man with long-standing localization-related epilepsy and mental retardation had seizures that were partially controlled with valproate (VPA) 500 mg four times daily. Routine examination showed severe thrombocytopenia with mild leukopenia and chronic low-grade hemolytic anemia. Pertinent laboratory results included positive ANA, rheumatoid factor, anti-NIA, circulating immune complexes, and antihistone antibody. The patient was treated with high dosage prednisone with partial improvement, but continued to have exacerbations at lower dosages. Fourteen months later, VPA was discontinued, and rapid improvement ensued. Prednisone was subsequently discontinued, and the patient has now maintained normal platelet counts for 18 months.
Asconapé
J J
JJ
Department of Neurology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina 27157-1078.
Manning
K R
KR
Lancman
M E
ME
D000328:Adult; D004827:Epilepsy / Q000188:drug therapy; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000139:chemically induced*; D008297:Male; D010976:Platelet Count; D013921:Thrombocytopenia / Q000139:chemically induced; D014635:Valproic Acid / Q000009:adverse effects*
D014635:Valproic Acid