title: Successful reintroduction of valproic acid after the occurrence of pancytopenia.
abstract: BACKGROUND
  Valproic acid is associated with a variety of hematologic abnormalities, most commonly thrombocytopenia. Pancytopenia is much less common and potentially much more serious. Little is known about the natural course of valproate-induced pancytopenia.
  
  
  METHODS
  We present a patient who developed pancytopenia while taking valproic acid for bipolar illness. After failing to respond to several other mood stabilizers, valproic acid was cautiously reintroduced with close hematologic monitoring. The pancytopenia has not recurred in the past 6 months.
  
  
  CONCLUSIONS
  Pancytopenia may not represent an absolute contraindication to continuing valproate therapy, although caution is warranted.
authors.affiliation: James A. Haley VA Hospital, Tampa, Florida 33612, USA. jonathan.stewart1@va.gov
authors.forename: Jonathan T
authors.initials: JT
authors.lastname: Stewart
mesh_terms: D000368:Aged; D018692:Antimanic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D004334:Drug Administration Schedule; D016903:Drug Monitoring; D006801:Humans; D008297:Male; D010198:Pancytopenia / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis; D013997:Time Factors; D014635:Valproic Acid / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D018692:Antimanic Agents; D014635:Valproic Acid