title: [Lower limb edema during valpromide treatment: case report and literature review].
abstract: BACKGROUND
  Valpromide and sodium divalproate are indicated in the treatment of maniac episodes of bipolar disorder. These drugs are metabolized into valproic acid. The occurrence of peripheral edema has been described as a very rare adverse reaction of those drugs.
  
  
  METHODS
  We report the case of a patient treated with valpromide who presented edema of the lower limbs. The increase in furosemide dose allowed regression of edema, and valpromide discontinuation resulted in rapid normalization. Recurrence of mood disorders led to the reintroduction of valpromide, which was associated with recurrence of edema. The definitive withdrawal of valpromide resulted in resolution of edema.
  
  
  CONCLUSIONS
  Edema of the lower limbs can be induced by valproate. The mechanism of this reaction is unknown. These edema appear to be reversible upon discontinuation of the drug. Clinicians should be aware of a possible relationship between valproate-derived drugs and peripheral edema.
authors.affiliation: Service pharmaceutique, hôpital gériatrique Pierre-Garraud, hospices civils de Lyon, 136, rue du Commandant-Charcot, 69322 Lyon cedex 05, France. Electronic address: laurence.gabriel@yahoo.fr.
authors.forename: L
authors.initials: L
authors.lastname: Gabriel
authors.affiliation: Service centre antipoison-centre de pharmacovigilance, hospices civils de Lyon, 162, avenue Lacassagne, 69424 Lyon cedex 03, France.
authors.forename: C
authors.initials: C
authors.lastname: Darcissac
authors.affiliation: Service pharmaceutique, hôpital gériatrique Pierre-Garraud, hospices civils de Lyon, 136, rue du Commandant-Charcot, 69322 Lyon cedex 05, France; ISPB, faculté de pharmacie de Lyon, université Lyon 1, 8, avenue Rockefeller, 69373 Lyon cedex 08, France.
authors.forename: S
authors.initials: S
authors.lastname: Goutelle
authors.affiliation: Service de médecine interne, université de Lyon, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, Grande-Rue-de-la-Croix-Rousse, 69317 Lyon cedex 04, France.
authors.forename: P
authors.initials: P
authors.lastname: Sève
authors.affiliation: Service centre antipoison-centre de pharmacovigilance, hospices civils de Lyon, 162, avenue Lacassagne, 69424 Lyon cedex 03, France.
authors.forename: T
authors.initials: T
authors.lastname: Vial
authors.affiliation: Service de médecine gériatrique, hôpital Pierre-Garraud, hospices civils de Lyon, 136, rue du Commandant-Charcot, 69322 Lyon cedex 05, France.
authors.forename: B
authors.initials: B
authors.lastname: de La Gastine
mesh_terms: D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000009:adverse effects*; D004487:Edema / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D005665:Furosemide / Q000627:therapeutic use; D006801:Humans; D035002:Lower Extremity; D014635:Valproic Acid / Q000009:adverse effects / Q000031:analogs & derivatives*; D028761:Withholding Treatment
chemical_list: D000927:Anticonvulsants; D014635:Valproic Acid; D005665:Furosemide; C004651:dipropylacetamide
keywords: Acide valproïque; Furosemide; Furosémide; Lower limbs; Membres inférieurs; Peripheral edema; Valproic acid; Valpromide; Œdème périphérique