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Divalproex sodium-induced eosinophilic pleural effusion.
Prachi Joshi1, Rahil Kasmani, Jocelyn Hollingsworth
1Department of Family Medicine, St Vincent Mercy Medical Center, Toledo, OH, USA. prachi_joshi@mhsnr.org
American Journal of Therapeutics
|June 11, 2009
Summary
Drug-induced eosinophilic pleural effusion can occur. Withdrawal of divalproex sodium (Depakote) resolved a patient's eosinophilic pleural effusion, suggesting a causal link.
Area of Science:
- Pulmonology
- Toxicology
- Internal Medicine
Background:
- Eosinophilic pleural effusion (EPE) is characterized by >10% eosinophils in pleural fluid.
- Drug-induced effusions are a recognized, albeit less common, cause of EPE.
- Identifying causative agents is crucial for effective management.
Observation:
- A 48-year-old woman with epilepsy on divalproex sodium (Depakote) presented with dyspnea and right-sided pleural effusion.
- Peripheral blood eosinophilia and eosinophilic exudative pleural effusion were confirmed via thoracocentesis.
- Extensive workup excluded other common causes of EPE.
Findings:
- Divalproex sodium (Depakote) was identified as the likely cause of the eosinophilic pleural effusion.
- Discontinuation of divalproex sodium led to the complete resolution of the pleural effusion.
- This case highlights the potential of divalproex sodium to induce EPE.
Implications:
- Clinicians should consider drug-induced causes, including divalproex sodium, in patients with unexplained eosinophilic pleural effusion.
- Prompt recognition and withdrawal of the offending agent can lead to favorable outcomes.
- Further research into drug-specific mechanisms of EPE is warranted.
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