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Valproic acid-induced eosinophilic pleural effusion: An uncommon occurrence
Manisha Bhardwaj1, Pratibha Himral2, Surender Kashyap3
1Department of Pulmonary Medicine, Shri Lal Bahadur Shastri Government Medical College and Hospital, Mandi, Himachal Pradesh, India.
Lung India : Official Organ of Indian Chest Society
|January 25, 2023
Summary
Valproic acid (VA), used for seizure disorders, can rarely cause eosinophilic pleural effusion. Discontinuing the medication led to symptom resolution, highlighting its potential as an adverse drug event.
Area of Science:
- Neurology
- Pulmonology
- Pharmacology
Background:
- Valproic acid (VA) is a widely prescribed medication for conditions including seizure disorders, migraines, and schizophrenia.
- Drug-induced pleural effusion is a recognized but uncommon adverse effect of various medications.
Observation:
- A 43-year-old male on long-term valproic acid therapy presented with a moderate right-sided pleural effusion.
- Analysis of the pleural fluid revealed an exudative effusion with a significant eosinophil count (42%).
- Other potential causes such as hemothorax, pneumothorax, malignancy, and parasitic infections were ruled out.
Findings:
- Discontinuation of valproic acid resulted in clinical improvement.
- Resolution of the pleural effusion was confirmed radiographically within three weeks of stopping the medication.
- This case suggests a causal link between valproic acid and the development of eosinophilic pleural effusion.
Implications:
- Clinicians should consider valproic acid as a potential cause of unexplained pleural effusion, particularly eosinophilic types.
- Awareness of this rare adverse effect can prevent misdiagnosis and unnecessary invasive procedures.
- Further research is warranted to elucidate the mechanisms of valproic acid-induced pleural effusion.
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