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Severe Atelectasis due to Aspirated Valproic Acid Tablet.
Tomomi Tanigaki1, Takunori Ogawa1, Sakika Nomura1
1Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan.
Aspirated valproic acid (VPA) tablets can cause severe respiratory issues like mucus hypersecretion and atelectasis. Bronchoscopic removal of the VPA tablet resolved these symptoms, suggesting VPA directly upregulates airway mucin genes.
Area of Science:
- Pulmonology
- Pharmacology
- Molecular Biology
Background:
- Valproic acid (VPA) is an antiepileptic drug.
- Respiratory complications associated with VPA are rare.
Observation:
- A 60-year-old man on VPA developed atelectasis and respiratory failure.
- Symptoms were linked to an aspirated VPA tablet causing mucus hypersecretion.
- Bronchoscopic removal of the tablet led to rapid improvement.
Findings:
- VPA directly upregulates airway mucin-related genes in vitro.
- This mechanism explains the observed mucus hypersecretion.
Implications:
- Highlights a novel complication of VPA aspiration.
- Suggests bronchoscopic removal as an effective treatment.
- Warrants further investigation into VPA's effects on respiratory secretions.
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