Pure red cell aplasia associated with sodium valproate therapy

Pure red cell aplasia developed in a 9-year-old girl receiving sodium valproate therapy. Infection with measles and chickenpox had occurred two months previously. Regeneration of bone marrow erythroid precursors was demonstrated one month after drug withdrawal. Readministration of sodium valproate resulted in a second episode of red cell aplasia that again resolved promptly after drug withdrawal. The respective roles of infection and drugs in the etiology of red cell aplasia are discussed.