丙戊酸钠致三系血细胞减少

Three lineage hematocytopenia induced by sodium valproate

1例73岁男性患者因癫痫口服丙戊酸钠缓释片(0.5g,qd)治疗,用药2个月后患者入院检查血常规示:WBC 3.1×10^(9)·L^(-1),RBC2.6×10^(12)·L^(-1),PLT51×10^(9)·L^(-1),骨髓穿刺+涂片提示骨髓增生低下、三系减少。考虑为丙戊酸钠导致的三系血细胞减少,遂停用该药,改为左乙拉西坦治疗。患者停药15d后复查血常规示:WBC5.5×10^(9)·L^(-1),RBC3.62×10^(12)·L^(-1),PLT128.7×10^(9)·L^(-1),三系血细胞减少情况逐渐好转。2周后复查血常规示:WBC5.6×10^(9)·L^(-1),RBC4.62×10^(12)·L^(-1),PLT168×10^(9)·L^(-1),三系血细胞恢复正常。

A 73-year-old male patient was treated with sodium valproate sustained-release tablets(0.5 g,qd)for epilepsy.After 2 months of medication,the patient was admitted to hospital.The results of blood routine examination showed that WBC 3.1×10^(9)∙L^(-1),RBC 2.6×10^(12)∙L^(-1),PLT 51×10^(9)∙L^(-1).Result of bone marrow puncture and smear showed hypoplasia of bone marrow and reduction of three lineage hematocytopenia.Three lineage hematocytopenia induced by sodium valproate was considered and levetiracetam was given to him after sodium valproate withdrawal.15 days after drug withdrawal,the results of blood routine examination showed that WBC 5.5×10^(9)∙L^(-1),RBC 3.62×10^(12)∙L^(-1),PLT 128.7×10^(9)∙L^(-1).Three lineage hematocytopenia gradually improved.And the results of blood routine examination 2 weeks later showed that WBC 5.6×10^(9)∙L^(-1),RBC 4.62×10^(12)∙L^(-1),PLT 168×10^(9)∙L^(-1),the decrease of three lineage blood cells returned to normal.