A Case of Drug-Induced Interstitial Pneumonitis Caused by Valproic Acid for the Treatment of Seizure Disorders

Valproic acid is one of the most common antiepileptic drugs used for the treatment of several seizure disorders. A 20-year-old man presented with a sudden decline of consciousness. He had a neurosurgery operation for intracranial and intraventricular hemorrhage. Following surgery, antiepileptic medication was administered to the patient in order to control his seizure events. On valproic acid treatment, he began to complain of fever and dyspnea. His symptoms persisted despite receiving empirical antibiotic treatment. All diagnostic tests for infectious causes were negative. A high-resolution computed tomography scan of the chest revealed predominantly dependent consolidation and ground-glass opacities in both lower lobes. The primary differential was drug associated with interstitial lung disease. Therefore, we discontinued valproic acid treatment and began methylprednisolone treatment. His symptoms and radiologic findings had significantly improved after receiving steroid therapy. We propose that clinicians should be made aware of the potential for valproic acid to induce lung injury.

[1]  M. Neuman,et al.  Adverse drug reactions induced by valproic acid. , 2013, Clinical biochemistry.

[2]  O. Matsuno,et al.  Drug-induced interstitial lung disease: mechanisms and best diagnostic approaches , 2012, Respiratory Research.

[3]  K.‐H. Choi,et al.  Valproate associated diffuse alveolar hemorrhage , 2011, European journal of neurology.

[4]  S. Sahn,et al.  Valproic Acid–Induced Eosinophilic Pleural Effusion: A Case Report and Review of the Literature , 2007, The American journal of the medical sciences.

[5]  Juhong Shi,et al.  [Clinicopathological manifestations of drug-induced lung injury]. , 2007, Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases.

[6]  P. Foucher,et al.  Interstitial Lung Disease Induced by Drugs and Radiation , 2004, Respiration.

[7]  R. Matthay,et al.  Drug-induced pulmonary disease. Part 2: Noncytotoxic drugs. , 1986, The American review of respiratory disease.

[8]  N. Da’as,et al.  Valproic acid-induced eosinophilic pleural effusion: a case report and review of the literature. , 2012, The neurologist.

[9]  R. Matthay,et al.  Drug-induced pulmonary disease. Part 1: Cytotoxic drugs. , 1986, The American review of respiratory disease.