Acta Médica Colombiana

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Vol 42 # 1
Vol 42 # 1
VOL. 42 No 1 - 2017-05-28

Presentacin de casos / Case reports
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VOL. 42 No 1 - 2017-05-28

Derrame pleural asociado al uso de cido valproico

Toms Omar Zamora, Richard Fernando Imbach, Mara Fernanda Velasco

Las reacciones adversas medicamentosas son ampliamente conocidas, sin embargo, existen algunas reacciones menos frecuentes que otras. El derrame pleural secundario al uso de cido valproico, es una entidad clnica excepcional y por lo tanto difcilmente diagnosticada. Se presenta el caso de una mujer de 59 aos de edad quien padece de parlisis cerebral y epilepsia; recibi manejo con cido valproico y presento mltiples hospitalizaciones en contexto de neumona y derrame pleural de difcil manejo, del cual no se encontr etiologa infecciosa, oncolgica o autoinmune. Despus de observar eosinofilia en lquido pleural y en sangre, se sospech asociacin a uso de cido valproico. Se suspendi el medicamento obteniendo resolucin del derrame pleural, confirmando as esta asociacin. En la literatura se han reportado muy pocos casos y hacen referencia a aquel derrame pleural de etiologa no filiada que puede asociarse con eosinofilia o infiltrado linfoctico (menos frecuente) en el lquido pleural y acompaarse o no de eosinofilia srica. En todos los reportes se ha encontrado un factor comn clnicamente relevante. la resolucin completa del derrame pleural al suspender la medicacin.

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Pleural effusion associated with valproic acid use

Toms Omar Zamora, Richard Fernando Imbach, Mara Fernanda Velasco

Adverse drug reactions are widely known; however, there are some reactions less frequent than others. The pleural effusion secondary to the use of Valproic acid is an exceptional clinical entity and therefore difficult to diagnose. The case of a 59-year-old woman who suffers from cerebral palsy and epilepsy is presented. She received management with Valproic acid and presented multiple hospitalizations in the context of pneumonia and pleural effusion of difficult management. Infectious, oncological or autoimmune etiology was not found. After observing eosinophilia in pleural fluid and in blood, association with Valproic acid was suspected. The drug was discontinued obtaining resolution of the pleural effusion, thus confirming this association. In the literature, very few cases have been reported and refer to pleural effusion of non-affiliated etiology that may be associated with eosinophilia or lymphocytic infiltrate (less frequent) in the pleural fluid and with or without serum eosinophilia. A clinically relevant common factor has been found in all reports, which is the complete resolution of pleural effusion upon discontinuation of the medication

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Palabras claves / Key Words
derrame pleural, cido valproico, epilepsia, efectos adversosderrame pleural, cido valproico, epilepsia, efectos adversos
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