Tanigaki Tomomi, Ogawa Takunori, Nomura Sakika, Ito Koki, Kurata Yuhei, Matsukida Akira, Ishihara Morio, Yoshino Aihide, Kawana Akihiko, Kimizuka Yoshifumi
Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan.
Division of Psychiatry, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan.
Case Rep Pulmonol. 2024 Mar 18;2024:6650141. doi: 10.1155/2024/6650141. eCollection 2024.
A 60-year-old man treated with valproic acid (VPA) for epilepsy developed atelectasis and respiratory failure after an accidentally aspirated VPA tablet-induced mucus hypersecretion. Following bronchoscopic removal of the aspirated tablet, his respiratory status improved and massive sputum production did not recur. We hypothesized that the aspirated VPA tablet increased the expression of mucin-related genes, thereby increasing mucus production. Our experiments using a human respiratory epithelial cell line revealed that VPA directly upregulates the airway mucin-related genes. We believe that this is the first case report of aspirated VPA-induced severe atelectasis and respiratory failure, which were successfully treated with the bronchoscopic removal of the VPA tablet.
一名60岁男性因癫痫接受丙戊酸（VPA）治疗，在意外吸入一片VPA片剂导致黏液分泌过多后，出现肺不张和呼吸衰竭。在通过支气管镜取出吸入的片剂后，他的呼吸状况得到改善，大量痰液分泌未再复发。我们推测，吸入的VPA片剂增加了黏蛋白相关基因的表达，从而增加了黏液分泌。我们使用人类呼吸道上皮细胞系进行的实验表明，VPA直接上调气道黏蛋白相关基因。我们认为，这是首例关于吸入VPA导致严重肺不张和呼吸衰竭的病例报告，通过支气管镜取出VPA片剂成功治愈。
