Brichard B, Vermylen C, Scheiff J M, Ninane J, Cornu G
Department of Paediatric Haematology, University of Louvain Medical School, Brussels, Belgium.
Eur J Pediatr. 1994 May;153(5):378-80. doi: 10.1007/BF01956425.
A 14-year-old boy with mental retardation presented with severe thrombocytopenia, macrocytic anaemia and allergic dermatitis. He had been treated with valproate for seizures since the age of 2 years. Clinical examination showed severe purpura, mucous bleeding and extensive dermatitis. Tests to detect serum direct antiplatelet antibodies were positive and bone marrow examination revealed myelodysplastic abnormalities. Valproate was discontinued and both dermatitis and general condition of the child improved with normalization of the full blood count. This report suggests that valproate may produce both peripheral immune thrombocytopenia and severe bone marrow depression several years after the initiation of the therapy.
一名14岁智力发育迟缓男孩出现严重血小板减少、大细胞性贫血和过敏性皮炎。他自2岁起就因癫痫接受丙戊酸盐治疗。临床检查发现严重紫癜、黏膜出血和广泛性皮炎。检测血清直接抗血小板抗体的试验呈阳性，骨髓检查显示骨髓发育异常。停用丙戊酸盐后，皮炎和患儿的一般状况均有改善，全血细胞计数恢复正常。本报告提示，丙戊酸盐在治疗开始数年后可能会导致外周免疫性血小板减少和严重骨髓抑制。
