Abstract

Valproik asit; epilepsi, bipolar bozukluk ve migren gibi hastalıkların tedavisinde kullanılır. Valproik asitin en sık görülen yan etkileri saç dökülmesi, gastrointestinal sistem ilişkili semptomlar ve kilo alımıdır. Akut karaciğer yetmezliği, pankreatit, kanama diyatezi, ensefalopati ciddi yan etkileridir. Valproat kullanan hastalarda periferik ödem gelişmesi nadir görülen bir yan etkidir. Çoğunlukla uzun dönem yan etkisi olarak görülmekle beraber, kısa dönem kullanımlarda da bildirilen vakalar mevcuttur. Akut başlayan periferik ödem, geniş ayrıcı tanı spektrumuyla kapsamlı araştırmayı gerektirir. Olgumuzda 16 yaşındaki erkek hastada akut alt ekstremite ödemi, valproik asit kullanımına bağlı nadir görülen ilaç yan etkisi olarak karşımıza çıkmıştır.

Keywords

• valproik asit
• ödem
• yan etki

A Rare Side Effect of Valproic Acid Use: Edema

Abstract

Valproic acid is used in the treatment of diseases such as epilepsy, bipolar disorder and migraine. The most common side effects of valproic acid are hair loss, gastrointestinal system-related symptoms and weight gain. Acute liver failure, pancreatitis, bleeding diathesis, and encephalopathy are serious side effects. Peripheral edema is a rare side effect in patients using valproate. Although it is mostly seen as a long-term side effect, there are also cases reported in short-term use. Acute onset peripheral edema requires comprehensive investigation with a wide spectrum of differential diagnosis. In our case, acute lower extremity edema in a 16-year-old male patient occurred as a rare drug side effect due to valproic acid use.

Keywords

• valproic acid
• edema
• side effect

References

1. 1.Prajapati H, Kansal D, Negi R. Magnesium Valproate-Induced Pedal Edema on Chronic Therapy: A rare Adverse Drug Reaction. Indian Journal of Pharmacology 2017;49(5):399.
2. 2.Lin S-T, Chen C-S, Yen C-F, Tsei J-H, Wang S-Y. Valproate-related peripheral oedema: A Manageable But Probably Neglected Condition. International Journal of Neuropsychopharmacology 2009;12(7):991-3.
3. 3.Chuang K, Patel S. Valproate-Induced Lower Extremity Swelling. Federal Practitioner 2020;37(8):388.
4. 4.Maneerot T, Jenraumjit R, Kijsawatpaiboon S, Reungyos J. Low-Dose Valproate-Related Peripheral Edema in Patients With Bipolar Disorder: Two Case Reports. Journal of Clinical Psychopharmacology 2019;39(4):412-3.
5. 5.Ettinger A, Moshe S, Shinnar S. Edema Associated with long‐Term Valproate Therapy. Epilepsia 1990;31(2):211-3.
6. 6.Haviv Y, Kuper A. Severe Peripheral Oedema Associated with Valproic Acid. Clinical Drug Investigation 2000;19:385-7.
7. 7.Zimmerman HJ, Ishak KG. Valproate‐Induced Hepatic Injury: Analyses of 23 Fatal Cases. Hepatology 1982;2(5):591S-7S.
8. 8.Mathew T, D'Souza D, Nadimpally US, Nadig R. Clobazam‐Induced Pedal Edema:“An Unrecognized Side Effect of a Common Antiepileptic Drug”. Epilepsia 2016;57(3):524-5.

9. 9.Bourin M, Chenu F, Hascoet M. The Role of Sodium Channels in the Mechanism of Action of Antidepressants and Mood Stabilizers. Current Drug Targets 2009;10(11):1052-60.
10. 10.Takemoto Y. Effects of Gamma‐Aminobutyric Acid on Regional Vascular Resistances of Conscious Spontaneously Hypertensive Rats. Clinical and Experimental Pharmacology and Physiology 1995;22:S102-Sl04.