[P2-127] Pleural effusion associated with long-term sodium valproate treatment
A drug-induced lung injury (DLI) is associated with the specific use of a drug and specifically occurs in the pulmonary system including the pleura. The length of the latent period between drug exposure and onset of DLI is various. We present a 47-year-old patient who developed pleural effusion associated with long-term sodium valproate (VPA) treatment. He has been suffered from progressive myoclonic epilepsy since 11 years old. He had intractable several types of seizure. He became bedridden at his age of 16 and took a gastrostomy and laryngo-tracheal separation in his thirties. He had been treated with some anti epileptic drugs including VPA. He developed right-sided pleural effusion at his age of 47 after over a 30-year VPA treatment. Infection, cardiogenic pulmonary edema, collagen disease and malignant mesothelioma were ruled out. We suspected that VPA was the most causative drug and then VPA was replaced by levetiracetam. After discontinuance of VPA, pleural effusion gradually decreased and disappeared after ten months. VPA hardly ever induces pleuritis but there are some patient reports of pleural effusion due to long-term VPA treatment. It is important to keep in mind that VPA is one of the causative drugs of pleural effusion.