Delayed-Onset Neutropenia with Divalproex Sodium
| العنوان: | Delayed-Onset Neutropenia with Divalproex Sodium |
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| المؤلفون: | Eli N. Deal, Jason T Lurk, Steven C. Stoner |
| المصدر: | Annals of Pharmacotherapy. 42:1507-1510 |
| بيانات النشر: | SAGE Publications, 2008. |
| سنة النشر: | 2008 |
| مصطلحات موضوعية: | Male, Divalproex, medicine.medical_specialty, Neutropenia, medicine.medical_treatment, Gastroenterology, hemic and lymphatic diseases, Internal medicine, White blood cell, medicine, Humans, Pharmacology (medical), Valproic Acid, Leukopenia, Dose-Response Relationship, Drug, business.industry, Middle Aged, medicine.disease, Blood Cell Count, Regimen, Dose–response relationship, Endocrinology, medicine.anatomical_structure, Anticonvulsant, Delayed-Action Preparations, Anticonvulsants, Drug Monitoring, medicine.symptom, business, medicine.drug |
| الوصف: | Objective: To report the development of neutropenia in a patient after almost 8 years of being stabilized on delayed-release divalproex sodium (DVPX). Case Summary: A 45-year-old man had been maintained on DVPX for nearly 8 years, with serum valproic acid concentrations of 85-120 mg/L and normal white blood cell (WBC) counts and absolute neutrophil counts (ANCs). Five months prior to the development of neutropenia (defined as ANC Discussion: Although a complete blood cell count with differential is a commonly accepted form of therapeutic drug monitoring with DVPX, the monitoring is considered most necessary to identify dose-retated thrombocytopenia. However, neutropenia has been rarely associated with the use of DVPX and could contribute to the development of different types of infection, including those of a bacterial, viral, or fungal origin. Although neutropenia is generally mild in severity, potentially severe DVPX-associated neutropenia can occur any time during the course of therapy, although it is most common within the first few months of treatment. In this case, DVPX was the probable cause of the neutropenia, according to the Naranjo probability scale. However, this case of neutropenia is atypical with respect to the timeframe in which it developed and was identified. Although the documented laboratory findings suggest neutropenia, the patient did not experience any clinical complications as a result. The late onset of the patient's neutropenia is unlike other cases that have been documented in the literature. Conclusions: Hematologic therapeutic drug monitoring continues to be clinically important regardless of whether the patient is early in therapy or even years later in the course. In this patient, continued regular therapeutic drug monitoring identified a suspected drug-related complication and the medication was able to be discontinued without the development of clinical complications. |
| تدمد: | 1542-6270 1060-0280 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::813f6f81591f5d132eb49287e54df4a1 https://doi.org/10.1345/aph.1l239 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....813f6f81591f5d132eb49287e54df4a1 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15426270 10600280 |
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