A case report of thrombocytopenia induced by sodium valproate sustained release tablets in a schizophrenic patient

Abstract

The patient, a 28-year-old female, was aggravated by suspicion for more than a year, and the total course of the disease was unknown. She was sent to the outpatient clinic of our hospital by the staff of the rescue station on December 20, 2020. Outpatient clinic with “schizophrenia?” Admitted to hospital. Psychiatric examination after admission found that patients had obvious victim delusion, absurd content, the object was generalized, and the patient firmly believed it. No obvious abnormalities were found in admission physical examination. The patient denied the history of severe somatic disease, drug allergy and infection. Deny taking any drugs recently. No obvious abnormalities were found in the blood routine examination, liver and kidney function, electrolyte, blood glucose, blood lipid, thyroxine, stool routine, infectious diseases (5 markers of hepatitis B, hepatitis C, syphilis, HIV antibody), electrocardiogram, electroencephalogram, chest CT, abdominal color ultrasound and so on. PANSS score 81. According to ICD-10 diagnostic criteria, schizophrenia was diagnosed after admission, and aripiprazole was given antipsychotic treatment. The initial dose was 10 mg/day, and increased to 20 mg/day after 3 days and maintained until discharge. On January 10, 2021, the patient developed impulsive behavior and was treated with sodium valproate sustained-release tablets (VAP) 500 mg/day to stabilize emotion. The effective concentration of drug treatment was 50-100 μg/mL [1]. During the follow-up of 7 February 2021, the platelet count of the patients was decreased, and the platelet count was 82 X 109 /L Considering the adverse drug reactions caused by VAP, VAP was stopped immediately on the same day. On February 16,2021, routine blood platelet count showed that it returned to normal. After March 10,2021, the platelet was in the normal range, and further increased compared with February 16 (See Table 1).