Abstract
The role of arachidonate metabolites in valproate-induced platelet dysfunction and hemorrhagic diathesis was investigated by ex vivo methods at the Albert Szent-Gyorgyi Medical University, Szeged, Hungary.
Highlights
Phenytoin-associated thrombocytopenia is reported in a 2-year-old girl on the 11th day of therapy, with recovery 5 days after withdrawal of treatment
Thrombocytopenia and platelet dysfunction are suggested causes for the bleeding, and ex vivo experiments have demonstrated a VPA-induced inhibition of arachidonate cascade in the platelets, leading to reduced synthesis of platelet aggregators
Erythema multiforme had occurred in only one patient, whereas milder rashes occurred in 18% of exposures to AEDs, including 22% of exposures to phenytoin, compared with the expected rate of 5-10%
Summary
Phenytoin-associated thrombocytopenia is reported in a 2-year-old girl on the 11th day of therapy, with recovery 5 days after withdrawal of treatment. The role of arachidonate metabolites in valproate-induced platelet dysfunction and hemorrhagic diathesis was investigated by ex vivo methods at the Albert Szent-Gyorgyi Medical University, Szeged, Hungary. Platelets isolated from patients receiving long-term valproate (VPA) therapy or carbamazepine (CBZ) as a control were labeled with C14 arachidonic acid.
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