Sodium Valproate-induced Eosinophilic Exudative Pleural Effusion

A 34-year-old woman presented with a 3-day history of dyspnea. She denied any preceding fever, night sweats, cough, pleurisy, or coryzal symptoms. was maintained on sodium valproate 800 mg b.i.d., phenytoin 100 o.d., folate 5 and clonazepam 2 nocte for known seizure disorder. Clinical examination radiologic imaging revealed large left-sided pleural effusion the associated collapse left lower lung lobe. chest tube inserted diagnostic therapeutic purposes ≈500 mls serous fluid drained. The analysis confirmed an exudative effusion. Extensive evaluation excluded causes effusion, diagnosis valproate-induced made. Sodium tapered off topiramate added to patient’s antiepileptic regimen. We recommend physicians be cognizant valproate-associated even in setting chronic use.