Tuberc Respir Dis.  2014 Sep;77(3):145-148. 10.4046/trd.2014.77.3.145.

A Case of Drug-Induced Interstitial Pneumonitis Caused by Valproic Acid for the Treatment of Seizure Disorders

• Kim SJ
• Jhun BW
• Lee JE
• Kim K
• Choi HY

• KMID: 2320562
• DOI: http://doi.org/10.4046/trd.2014.77.3.145

Abstract

Valproic acid is one of the most common antiepileptic drugs used for the treatment of several seizure disorders. A 20-year-old man presented with a sudden decline of consciousness. He had a neurosurgery operation for intracranial and intraventricular hemorrhage. Following surgery, antiepileptic medication was administered to the patient in order to control his seizure events. On valproic acid treatment, he began to complain of fever and dyspnea. His symptoms persisted despite receiving empirical antibiotic treatment. All diagnostic tests for infectious causes were negative. A high-resolution computed tomography scan of the chest revealed predominantly dependent consolidation and ground-glass opacities in both lower lobes. The primary differential was drug associated with interstitial lung disease. Therefore, we discontinued valproic acid treatment and began methylprednisolone treatment. His symptoms and radiologic findings had significantly improved after receiving steroid therapy. We propose that clinicians should be made aware of the potential for valproic acid to induce lung injury.

Keyword

Valproic Acid; Lung Diseases, Interstitial; Drug Hypersensitivity

MeSH Terms

Anticonvulsants
Consciousness
Diagnostic Tests, Routine
Drug Hypersensitivity
Dyspnea
Epilepsy*
Fever
Hemorrhage
Humans
Lung Diseases, Interstitial*
Lung Injury
Methylprednisolone
Neurosurgery
Seizures
Thorax
Valproic Acid*
Young Adult
Anticonvulsants
Methylprednisolone
Valproic Acid

Figure

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  Figure 1 Chest radiography showed no active parenchymal lesion on admission.

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  Figure 2 At day 5 after the initiation of valproic acid, chest radiography revealed bilateral consolidation in both lower lung fields (A). A high-resolution computed tomography scan of the chest revealed predominantly dependent consolidation with air bronchogram and ground-glass opacities in both lower lobes (B).

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  Figure 3 After the discontinuation of quetiapine therapy and 14 days of steroid therapy, a high-resolution computed tomography scan of the chest revealed a decreased extent of consolidation in both lung fields.

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