SYSTEMIC LUPUS-ERYTHEMATOSUS ASSOCIATED WITH USE OF VALPROATE

A 30-year-old man with long-standing localization-related epilepsy and mental retardation had seizures that were partially controlled with v alproate (VPA) 500 mg four times daily. Routine examination showed sev ere thrombocytopenia with mild leukopenia and chronic low-grade hemoly tic anemia. Pertinent laboratory results included positive ANA, rheuma toid factor, anti-NIA, circulating immune complexes, and antihistone a ntibody.The patient was treated with high dosage prednisone with parti al improvement, but continued to have exacerbations at lower dosages. Fourteen months later, VPA was discontinued, and rapid improvement ens ued. Prednisone was subsequently discontinued, and the patient has now maintained normal platelet counts for 18 months.