Severe thrombocytopenia caused by sodium valproate

An 87-year-old woman with convulsions and bradycardia received a continuous IV infusion of sodium valproate 1200 mg once daily by a pump at a rate of 20 ml per hour.Her platelet count was 214 × 10~9 /L before treatment.Eight days after treatment,her platelet count decreased to 63 × 10~9/L. Sodium valproate injection was withdrawn and her therapy was changed to sustained-release sodium valproate tablets 500 mg/d once daily.Five days later,the patient's platelet count decreased to 25 × 10~9/L. Sustained-release sodium valproate tablets were withdrawn.The patient received platelet transfusion 1 U and amino-polypeptide tablets 1000 mg three times a day.After eight days of symptomatic treatment,the patient's platelet count increased to 160 × 10~9 /L.