• Chen Li, Lei Su, Minxi Lao, Shaofang Zhu, and Meilin Ding.
• Department of Geriatrics.
• Medicine (Baltimore). 2018 Dec 1; 97 (50): e13626.

RationaleSodium valproate is a widely used antiepileptic drug and also used to prevent postoperative seizures in neurosurgery. Anemia caused by sodium valproate is occasionally reported and most are from pediatric patients.Patient ConcernsWe present the case of a 79-year-old man who developed anemia in the setting of a short-term sodium valproate therapy for the prevention of postoperative seizures.DiagnosisBy testing complete blood count we found anemia and hepatic enzyme elevations arising after 3-week standard dose sodium valproate therapy for preventing postoperative seizures. Our investigations ruled out most of the known causes of anemia including infection, uncontrolled bleeding, underlying systemic disease, malnutrition, immune hemolytic anemia, and neoplasia. On the drug's discontinuation as diagnostic therapy the patient's hemoglobin began to rise spontaneously and liver function returned to normal. Thus anemia secondary to sodium valproate was considered as the most likely diagnosis.InterventionsSodium valproate was suspended and the patient was transfused with concentrated red blood cells.OutcomesThe hemoglobin recovered obviously on the drug's discontinuation.LessonsHematologic toxicity of sodium valproate can occur quickly. Regular complete blood count test helps to make prompt diagnosis and drug discontinuation leads to the recovery.

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