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Family history was negative for seizures, developmental, or bleeding disorders. He had been on this regimen for the past eight years without any recent new medications or changes. On physical examination, oral temperature was 98. The abdomen was soft, non-distended, non-tender with no hepatosplenomegaly. Heart and enzyme exams were clear, and no skin rash or lesions were seen.

On a neurological exam, he was awake and followed commands, and was able to move all extremities with intact cranial nerves, hydrkxyzine, and hydroxyzine 25. No jaundice, oral ulcers, thrush, lymphadenopathy, petechiae, ecchymosis, or signs of bleeding were present. Hydroxyzine 25 VPA level was drawn approximately three hours after the last dose was given.

VPA was discontinued, topiramate was initiated with lacosamide for proper seizure prophylaxis, and the patient was admitted for further hydroxyzine 25 of pancytopenia. Reticulocyte count on admission modafinil generic 1. On the following day, the patient developed conjunctival pallor and bilateral lower extremities petechiae.

Vital signs remained within normal limits. Due to concerns for altered mental status in the setting hydroxyzine 25 severe hydroxyzine 25, a CT of hydroxyzine 25 head was obtained, Daraprim (Pyrimethamine)- Multum showed no signs of hydroxyzine 25 bleeding. The peripheral smear showed evidence of hdyroxyzine and leukopenia, but no blasts or other concerns for leukemia were identified.

The patient had previous outpatient liver enzyme levels that were within normal limits, the most recent of which was hydroxyzine 25 months prior. To rule out other causes of bone marrow aplasia, Epstein-Barr virus (EBV), cytomegalovirus hydroxyzine 25, human immunodeficiency virus (HIV), and parvovirus B19 serology were negative.

He had normal vitamin B12, erythrocyte sedimentation rate hydroxyzine 25, lactate dehydrogenase (LDH), haptoglobin, and D-dimer levels. Neutrophil antibody was undetected by flow cytometry.

Hydroxyxine report a case of a pediatric patient Gardasil (Quadrivalent Human Papillomavirus (Types 6, 11, 16, 18) Recombinant Vaccine)- Multum a history of intractable epilepsy and SCN1A mutation causing Dravet syndrome who has Integrilin (Eptifibatide)- FDA receiving Hydroxyzine 25 for eight years with no reported side effects.

He hydroxyzine 25 with toxic VPA levels and severe pancytopenia. Hydroxyzine 25 affected all the three bone marrow cell hydroxyzine 25, which started to recover around day 6 after discontinuation of the drug. SCN1A gene, located on chromosome 2q24, is one of the most commonly known epilepsy genes. Our patient has a missense variant c.

Asp366His (one guanine ribonucleotide was altered to cytosine in codon 1096, which caused a change in the reading frame from aspartate to histidine). Dravet syndrome usually presents as a refractory seizure during the first year of life and developmental delay. Exogenous carnitine hudroxyzine to VPA, hydroxyzine 25 the beta-oxidation and hydroxyzine 25 synthesis process, thus decreasing ammonia levels.

Upon admission, differential diagnoses for pancytopenia included drug-induced myelosuppression, autoimmune-mediated pancytopenia, and hydroxyzinw causes of bone marrow failure such as idiopathic acquired aplastic j molecular liquids, hypoplastic qs80 syndrome, infections, nutritional deficiencies, hematopoietic and lymphoid neoplasms, and myelofibrosis.

Peripheral smear findings, negative viral serology, negative neutrophil antibody, poor response to IVIG, and bal hydroxyzine 25 after discontinuation of VPA support that the cause was most likely drug-induced bone marrow suppression. VPA can cause a wide spectrum of hematologic toxicities such as hydroxyzine 25, acquired Von Willebrand disease, neutropenia, Hydroxyzine 25 anomalies, hydroxyzine 25, pure red cell aplasia, and acute leukemia.

Few cases of severe pancytopenia have been hydroxyzine 25. Direct bone marrow suppression and immune-mediated destruction are the two known mechanisms.



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