Development of acute pancreatitis caused by sodium valproate in a patient with bipolar disorder on hemodialysis for chronic renal failure: a case report

Okayasu, Hiroaki; Shinozaki, Takahiro; Osone, Akira; Ozeki, Yuji; Saito, Kazutaka

doi:10.1186/1471-244x-14-93

Cited by 8 publications

(4 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Generally, the allergic reactions may not occur at low initial dose and slow titration rate, giving time for the body to become desensitized. Additionally, other factors include the similar responses to prior treatment, or disease-related factors such as metabolic disorder patients with sodium valproate-related liver toxicity [8] and end-stage renal disease patients with sodium valproate-associated pancreatitis [2].…”

Section: Discussionmentioning

confidence: 99%

“…Acute pancreatitis as one of the most severe sodium valproate-related toxic effects makes a total of less than 100 cases reported in the English literature from 1979 to 2005 [1] , and even fewer after 2005. Most of them are children with epilepsy, however, only 1 bipolar disorder patient with renal failure who underwent hemodialysis and subsequently developed acute pancreatitis due to sodium valproate treatment [2]. Hereby, we present a case of bipolar disorder with sodium valproate-induced acute pancreatitis.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Sodium valproate induced acute pancreatitis in a bipolar disorder patient: a case report

Huang

Ren

Shen

et al. 2019

BMC Pharmacol Toxicol

View full text Add to dashboard Cite

BackgroundSodium valproate is one of the most widely used antiepileptics and mood stabilizers. However, this drug may induce acute pancreatitis. Few cases have been reported so far, mainly on the pediatric patients who underwent antiepileptic treatment. Hereby, we present a case of bipolar disorder with sodium valproate-induced acute pancreatitis.Case presentationThe patient is a 54-year-old Chinese male. He was diagnosed with bipolar disorder for more than 39 years. Since the first onset of the disease, he had several relapses. The patient had had sodium valproate to stabilize mood swings for a year before the occurrence of acute pancreatitis. But he did vomit once during the inpatient care period. Then he was referred to another hospital following a notably high level of amylase. The results of computed tomography demonstrated an increased pancreatic volume and swollen peripancreatic fat tissue. As a result, the patient was diagnosed with acute pancreatitis. Unlike other cases reported in literatures, the high amylase level did not revert to normal after the withdrawal of medications. The patient was discharged from hospital with a high level of amylase, and was placed under follow-up observations.ConclusionAcute pancreatitis is considered as one of the idiosyncratic adverse reactions to antiepileptic drugs. Previous reports were mainly on the pediatric patients with increased propensity to idiosyncratic drug effects, or the adult chronic renal failure patients with sodium valproate-induced pancreatitis due to the retention of intermediate metabolites in their bodies. In this study, even though our patient exhibited no high risk of developing pancreatitis, he was treated for drug-induced acute pancreatitis in three hospitals. As rare as drug-induced acute pancreatitis can be, it should not be overlooked, Moreover, the mechanism of how sodium valproate induces acute pancreatitis remains unknown. Therefore, physicians need to consider the medical history of patients before prescribing this medication.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sodium valproate induced acute pancreatitis in a bipolar disorder patient: a case report

Huang

Ren

Shen

et al. 2019

BMC Pharmacol Toxicol

View full text Add to dashboard Cite

show abstract

“…Potential risk factors are represented by age under 3 years (an occurrence unlikely to happen in the treatment of BD), an antiepileptic polytherapy, and a developmental delay [77], and VPA can cause pancreatitis, usually mild but it can be fatal. It has been reported in case reports and case series, mostly on patients affected with epilepsy, but also with BD, and occurs in 40 % of cases within the first 3 months of treatment, in 70 % of cases in the first year [78,79]. It is idiosyncratic and unpredictable, but identified risk factors are a young age and polypharmacy [80].…”

Section: Valproatementioning

confidence: 95%

Management of Adverse Effects of Mood Stabilizers

Murru

Popović

Pacchiarotti

et al. 2015

Curr Psychiatry Rep

View full text Add to dashboard Cite

Mood stabilizers such as lithium and anticonvulsants are still standard-of-care for the acute and long-term treatment of bipolar disorder (BD). This systematic review aimed to assess the prevalence of their adverse effects (AEs) and to provide recommendations on their clinical management. We performed a systematic research for studies reporting the prevalence of AEs with lithium, valproate, lamotrigine, and carbamazepine/oxcarbazepine. Management recommendations were then developed. Mood stabilizers have different tolerability profiles and are eventually associated to cognitive, dermatological, endocrine, gastrointestinal, immunological, metabolic, nephrogenic, neurologic, sexual, and teratogenic AEs. Most of those can be transient or dose-related and can be managed by optimizing drug doses to the lowest effective dose. Some rare AEs can be serious and potentially lethal, and require abrupt discontinuation of medication. Integrated medical attention is warranted for complex somatic AEs. Functional remediation and psychoeducation may help to promote awareness on BD and better medication management.

show abstract

“…19 Most of the cases are children with epilepsy; however, only one bipolar disorder patient with renal failure, who underwent haemodialysis and subsequently developed acute pancreatitis due to VPA treatment, has been reported. 20 Herein, the authors present a rare case of adult valproate-induced acute pancreatitis, presenting 12 years after starting the drug, and who had a good outcome due to early diagnosis and resuscitation.…”

Section: Introductionmentioning

confidence: 99%

A Rare Complication of Valproate-Induced Acute Pancreatitis in an Adult Patient with Bipolar Disorder: A Case Report

2023

View full text Add to dashboard Cite

Background: Valproate-induced pancreatitis is an idiosyncratic reaction of the drug, commonly seen in the paediatric age group, between 1 week to 8 years of starting the drug. Case: The authors present a case report of a 61-year-old patient who presented with acute pancreatitis. All common causes were ruled out. The patient had a significant treatment history of taking valproate for bipolar disorder for 12 years. The patient was resuscitated with intravenous fluids and analgesics. Sodium valproate was stopped. The patient was monitored to detect early symptoms of systemic inflammatory response syndrome or any organ dysfunction or failure. The patient was sent to the ward after 4 days. The patient had a good outcome due to early diagnosis and resuscitation. Conclusion: Acute pancreatitis is a rare and potentially fatal complication in patients on valproate. After ruling out other common causes, a detailed medical and treatment history can lead to the diagnosis of this entity. Healthcare providers should be vigilant about the early signs and symptoms of pancreatitis, including acute abdomen, vomiting, and raised serum amylase and lipase.

show abstract

Development of acute pancreatitis caused by sodium valproate in a patient with bipolar disorder on hemodialysis for chronic renal failure: a case report

Cited by 8 publications

References 9 publications

Sodium valproate induced acute pancreatitis in a bipolar disorder patient: a case report

Sodium valproate induced acute pancreatitis in a bipolar disorder patient: a case report

Management of Adverse Effects of Mood Stabilizers

A Rare Complication of Valproate-Induced Acute Pancreatitis in an Adult Patient with Bipolar Disorder: A Case Report

Contact Info

Product

Resources

About