Pancreatitis in children on chronic dialysis treated with valproic acid

Ford, Douglas M.; Portman, Ronald J.; Lum, Gary

doi:10.1007/bf00857671

Cited by 30 publications

(15 citation statements)

References 10 publications

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“…Ng et al reported a female patient with epilepsy who was administered VPA and developed pancreatitis during hemodialysis [7]. Since then, the similar types of cases that have been reported thus far were cases with epilepsy [1,8-10]. To the best of our knowledge, the present report is the first case of VPA-induced pancreatitis in a patient with bipolar disorder who was also undergoing hemodialysis.…”

Section: Discussionsupporting

confidence: 65%

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

et al. 2014

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BackgroundCases of acute pancreatitis caused by sodium valproate (VPA) have been reported by many authors thus far. However, most of these were cases with epilepsy. Chronic renal failure is also regarded as a risk factor for acute pancreatitis. Here, we report a case of acute pancreatitis development due to VPA in a patient with bipolar disorder on hemodialysis for chronic renal failure.Case presentationThe patient was a 52-year-old Japanese male who was diagnosed as bipolar disorder on hemodialysis for renal failure. He was treated with VPA and manic symptoms gradually stabilized. However, the patient complained of severe abdominal pain. Blood amylase was found to be markedly high, and computed tomography revealed pancreatomegaly and an increased amount of peripancreatic fat. Hence, we diagnosed the case as acute pancreatitis caused by VPA. We discontinued oral medication, and he was started on a pancreatic enzyme inhibitor, antibiotics, and transfusion, and he showed improvement.ConclusionIt has been reported that acute pancreatitis induced by VPA is caused by intermediate metabolites of VPA. We consider that patients with renal failure are prone to pancreatitis caused by VPA because of the accumulation of these intermediate metabolites. We need close monitoring for serious adverse effects such as pancreatitis when we prescribe VPA to patients with bipolar disorder on hemodialysis for chronic renal failure, although VPA is safer than other mood stabilizers.

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Section: Discussionsupporting

confidence: 65%

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

et al. 2014

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“…1 Some authors have suggested a potential correlation between valproic acid-induced pancreatitis and either peritoneal dialysis or hemodialysis. 29,30 Of the 45 patients we evaluated, nine were on hemodialysis or peritoneal dialysis when they developed pancreatitis. It is notable that two of the nine patients recovered and were able to resume valproic acid therapy without recurrence of pancreatitis following kidney transplantation, and three patients recovered following discontinuation of valproic acid with continued dialysis.…”

Section: Discussionmentioning

confidence: 99%

Pancreatitis Associated with Valproic Acid: A Review of the Literature

Chapman

Wacksman²,

Patterson

2001

Pharmacotherapy

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Black box warnings for valproic acid caution clinicians of the potential for fatal hepatotoxicity and teratogenicity. Since 1979, case reports of pancreatitis induced by valproic acid have been published in the medical literature. As a result, pancreatitis was added to the black box warnings for valproic acid. We performed searches of MEDLINE and International Pharmaceutical Abstracts and found valproic acid-induced pancreatitis in 45 patients from 31 published articles. Demographics, clinical characteristics, and outcomes of these patients are summarized. Recommendations for monitoring the potential for pancreatitis to develop in patients receiving valproic acid therapy are described, as are potential mechanisms for inducement of pancreatitis by valproic acid.

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“…These consisted of 14 individual case reports [14][15][16][17][18][19][20][21][22][23][24][25][26][27], five case series [6,11,12,28,29] and nine population-based studies [2,4,[7][8][9][10]13,30,31] reporting a total of 94 cases with 133 episodes of pancreatitis from 1985 to 2011. Only articles in English and those describing cases of AP in PD patients were included.…”

Section: Discussionmentioning

confidence: 99%

Acute pancreatitis in peritoneal dialysis

Manga

Lim²,

Mangena³

et al. 2012

European Journal of Gastroenterology & Hepatology

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Abdominal pain with a discoloured dialysate in a patient on peritoneal dialysis (PD) is usually attributed to infective peritonitis. Although acute pancreatitis (AP) is not usually a complication of end-stage renal disease, some studies suggest an increased risk especially in patients on PD. We report a case of idiopathic AP in a 41-year-old female on PD who presented with abdominal pain, fever, vomiting and a clear dark dialysate. Initial diagnosis of PD-associated infective peritonitis was made but dialysate cultures proved negative. Serum amylase showed a mild rise and computed tomography revealed necrotising pancreatitis. No common risk factors for AP were identified and she was successfully treated with conservative therapy. A literature review was carried out using a PubMed search with the words 'acute pancreatitis and peritoneal dialysis'. The literature search found a total of 94 cases of AP in the setting of PD. In more than a quarter, no cause for AP was found. Serum amylase was normal in 12.8% of episodes. Complications developed in 25 cases, and 28 patients died from the condition. Therefore, AP can be a rare, but serious complication of PD with a high mortality and must be considered in the differential diagnosis of abdominal pain in a PD patient.

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Pancreatitis in children on chronic dialysis treated with valproic acid

Cited by 30 publications

References 10 publications

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

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

Pancreatitis Associated with Valproic Acid: A Review of the Literature

Acute pancreatitis in peritoneal dialysis

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