Valproic acid-induced pancreatitis in an adult

Santos, Bruno Lopes dos; Fernandes, Regina Maria França; Neves, Fábio Fernandes

doi:10.1590/s0004-282x2010000100029

Cited by 10 publications

(7 citation statements)

References 6 publications

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“…Since then, more than 100 such cases have appeared in the literature [4], although most cases involved epilepsy, and only two cases involved bipolar disorder [5,6]. Ng et al reported a female patient with epilepsy who was administered VPA and developed pancreatitis during hemodialysis [7].…”

Section: Discussionmentioning

confidence: 99%

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: Discussionmentioning

confidence: 99%

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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“…The dosage given to the patient was well within the maximum tolerated dose range. [5] Similarly, the serum sodium valproate level on admission was 67 μg/ml, which was within the normal therapeutic range (50–125 μg/ml). Other VPA-related idiosyncratic reactions reported are alopecia, bone marrow aplasia, and immune-mediated hepatotoxicity.…”

mentioning

confidence: 91%

“…The first case of valproate-associated acute pancreatitis was reported in 1979 and since then, around 120 cases have been published in medical literature including few fatal cases. [5] Management of the drug-induced pancreatitis involves withdrawal of the offending drug and supportive care to the patient. However, patient outcomes have been observed to vary from full recovery after discontinuation of drug to severe acute pancreatitis and death.…”

mentioning

confidence: 99%

Valproic acid-induced acute pancreatitis

Jain

Haque

Tayal

et al. 2019

Indian J Psychiatry

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“…[5] Acute pancreatitis occurs due to several etiologies and is sometimes associated with the use of medications. [6] The authors herein report a case of valproate-induced pancreatitis with established causality, severity, and preventability assessments using Naranjo algorithm, [7] Modified Hartwig and Siegel Scale, [8] and Modified Schumock and Thornton scales, [9] respectively.…”

Section: Introductionmentioning

confidence: 99%