Managing valproic acid toxicity-related hyperammonaemia: an unpredicted course.
drugs: psychiatry
general practice / family medicine
Journal
BMJ case reports
ISSN: 1757-790X
Titre abrégé: BMJ Case Rep
Pays: England
ID NLM: 101526291
Informations de publication
Date de publication:
19 Apr 2021
19 Apr 2021
Historique:
entrez:
20
4
2021
pubmed:
21
4
2021
medline:
15
5
2021
Statut:
epublish
Résumé
A 20-year-old woman presented following an intentional overdose of valproic acid. Use of valproic acid, either acute or chronic, can result in hyperammonaemia. Mild hyperammonaemia with chronic use is mostly asymptomatic but can also present with concern for encephalopathy. Acute valproic acid toxicity results in significant hyperammonaemia, which can contribute to encephalopathy. Levocarnitine is the treatment of choice in valproic acid toxicity-related hyperammonaemia. For severe cases of encephalopathy, intermittent haemodialysis can also be considered. To our knowledge, this is the first case report to clearly show symptom relapse and hyperammonaemia after discontinuing levocarnitine. We recommend levocarnitine therapy for at least 72 hours, followed by an additional 24 hours of monitoring for symptom relapse and hyperammonaemia after levocarnitine discontinuation.
Identifiants
pubmed: 33875509
pii: 14/4/e241547
doi: 10.1136/bcr-2020-241547
pmc: PMC8057561
pii:
doi:
Substances chimiques
Valproic Acid
614OI1Z5WI
Carnitine
S7UI8SM58A
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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