Journals / Türkiye Acil Tıp Dergisi / 2008 / Cilt: 8 - Sayı: 3

Haemodialysis in serious valproic acid poisoning: A case report

Ciddi valproik asit zehirlenmesinde hemodiyaliz uygulanması: Olgu sunumu

Pages
139–142
Publication Date
2022-11-05
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

In the present study, we aimed to emphasize the importance of haemodialysis in serious VA poisoning as well as the standard therapy options.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Valproic acid (VA) is commonly used in treatment of epilepsy and bipolar affective disorder as well as prophylaxis of migraine.
📊
Key Findings & Data:A 32 years old female admitted to our emergency department because of altered mental status due to ingesting high dose VA 5 hours ago.
💡
Conclusion & Impact:In the present study, we aimed to emphasize the importance of haemodialysis in serious VA poisoning as well as the standard therapy options.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Valproic acid (VA) is commonly used in treatment of epilepsy and bipolar affective disorder as well as prophylaxis of migraine. The ingestion of high dose VA may cause depression of central nervous system, breath failure, renal failure, acute pancreatitis, hepatotoxicity and bone marrow depression. A 32 years old female admitted to our emergency department because of altered mental status due to ingesting high dose VA 5 hours ago. An immediate haemodialysis was performed to the patient because of high plasma VA level (1153 μg/mL). Plasma VA concentration decreased to 193 μg/mL after haemodialysis. The patient discharged from the hospital on the 10th of ingestion without any problem. In the present study, we aimed to emphasize the importance of haemodialysis in serious VA poisoning as well as the standard therapy options.

Özet

Valproik asit (VA) epilepsi, bipolar afektif bozukluk ve migren profilaksisinde yaygın olarak kullanılmaktadır. Yüksek doz alımlarda, uykuya eğilim, koma, merkezi sinir sistemi depresyonu, solunum yetmezliği, böbrek yetmezli- ği, akut pankreatit, hepatotoksisite ve kemik iliği depresyonuna neden olabilmektedir. Otuz iki yaşında kadın hasta özkıyım amaçlı yüksek doz VA aldıktan yaklaşık 5 saat sonra bilinci kapalı olarak acil servisimize getirildi. Plazma VA düzeyi 1153 μg/ml ölçülen hastaya hemodiyaliz uygulandı. Hemodiyaliz sonrası plazma VA düzeyi 193 μg/ml idi. Olgu, takibinin 10. gününde şifa ile taburcu oldu. Bu yazıdaki amacımız, ciddi VA zehirlenmesinde alternatif bir tedavi olan hemodiyalizin önemini vurgulamaktır.

🔖

Cite This Article

ERENLER, A. K., ACAR, E., BAYDIN, A., AYGÜN, D., GENÇ, S., YANDAN, T. (2022). Haemodialysis in serious valproic acid poisoning: A case report. Türkiye Acil Tıp Dergisi, Cilt: 8 - Sayı: 3, 139–142. https://ajindex.com/articles/626123

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (16)

  1. Engbersen R, Kramers C. Enhanced extracorporeal elimination of valproic acid in overdose. Neth J Med 2004;62:307-8
  2. Houghton BL, Bowers JB. Valproic acid overdose: a case report and review of therapy. MedGenMed 2003;5:5
  3. Sztajnkrycer MD. Valproic acid toxicity: overview and management. J Toxicol Clin Toxicol 2002;40:789-801
  4. Al Aly Z, Yalamanchili P, Gonzalez E. Extracorporeal management of valproic acid toxicity: a case report and review of the literature. Semin Dial 2005;18:62-6
  5. Sikma MA, Mier JC, Meulenbelt J. Massive valproic acid overdose, a misleading case. Am J Emerg Med 2008;26:110.e3-6
  6. Lackmann GM. Valproic-acid-induced thrombocytopenia and hepatotoxicity: discontinuation of treatment? Pharmacology 2004;70:57-8
  7. Guillaume CP, Stolk L, Dejagere TF, Kooman JP. Successful use of hemodialysis in acute valproic acid intoxication. J Toxicol Clin Toxicol 2004;42:335-6
  8. Katiyar A, Aaron C. Case files of the Children's Hospital of Michigan Regional Poison Control Center: the use of carnitine for the management of acute valproic acid toxicity. J Med Toxicol 2007;3:129-38
  9. Lheureux PE, Penaloza A, Zahir S, Gris M. Science review: carnitine in the treatment of valproic acid-induced toxicity - what is the evidence? Crit Care 2 0 0 5; 9: 4 3 1 - 4 0
  10. Pinkston R, Walker LA. Multiorgan system failure caused by valproic acid toxicity. Am J Emerg Med 1997;15:504-6
  11. Khan E, Huggan P, Celi L, MacGinley R, Schollum J, Walker R. Sustained lowefficiency dialysis with filtration (SLEDD-f) in the management of acute sodium valproate intoxication. Hemodial Int 2008;12:211-4
  12. Meek MF, Broekroelofs J, Yska JP, Egbers PH, Boerma EC, van der Voort PH. Valproic acid intoxication: sense and non-sense of haemodialysis. Neth J Med 2004;62:333-6
  13. Eyer F, Felgenhauer N, Gempel K, Steimer W, Gerbitz KD, Zilker T. Acute valproate poisoning: pharmacokinetics, alteration in fatty acid metabolism, and changes during therapy. J Clin Psychopharmacol 2005;25:376-80
  14. Spiller HA, Krenzelok EP, Klein-Schwartz W, Winter ML, Weber JA, Sollee DR, et al. Multicenter case series of valproic acid ingestion: serum concentrations and toxicity. J Toxicol Clin Toxicol 2000;38:755-60
  15. Cerulli TR, Alkoc SC, Salzman C. Effects of psychotropic medications on pancreatic function: a review. Harv Rev Psychiatry 1999;7:54-60
  16. Dharnidharka VR, Fennell RS 3rd, Richard GA. Extracorporeal removal of toxic valproic acid levels in children. Pediatr Nephrol