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Valproic Acid Producing a Reye-Like Syndrome

Published online by Cambridge University Press:  18 September 2015

D. L. Keene
Affiliation:
the Children’s Hospital of Eastern Ontario, Ottawa, Ontario
P. Humphreys
Affiliation:
the Children’s Hospital of Eastern Ontario, Ottawa, Ontario
B. Carpenter
Affiliation:
the Children’s Hospital of Eastern Ontario, Ottawa, Ontario
J.P. Fletcher
Affiliation:
the Children’s Hospital of Eastern Ontario, Ottawa, Ontario
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Summary:

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Although several cases of acute hepatic failure associated with the administration of valproic acid (VPA) have been reported, the pathogenesis of this problem remains unclear. We report the case of a 40 month old male with a chronic seizure disorder treated with VPA and phenytoin for two years, who developed sudden progressive neurological deterioration with evidence of increased intracranial pressure and hepatic failure. The clinical features closely resembled those of Reye’s syndrome suggesting the possibility of a common pathogenesis.

Type
Research Article
Copyright
Copyright © Canadian Neurological Sciences Federation 1982

References

Addison, G.M. AND Gordan, N.S. (1980). Sodium Valproate and Acute Hepatic Failure. Dev. Med. Child. Neurol. 22: 248249.CrossRefGoogle ScholarPubMed
Browne, T R. (1980). Drug Therapy – Valproic Acid. N. Eng. J. Med. Vol. 302: 661666.Google Scholar
Devivo, D.C. (1978). Reye Syndrome – A Metabolic Response to An Acute Mitochondrial Insult? Neurol. 28: 105108.CrossRefGoogle Scholar
Donat, J.; Bocchini, J.; Gonzalez, E. AND Schwendimann, R. N. (1979). Valproic Acid and Fatal Hepatitis. Neurol. 29: 273274.Google ScholarPubMed
Gerber, N.; Dickinson, R.G.; Harland, R.C.; Lynn, R.K.; Houghton, D.; Antonias, J.L.; AND Schimschock, J.C. (1979). Reye-Like Syndrome Associated with Valproic Acid Therapy. J. Peds. 95: 142144.CrossRefGoogle ScholarPubMed
Haas, R.; Stumpf, D.A.; Parks, J.K.; and Eguren, L. (1981). Inhibitory Effects of Sodium Valproate on Oxidative Phosphorylation. Neurol. 31: 14731476.CrossRefGoogle ScholarPubMed
Jacobi, G.; Thurbeck, R.; Ritz, A.; Janssen, W. and Schmidts, H. (1980). Fatal hepatotoxicity in Child on Phenobarbitone and Sodium Valproate. Lancet 1: 712714.CrossRefGoogle ScholarPubMed
Luther, R.; – Abbott Laboratories – personal communications.Google Scholar
Monnet, P.; David, M.; Phillippe, N.; Dechauanne, M.; Floret, D.; Renaud, H.; Trezeciak, M.C.; Brazier, J.L. AND Bourdillon, D. (1979). Changes of Hemostasis During Treatment with Sodium Dipropylacetate (Depakene). Pediatrics 24: 603620.Google Scholar
Sherard, E.; Steinman, G.S.; and Coun, D. (1980). Treatment of Childhood Epilepsy with Valproic Acid: Results of the First 100 Patients in a 6-Month trial. Neurol. 30: 3135.CrossRefGoogle Scholar
Suchy, F.; Balistreri, W.; BUCHINO. J.; Sondheimer, J.; Bates, S.; Kearns, G.L.; Stull, J.D.; AND Bove, K. (1979). Acute Hepatic Failure Associated with the Use of Sodium Valproate. N. Eng. J. Med. 300: 962966.CrossRefGoogle ScholarPubMed
Sussman, N.; and Mclain, W. (1979). A Direct Hepatotoxic Effect of Valproic Acid. J.A.M.A. 2421173-1174.Google ScholarPubMed
Trauner, D.A. (1980). Treatment of Reye’s Syndrome. Ann. Neurol. 7: 24.CrossRefGoogle Scholar
Trauner, D.A.; Myham, W.L.; Sweetman, L. (1975). Short-Chain Organic Acidemia and Reye’s Syndrome. Neurol. 25: 296298.CrossRefGoogle ScholarPubMed
Vining, E.P.G.; Botsford, E.: and Freeman, J.M. (1979). Valproate Sodium in Refractory Seizures. Am. J. Dis Child 133: 274276.CrossRefGoogle ScholarPubMed
Ware, S.; and Millward-Sadler, G.H. (1980). Acute Liver Disease Associated with Sodium Valproate. Ann. Neuro. 7: 11101113.Google Scholar
Willmore, LJ.; Wilder, B.J.; Bruni, J. and Villareal, H.J. (1978). Effect of Valproic Acid on Hepatic Functions. Neurol. 28: 961964.CrossRefGoogle Scholar
Young, R.S.; Bergman, I.; Gang, D.L.; and Richardson, E. (1980). Fatal Reye-Like Syndrome Associated with Valproic Acid. Ann. Neurol. Vol. 7: 389.CrossRefGoogle ScholarPubMed