Rose E, de Miscault G, Thome M, Boussard N
Département d'anesthésie-réanimation, CHU de Brabois, Vandoeuvre-lès-Nancy, France.
Pediatrie. 1991;46(12):831-7.
The authors report on the case of a 12.5 and year-old epileptic boy with severe acute pancreatitis which appeared 39 months after starting treatment with sodium valproate (VAP) at a daily dosage of 26.6 mg/kg. Twelve days after hospitalization, a pseudocyst of the pancreas developed, leading to cystoduodenostomy 3 months later. Following VPA suppression, no recurrence of pancreatic symptomatology was observed. The pathophysiological mechanism of this adverse side-effect of VPA treatment remains unclear. The appearance of a painful epigastric syndrome and/or vomiting in a patient subjected to a VPA treatment indicates the possibility or acute pancreatitis, to be confirmed by blood and urinary determination of amylases and abdominal tomodensitometric examination. Finally, the fact that this side-effect may be severe even lethal, brings into question the prescription of this drug in the management of epilepsy.
作者报告了一例12岁半的癫痫男孩，在开始使用丙戊酸钠（VAP）治疗，每日剂量为26.6mg/kg 39个月后出现严重急性胰腺炎。住院12天后，胰腺假性囊肿形成，3个月后进行了囊肿十二指肠吻合术。停用丙戊酸后，未观察到胰腺症状复发。丙戊酸治疗这种不良反应的病理生理机制尚不清楚。接受丙戊酸治疗的患者出现上腹部疼痛综合征和/或呕吐提示可能患有急性胰腺炎，需通过血液和尿液淀粉酶测定及腹部计算机断层扫描检查来确诊。最后，这种副作用可能很严重甚至致命，这使得在癫痫治疗中使用该药物受到质疑。
