Binek J, Hany A, Heer M
Department of Medicine, Gastroenterology, Medizinische Klinik Kantonsspital, Winterthur, Zürich, Switzerland.
J Clin Gastroenterol. 1991 Dec;13(6):690-3.
We report a case of pancreatitis with fatal liver failure, in a 21-year-old, mentally retarded patient, taking valproic acid (VPA) therapy, together with a review of the literature of this rare side effect. Until March 1991, only 24 cases of isolated pancreatitis and six cases (including ours) of pancreatitis with hepatic failure under VPA treatment have been published. Most of the patients were less than 20 years old, and injury to the pancreas developed during the first year of therapy in 72% of the patients, approaching a mortality of 21%. Pancreatitis associated with liver failure has a poor prognosis mainly because of the VPA hepatotoxicity. It seems that the pancreatic side effects fluctuate between two extremes: asymptomatic hyperamylasemia and fatal pancreatitis.
我们报告一例21岁智力发育迟缓患者在接受丙戊酸（VPA）治疗时发生胰腺炎并导致致命性肝衰竭的病例，并对这种罕见副作用的文献进行综述。截至1991年3月，仅发表了24例孤立性胰腺炎病例以及6例（包括我们的病例）在VPA治疗下发生胰腺炎合并肝衰竭的病例。大多数患者年龄小于20岁，72%的患者在治疗的第一年出现胰腺损伤，死亡率接近21%。与肝衰竭相关的胰腺炎预后较差，主要是由于VPA的肝毒性。胰腺副作用似乎在两个极端之间波动：无症状高淀粉酶血症和致命性胰腺炎。
