Bota Robert G, Ligasan Allein P, Najdowski Tom G, Novac Andrei
Perm J. 2011 Spring;15(2):80-4. doi: 10.7812/TPP/10-140.
Valproic acid (VPA) is an antiepileptic medication used in the treatment of bipolar disorder. Its toxicity profile is characterized by a very rare but well-documented complication-hepatotoxicity. The risk of acute hypersensitivity syndrome (AHS) caused by VPA is less well known. In the vast majority of reported cases of AHS, the syndrome is the result of aromatic anticonvulsants (AAs), such as carbamazepine or phenytoin. These compounds also have in-class cross-reactivity. We present the case of a 25-year-old woman with bipolar disorder who was unable to tolerate aripiprazole, ziprasidone, and lamotrigine. She was given extended-release VPA as a trial and developed AHS with a generalized rash, fever, liver and kidney involvement, and eosinophilia one week after the initiation of treatment. She recovered after one month of treatment, which included ten days of hospitalization. Our review of the literature focuses on AA and non-AA medications causing AHS.
丙戊酸(VPA)是一种用于治疗双相情感障碍的抗癫痫药物。其毒性特征表现为一种非常罕见但有充分文献记载的并发症——肝毒性。VPA引起急性超敏反应综合征(AHS)的风险则鲜为人知。在绝大多数已报道的AHS病例中,该综合征是由芳香族抗惊厥药(AAs),如卡马西平或苯妥英引起的。这些化合物在同类药物中也存在交叉反应性。我们报告了一例25岁双相情感障碍女性病例,她无法耐受阿立哌唑、齐拉西酮和拉莫三嗪。作为试验,她接受了缓释VPA治疗,治疗开始一周后出现了AHS,伴有全身性皮疹、发热、肝肾功能损害和嗜酸性粒细胞增多。经过一个月的治疗,包括住院十天,她康复了。我们对文献的回顾聚焦于引起AHS的AAs和非AAs药物。