Deschenes Pierre-Charles, Autmizguine Julie, Major Philippe, Kleiber Niina
J Pediatr Pharmacol Ther. 2020;25(3):256-260. doi: 10.5863/1551-6776-25.3.256.
A 2-year-old Caucasian boy with tuberous sclerosis complex presented to the emergency department with lethargy and new onset myoclonias. Pancreatitis, thrombocytopenia, and coagulopathy associated to a decreased level of consciousness were diagnosed. Valproic acid had been initiated 13 months before and had been slowly increased to a dose of approximately 38 mg/kg/day. All the symptoms resolved after discontinuation of the medication. The clinical presentation of this child highlights that valproic acid-related pancreatitis can present with decreased level of consciousness without associated gastrointestinal symptoms. Adverse drug reactions associated with valproic acid can lead to damage of multiple organs and may prove fatal if not promptly recognized and managed.
一名患有结节性硬化症复合体的2岁白人男孩因嗜睡和新发肌阵挛被送往急诊科。诊断为胰腺炎、血小板减少症以及与意识水平下降相关的凝血病。丙戊酸在13个月前开始使用，并已缓慢增加至约38毫克/千克/天的剂量。停药后所有症状均得到缓解。该患儿的临床表现突出表明，丙戊酸相关胰腺炎可表现为意识水平下降且无相关胃肠道症状。与丙戊酸相关的药物不良反应可导致多器官损害，若不及时识别和处理可能会致命。
