Wyllie E, Wyllie R, Cruse R P, Erenberg G, Rothner A D
Am J Dis Child. 1984 Oct;138(10):912-4. doi: 10.1001/archpedi.1984.02140480014005.
Four patients had pancreatitis associated with valproic acid therapy. Three patients received valproic acid at usual doses, and all were free of other symptoms of toxic reactions, with serum levels of valproic acid in the usual therapeutic range. Two patients underwent exploratory laparotomy prior to diagnosis. Complications included pseudocyst, pericardial effusion, laparotomy wound infection, and coagulopathy. All patients recovered with discontinuation of valproic acid therapy and enteral feeding and administration of intravenous fluids. After recovery, a valproic acid regimen was restarted uneventfully (in one patient). All were asymptomatic with normal serum amylase levels after five to 14 months. Pancreatitis is a serious complication of valproic acid therapy that must be considered in any patient receiving valproic acid who experiences severe abdominal pain and vomiting.
4例患者出现与丙戊酸治疗相关的胰腺炎。3例患者接受常规剂量的丙戊酸治疗，且均无其他中毒反应症状，丙戊酸血清水平处于常规治疗范围内。2例患者在诊断前接受了剖腹探查术。并发症包括假性囊肿、心包积液、剖腹手术伤口感染和凝血病。所有患者在停用丙戊酸治疗、进行肠内喂养并给予静脉输液后均康复。康复后，1例患者顺利重新开始丙戊酸治疗方案。5至14个月后，所有患者均无症状，血清淀粉酶水平正常。胰腺炎是丙戊酸治疗的严重并发症，对于任何接受丙戊酸治疗且出现严重腹痛和呕吐的患者都必须予以考虑。
