Galdames D, Silva C, Aguilera L, Chesta J
Servicio de Neurología-Neurocirugía, Hospital Clínico de la U de Chile Dr José Joaquín Aguirre, Santiago.
Rev Med Chil. 1993 Dec;121(12):1432-6.
Valproic acid is a useful antiepileptic drug, with occasional gastrointestinal side effects. Hepatotoxicity is the most serious adverse reaction and, although rare, it can be fatal. Risk factors for hepatotoxicity are an age of less than two years, polytherapy and mental retardation; it has been rarely reported in adults. We report three mentally retarded adult patients receiving polytherapy, who developed valproic acid induced hepatotoxicity. Two patients had a symptomatic hepatitis with a concomitant paradoxical increase in seizure frequency and one an asymptomatic alteration of hepatic function tests. After discontinuing the drug, the hepatitis subsided. We conclude that hepatotoxicity must be considered as a possible side effect of valproic acid and we suggest some recommendations for its early detection.
丙戊酸是一种有效的抗癫痫药物，偶尔会有胃肠道副作用。肝毒性是最严重的不良反应，虽然罕见，但可能致命。肝毒性的危险因素包括年龄小于两岁、联合治疗和智力迟钝；在成人中很少有报道。我们报告了三名接受联合治疗的智力迟钝成年患者，他们发生了丙戊酸诱导的肝毒性。两名患者出现有症状的肝炎，同时癫痫发作频率反常增加，另一名患者肝功能检查有无症状改变。停药后，肝炎消退。我们得出结论，肝毒性必须被视为丙戊酸可能的副作用，并且我们提出了一些早期检测的建议。
