König S A, Elger C E, Vassella F, Schmidt D, Bergmann A, Boenigk H E, Despland P A, Genton P, Krämer G, Löscher W, Mayer T, Nau H, Schneble H, Siemes H, Stefan H, Wolf P
Klinik für Epileptologie, Universität Bonn.
Nervenarzt. 1998 Oct;69(10):835-40. doi: 10.1007/s001150050351.
Valproate is a frequently used antiepileptic drug. It is associated with rare but serious adverse effects like liver failure. The first symptom is impairment of the patient's well being. Isolated changes of standard laboratory liver parameters are not reliable early indicators. Thus, according to the knowledge of today, prophylactic blood screening cannot predict complications. On the contrary, clinical symptoms are the most relevant indicators of impending complications, eventually supported by laboratory findings. An abrupt withdrawal of valproate and administering carnitin in parallel can interrupt the otherwise fatal course of the complication and induce a subsequent recovery. At a Consensus Conference the current knowledge about early detection and therapy of the valproate-induced serious hepatotoxicity was discussed. The results regarding recommended laboratory screening, as well as diagnostic and therapeutic strategies are reported.
丙戊酸盐是一种常用的抗癫痫药物。它与罕见但严重的不良反应如肝衰竭有关。最初的症状是患者健康状况受损。标准实验室肝脏参数的孤立变化并非可靠的早期指标。因此，根据目前的认知，预防性血液筛查无法预测并发症。相反，临床症状是即将出现并发症的最相关指标，最终可得到实验室检查结果的支持。突然停用丙戊酸盐并同时给予肉碱可以中断并发症原本致命的进程，并促使随后康复。在一次共识会议上，讨论了关于丙戊酸盐所致严重肝毒性的早期检测和治疗的现有知识。报告了关于推荐的实验室筛查以及诊断和治疗策略的结果。
