[Fatal hepatic necrosis during treatment with sodium valproate].
The authors report a case of fatal hepatic failure in a 19-year old young man suffering from absence seizures and treated for two months with valproic acid (VPA). The duration of VPA therapy before onset of clinical manifestations was four weeks. The prodromal symptoms were weakness, anorexia, and vomiting, then in a few weeks occurred a jaundice and an hepatic encephalopathy leading to death. Among laboratory findings disturbance of liver tests and particularly depressed levels of clotting factors were observed. The histologic study of the liver showed an extended centrolobular necrosis associated with fatty change and fibrosis. The mechanism of this hepatic failure remains unknown. The seriousness of this complication necessitates to respect any contraindications.
Miguil
M
M
Service de Réanimation des Urgences médicales, CHU Ibn Rochd, Casablanca, Maroc.
Chlihi
A
A
Mjahed
K
K
Sarf
I
I
Moutawakkil
S
S
Benaguida
M
M
D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use; D056486:Chemical and Drug Induced Liver Injury; D017809:Fatal Outcome; D006501:Hepatic Encephalopathy / Q000139:chemically induced; D006801:Humans; D008107:Liver Diseases / Q000473:pathology; D008297:Male; D009336:Necrosis / Q000139:chemically induced*; D012640:Seizures / Q000188:drug therapy*; D014635:Valproic Acid / Q000009:adverse effects* / Q000627:therapeutic use
D000927:Anticonvulsants; D014635:Valproic Acid
Nécrose hépatique mortelle au cours d'un traitement par le valproate de sodium.