Pancreatitis with normal serum amylase associated with sodium valproate: a case report.
The patient was a 1-year-old infant with severe postencephalitis syndrome. Diarrhea and elevation of the pancreatic enzymes, except for serum amylase (elastase 1 > 1, 5000 ng/dl (100-400); lipase, 885 IU/I/37 degrees C (10-48); trypsin, > 900 ng/ml (110-460)), were observed starting 70 days after starting valproate (dose, 70 mg/kg; serum level, 83.8 micrograms/ml). These findings as well as those obtained by abdominal ultrasonography suggested a diagnosis of pancreatitis, which was thought to be caused by sodium valproate. Important signs of valproate-induced pancreatitis may be easily overlooked in patients with neurological impairment, such as in ours. Because the blood half-life of amylase is short, not only amylase but some other pancreatic enzymes should be promptly investigated when valproate-related pancreatitis is clinically suspected in physically or mentally handicapped children.
Otusbo
S
S
Department of Pediatrics, Faculty of Medicine, Kagoshima University, Japan.
Huruzono
T
T
Kobae
H
H
Yoshimi
S
S
Miyata
K
K
D000328:Adult; D000681:Amylases / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D004660:Encephalitis / Q000188:drug therapy; D006801:Humans; D007223:Infant; D008297:Male; D010195:Pancreatitis / Q000209:etiology*; D014635:Valproic Acid / Q000009:adverse effects*
D014635:Valproic Acid; D000681:Amylases