Effect of L-carnitine supplementation on acute valproate intoxication.
We analyzed urinary valproate (VPA) metabolites and carnitine concentrations in a child who accidentally ingested 400 mg/kg VPA. The concentration of 4-en VPA, the presumed major factor in VPA-induced hepatotoxicity, was markedly increased, without liver dysfunction or hyperammonemia. The other major abnormality was decreased beta-oxidation and markedly increased omega-oxidation. After L-carnitine supplementation, VPA metabolism returned to normal. The level of valproylcarnitine was not increased and therefore was not affected by L-carnitine. L-Carnitine may be useful in treating patients with coma after VPA overdose.
Murakami
K
K
Nakano Children's Hospital, Osaka, Japan.
Sugimoto
T
T
Woo
M
M
Nishida
N
N
Muro
H
H
D000641:Ammonia / Q000097:blood; D002331:Carnitine / Q000031:analogs & derivatives / Q000378:metabolism / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D003128:Coma / Q000188:drug therapy / Q000378:metabolism; D062787:Drug Overdose / Q000097:blood / Q000188:drug therapy; D004827:Epilepsy / Q000188:drug therapy; D006801:Humans; D007223:Infant; D008297:Male; D010084:Oxidation-Reduction / Q000187:drug effects; D014635:Valproic Acid / Q000378:metabolism / Q000493:pharmacokinetics / Q000506:poisoning*
D014635:Valproic Acid; D000641:Ammonia; C044923:valproylcarnitine; D002331:Carnitine