[Recommendations for blood studies and clinical monitoring in early detection of valproate-associated liver failure. Results of a consensus conferences 9 May - 11 May 1997 in Berlin].
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.
König
S A
SA
Klinik für Epileptologie, Universität Bonn.
Elger
C E
CE
Vassella
F
F
Schmidt
D
D
Bergmann
A
A
Boenigk
H E
HE
Despland
P A
PA
Genton
P
P
Krämer
G
G
Löscher
W
W
Mayer
T
T
Nau
H
H
Schneble
H
H
Siemes
H
H
Stefan
H
H
Wolf
P
P
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D001780:Blood Coagulation Tests; D056486:Chemical and Drug Induced Liver Injury / Q000097:blood / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D016903:Drug Monitoring; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007223:Infant; D017093:Liver Failure / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis; D008111:Liver Function Tests; D008297:Male; D014635:Valproic Acid / Q000009:adverse effects* / Q000627:therapeutic use
D000927:Anticonvulsants; D014635:Valproic Acid
Empfehlungen zu Blutuntersuchungen und klinischer Uberwachung zur Früherkennung des Valproat-assoziierten Leberversagens. Ergebnisse einer Konsensus-Konferenz vom 9.5.-11.5.1997 in Berlin.