Pancreatitis, complicated by a pancreatic pseudocyst associated with the use of valproic acid.
A 12-year-old boy developed pancreatitis, complicated by a pancreatic pseudocyst, as an adverse reaction to valproic acid (VPA) treatment for epilepsy. Pancreatitis subsided within three weeks after discontinuation of VPA. The pancreatic pseudocyst was managed without surgery and resolved spontaneously in four weeks. Valproic acid was concluded to be the most probable cause, since no other explanation was found. According to the literature VPA is a rare but known cause of pancreatitis. A computer-assisted literature search revealed seven previously reported cases of VPA-induced pancreatitis complicated by a pancreatic pseudocyst. Six of these patients were under 20 years of age. Four patients were treated conservatively; three needed cystostomy or external drainage. All patients recovered. Patients using VPA, especially children, presenting with acute abdominal pain should be suspected of valproic acid-induced pancreatitis. If VPA induced pancreatitis is complicated by a pseudocyst, conservative treatment should be the first line of treatment.
Houben
Michiel L
ML
Department of Paediatrics, St Elisabeth Hospital, P.O. Box 90151, 5000 LC Tilburg, The Netherlands.
Wilting
Ingeborg
I
Stroink
Hans
H
van Dijken
Pieter J
PJ
D000208:Acute Disease; D000927:Anticonvulsants / Q000009:adverse effects*; D002648:Child; D004827:Epilepsy / Q000188:drug therapy; D006801:Humans; D008297:Male; D010192:Pancreatic Pseudocyst / Q000150:complications*; D010195:Pancreatitis / Q000139:chemically induced*; D014635:Valproic Acid / Q000009:adverse effects*
D000927:Anticonvulsants; D014635:Valproic Acid