Valproic acid-induced hepatopathy: nine new fatalities in Germany from 1994 to 2003.
OBJECTIVE
Valproic acid (VPA) is an antiepileptic drug (AED) commonly used for generalized and focal epilepsies. We provide an update on hepatotoxic side effects in Germany between 1994 and 2003.


METHODS
We mailed a questionnaire to all members of the German Section of the International League Against Epilepsy, asking for VPA-induced side effects, especially severe side effects such as hepatopathy.


RESULTS
As a result of our questionnaire, we found 31 cases of reversible hepatotoxicity and nine cases of lethal hepatopathies in Germany from 1994 to 2003.


CONCLUSIONS
The outcome of patients with severe hepatotoxicity is better than that in the past. The risk of a VPA-induced hepatopathy is not limited to patients younger than 2 years, receiving polytherapy, or patients with congenital or acquired metabolic diseases.
Koenig
Stephan A
SA
University Children's Hospital Mannheim, Neuropediatric Unit, Mannheim, Germany. stephan.koenig@kikli.ma.uni-heidelberg.de
Buesing
Deike
D
Longin
Elke
E
Oehring
Randi
R
Häussermann
Peter
P
Kluger
Gerhard
G
Lindmayer
Friedemann
F
Hanusch
Ralf
R
Degen
Ingrid
I
Kuhn
Hans
H
Samii
Kamrun
K
Jungck
Albrecht
A
Brückner
Reinhard
R
Seitz
Reinhild
R
Boxtermann
Wolfgang
W
Weber
Yvonne
Y
Knapp
Rolf
R
Richard
Hans Helmut
HH
Weidner
Birgit
B
Kasper
Johannes-Martin
JM
Haensch
Carl-Albrecht
CA
Fitzek
Sabine
S
Hartmann
Margarete
M
Borusiak
Peter
P
Müller-Deile
Andrea
A
Degenhardt
Volker
V
Korenke
Georg-Christoph
GC
Hoppen
Thomas
T
Specht
Ulrich
U
Gerstner
Thorsten
T
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D056486:Chemical and Drug Induced Liver Injury / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D004359:Drug Therapy, Combination; D004827:Epilepsy / Q000188:drug therapy* / Q000453:epidemiology; D017809:Fatal Outcome; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008107:Liver Diseases / Q000453:epidemiology / Q000401:mortality; D017093:Liver Failure / Q000139:chemically induced / Q000453:epidemiology / Q000401:mortality; D008297:Male; D008659:Metabolic Diseases / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014635:Valproic Acid / Q000009:adverse effects* / Q000627:therapeutic use
D000927:Anticonvulsants; D014635:Valproic Acid