title: Valproic acid-induced hepatopathy: nine new fatalities in Germany from 1994 to 2003.
abstract: 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.
authors.affiliation: University Children's Hospital Mannheim, Neuropediatric Unit, Mannheim, Germany. stephan.koenig@kikli.ma.uni-heidelberg.de
authors.forename: Stephan A
authors.initials: SA
authors.lastname: Koenig
authors.forename: Deike
authors.initials: D
authors.lastname: Buesing
authors.forename: Elke
authors.initials: E
authors.lastname: Longin
authors.forename: Randi
authors.initials: R
authors.lastname: Oehring
authors.forename: Peter
authors.initials: P
authors.lastname: Häussermann
authors.forename: Gerhard
authors.initials: G
authors.lastname: Kluger
authors.forename: Friedemann
authors.initials: F
authors.lastname: Lindmayer
authors.forename: Ralf
authors.initials: R
authors.lastname: Hanusch
authors.forename: Ingrid
authors.initials: I
authors.lastname: Degen
authors.forename: Hans
authors.initials: H
authors.lastname: Kuhn
authors.forename: Kamrun
authors.initials: K
authors.lastname: Samii
authors.forename: Albrecht
authors.initials: A
authors.lastname: Jungck
authors.forename: Reinhard
authors.initials: R
authors.lastname: Brückner
authors.forename: Reinhild
authors.initials: R
authors.lastname: Seitz
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Boxtermann
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Weber
authors.forename: Rolf
authors.initials: R
authors.lastname: Knapp
authors.forename: Hans Helmut
authors.initials: HH
authors.lastname: Richard
authors.forename: Birgit
authors.initials: B
authors.lastname: Weidner
authors.forename: Johannes-Martin
authors.initials: JM
authors.lastname: Kasper
authors.forename: Carl-Albrecht
authors.initials: CA
authors.lastname: Haensch
authors.forename: Sabine
authors.initials: S
authors.lastname: Fitzek
authors.forename: Margarete
authors.initials: M
authors.lastname: Hartmann
authors.forename: Peter
authors.initials: P
authors.lastname: Borusiak
authors.forename: Andrea
authors.initials: A
authors.lastname: Müller-Deile
authors.forename: Volker
authors.initials: V
authors.lastname: Degenhardt
authors.forename: Georg-Christoph
authors.initials: GC
authors.lastname: Korenke
authors.forename: Thomas
authors.initials: T
authors.lastname: Hoppen
authors.forename: Ulrich
authors.initials: U
authors.lastname: Specht
authors.forename: Thorsten
authors.initials: T
authors.lastname: Gerstner
mesh_terms: 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
chemical_list: D000927:Anticonvulsants; D014635:Valproic Acid