title: Life-threatening valproate overdose successfully treated with haemodialysis.
abstract: Valproate (VPA) poisoning is an increasing clinical problem. The most common finding in VPA overdose is the depression of the central nervous system, which may progress to coma and death. This type of poisoning is difficult to treat, as no antidote exists. This report describes a case with a 16-year-old girl who poisoned herself with valproate. Initial treatment included naloxone, but she did not respond. She became comatose, with serum VPA concentration of 1320 microg mL(-1). Three sessions of haemodialysis were performed, effectively eliminating VPA and decreasing the serum concentration. The patient regained consciousness and fully recovered.To our knowledge, this is the highest serum VPA concentration reported by now in children aged 16 or less. Haemodialysis has proved to be the treatment of choice for life-threatening acute VPA overdose in children.
authors.affiliation: Department of Paediatrics, Paediatric Intensive Care Unit, University Hospital Split, Split, Croatia. julije.mestrovic@st.t-com.hr
authors.forename: Julije
authors.initials: J
authors.lastname: Mestrović
authors.forename: Tomislav
authors.initials: T
authors.lastname: Filipović
authors.forename: Branka
authors.initials: B
authors.lastname: Polić
authors.forename: Luka
authors.initials: L
authors.lastname: Stricević
authors.forename: Ante
authors.initials: A
authors.lastname: Omazić
authors.forename: Radenka
authors.initials: R
authors.lastname: Kuzmanić-Samija
authors.forename: Josko
authors.initials: J
authors.lastname: Markić
mesh_terms: D000293:Adolescent; D062787:Drug Overdose; D005260:Female; D006801:Humans; D006435:Renal Dialysis; D013406:Suicide, Attempted; D014635:Valproic Acid / Q000506:poisoning*
chemical_list: D014635:Valproic Acid