title: Fractures and Fanconi syndrome due to prolonged sodium valproate use.
abstract: BACKGROUND
  Sodium valproate (VPA) is commonly used to treat epilepsy in children. Renal dysfunction is a rare side eff ect but can present as tubulopathy such as Fanconi syndrome.
  
  
  METHODS
  We report on an 8-year-old disabled girl with myoclonic epilepsy who was referred for investigation of recurrent low impact fractures of the distal femur which were initially thought to be caused by her severe immobility. However, she was subsequently found to have hypophosphataemia secondary to Fanconi syndrome due to prolonged VPA use. After VPA withdrawal renal function and serum phosphate levels normalised and X-rays improved dramatically.
  
  
  CONCLUSIONS
  The possibility of drug-induced osteoporosis and fractures should always be considered in disabled children, even in the presence of severe immobility.
authors: Birmingham Children’s Hospital, Department of Endocrinology and Diabetes, Birmingham, UK. navpreetdhillon@nhs.net
authors: N
authors: N
authors: Dhillon
authors: W
authors: W
authors: Högler
mesh_terms: D002648:Child; D019988:Children with Disabilities; D004831:Epilepsies, Myoclonic / Q000188:drug therapy*; D005198:Fanconi Syndrome / Q000139:chemically induced*; D005260:Female; D005264:Femoral Fractures / Q000139:chemically induced*; D006801:Humans; D014635:Valproic Acid / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D014635:Valproic Acid