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VALPROİK ASİT KULLANIMINA BAĞLI TROMBOSİTOPENİ VE FULMİNAN KARACİĞER YETERSİZLİĞİ: OLGU SUNUMU

Year 2021, Volume: 7 Issue: 3, 483 - 486, 01.09.2021
https://doi.org/10.53394/akd.982115

Abstract

İlaç kullanımına bağlı hepatotoksisiteler, asemptomatik karaciğer enzim yüksekliğinden, yoğun bakım şartlarında multidisipliner takibi gereken ve tek tedavisinin karaciğer transplantasyonu olduğu fulminan karaciğer yetersizliği arasında geniş bir yelpazede izlenirler. İlaç kullanımına bağlı karaciğer yetmezliği karaciğer transplantasyonunun sık gözlenen endikasyonudur. İlaç kullanımına bağlı fulminan karaciğer yetersizliğinde karaciğer transplantasyonu yapılamaması mortal iken, transplantasyonun gecikmesi de morbiditeye neden olmaktadır. Bu vaka sunumunda yirmi yaşında erkek hastada, valproik asit kullanımına bağlı trombositopeni ve fulminan karaciğer yetersizliği gelişmiş ve karaciğer transplantasyonu ile şifa sağlanmıştır. Fulminan karaciğer yetersizliği gelişen olgularda karaciğer transplantasyonu hayat kurtarıcıdır.

References

  • 1. Tseng YL, Huang CR, Lin CH, Lu YT, Lu CH, Chen NC, et al. Risk factors of hyperammonemia in patients with epilepsy under valproic acid therapy.Medicine (Baltimore).2014;93(11):e66.
  • 2. Engbersen R, Kramers C. Enhanced extracorporeal elimination of valproic acid in overdose. Neth J Med 2004;62:307-308.
  • 3. Houghton BL, Bowers JB. Valproic acid overdose: a case report and review of therapy. Med Gen Med 2003;5:5.
  • 4. Cotariu D, Zaidman JL. Valproic acid and the liver. Clin Chem. 1988;34(5): 890-897.
  • 5. Lee WM. Drug-induced hepatotoxicity. N Engl J Med. 2003; 349: 474-485.
  • 6. Ostapowicz G, Fontana RJ, Schiødt FV, Larson A, Davern TJ, Han SH, et al.; U.S. Acute Liver Failure Study Group. Results of a prospective study of acute liver failure at 17 tertiary care centers in the United States. Ann Intern Med 2002; 137: 947-954.
  • 7. Lammert F, Matern S. Hepatic diseases caused by drugs. Schweiz Rundsch Med Prax l997;86:1167-1171.
  • 8. Jaeschke H, Gores GJ, Cederbaum AI, Hinson JA, Pessayre D, Lemasters JJ. Mechanisms of hepatotoxicity Toxicol Sci 2002; 65:166-176.
  • 9. Pessayre D, Berson A, Fromenty B, Mansouri A. Mitochondria in steatohepatitis. Semin Liver Dis 2001; 21:57-69. 10. Jonsson JR, Edwards-Smith CJ, Catania SC, Morotomi Y, Hogan PG, Clouston AD, et al. Expression of cytokines and factors modulating apoptosis by human sinusoidal leucocytes. J Hepatol 2000; 22: 27-42.
  • 11. Franssen EJ, van Essen GG, Portman AT, de Jong J, Go G, Stegeman CA, et al. Ther Drug Monit. 1999;21(3):289-292.
  • 12. Mittal V, Muralee S, Tampi RR. Valproic Acid-induced hyperammonemia in the elderly : a review of the literature. Case report Med. 2009;802-21.
  • 13. Deutsch Sl, Burket JA, Rosse RB. Valproate-induced hyperammonemic encephalopathy and normal liver functions: possible synergism with topiramate. Clin Neuropharmacol. 2009; 32 (6) :350-352.
  • 14. Hebert SA, Bohan TP, Erikson CL, Swinford RD. Thrombotic microangiopathy associated with Valproic acid toxicity. BMC Nephrol. 2017; 3;18(1):262. doi: 10.1186/s12882-017-0677-4.
  • 15. Cattaneo CI, Ressico F, Valsesia R, D'Innella P, Ballabio M, Fornaro M. Sudden valproate-induced hyperammonemia managed with L-carnitine in a medically healthy bipolar patient: Essential review of the literature and case report. Medicine (Baltimore). 2017 ;96(39):e8117. doi: 10.1097/MD.0000000000008117.
  • 16. O'Connor JE, Costell M, Miguez MP, Grisolia S. Influence of the route of administration on the protective effect of L-carnitine on acute hyperammonemia. Biochem Pharmacol 1986; 18: 3173-3176.
  • 17. Matsuda I, Ohtani Y, Ninomiya N. Renal handling of carnitine in children with carnitine deficiency and hyperammonemia associated with valproate therapy. J Pediatr 1986: 109, 131-134.
  • 18. Sikma MA, Mier JC, Meulenbelt J. Massive valproic acid overdose, a misleading case. Am J Emerg Med 2008;26:110.e3-6.
  • 19. Eyer F, Felgenhauer N, Gempel K, Steimer W, Gerbitz KD, Zilker T. Acute valproate poisoning: pharmacokinetics, alteration in fatty acid metabolism, and changes during therapy. J Clin Psychopharmacol 2005;25:376-80.
  • 20. Naranjo CA, Busto U, Sellers EM et al.A method for estimating the probability of adverse drug reaction. Clin. Pharmacol. Ther 1981; 30 (2): 239–245.
  • 21. Danan G, Benichou C. Causality assessment of adverse reactions to drugs--I. A novel method based on the conclusions of international consensus meetings: application to drug-induced liver injuries. J Clin Epidemiol. 1993;46(11):1323-30.

THROMBOCYTOPENIA AND FULMINANT HEPATIC FAILURE DUE TO VALPROIC ACID USE: A CASE REPORT

Year 2021, Volume: 7 Issue: 3, 483 - 486, 01.09.2021
https://doi.org/10.53394/akd.982115

Abstract

Drug-induced hepatotoxicity is observed in a wide range from asymptomatic liver enzyme elevation to fulminant hepatic insufficiency, which requires multidisciplinary follow-up under intensive care and the only treatment is liver transplantation. Drug-induced liver failure is a common indication for liver transplantation. In fulminant hepatic failure due to drug use, failure to transplant liver is mortal, while delayed transplantation causes morbidity. In this case report, thrombocytopenia and fulminant hepatic failure due to valproic acid use developed in a 20-year-old male patient and healed with liver transplantation. Liver transplantation is life-saving in patients with fulminant hepatic failure.

References

  • 1. Tseng YL, Huang CR, Lin CH, Lu YT, Lu CH, Chen NC, et al. Risk factors of hyperammonemia in patients with epilepsy under valproic acid therapy.Medicine (Baltimore).2014;93(11):e66.
  • 2. Engbersen R, Kramers C. Enhanced extracorporeal elimination of valproic acid in overdose. Neth J Med 2004;62:307-308.
  • 3. Houghton BL, Bowers JB. Valproic acid overdose: a case report and review of therapy. Med Gen Med 2003;5:5.
  • 4. Cotariu D, Zaidman JL. Valproic acid and the liver. Clin Chem. 1988;34(5): 890-897.
  • 5. Lee WM. Drug-induced hepatotoxicity. N Engl J Med. 2003; 349: 474-485.
  • 6. Ostapowicz G, Fontana RJ, Schiødt FV, Larson A, Davern TJ, Han SH, et al.; U.S. Acute Liver Failure Study Group. Results of a prospective study of acute liver failure at 17 tertiary care centers in the United States. Ann Intern Med 2002; 137: 947-954.
  • 7. Lammert F, Matern S. Hepatic diseases caused by drugs. Schweiz Rundsch Med Prax l997;86:1167-1171.
  • 8. Jaeschke H, Gores GJ, Cederbaum AI, Hinson JA, Pessayre D, Lemasters JJ. Mechanisms of hepatotoxicity Toxicol Sci 2002; 65:166-176.
  • 9. Pessayre D, Berson A, Fromenty B, Mansouri A. Mitochondria in steatohepatitis. Semin Liver Dis 2001; 21:57-69. 10. Jonsson JR, Edwards-Smith CJ, Catania SC, Morotomi Y, Hogan PG, Clouston AD, et al. Expression of cytokines and factors modulating apoptosis by human sinusoidal leucocytes. J Hepatol 2000; 22: 27-42.
  • 11. Franssen EJ, van Essen GG, Portman AT, de Jong J, Go G, Stegeman CA, et al. Ther Drug Monit. 1999;21(3):289-292.
  • 12. Mittal V, Muralee S, Tampi RR. Valproic Acid-induced hyperammonemia in the elderly : a review of the literature. Case report Med. 2009;802-21.
  • 13. Deutsch Sl, Burket JA, Rosse RB. Valproate-induced hyperammonemic encephalopathy and normal liver functions: possible synergism with topiramate. Clin Neuropharmacol. 2009; 32 (6) :350-352.
  • 14. Hebert SA, Bohan TP, Erikson CL, Swinford RD. Thrombotic microangiopathy associated with Valproic acid toxicity. BMC Nephrol. 2017; 3;18(1):262. doi: 10.1186/s12882-017-0677-4.
  • 15. Cattaneo CI, Ressico F, Valsesia R, D'Innella P, Ballabio M, Fornaro M. Sudden valproate-induced hyperammonemia managed with L-carnitine in a medically healthy bipolar patient: Essential review of the literature and case report. Medicine (Baltimore). 2017 ;96(39):e8117. doi: 10.1097/MD.0000000000008117.
  • 16. O'Connor JE, Costell M, Miguez MP, Grisolia S. Influence of the route of administration on the protective effect of L-carnitine on acute hyperammonemia. Biochem Pharmacol 1986; 18: 3173-3176.
  • 17. Matsuda I, Ohtani Y, Ninomiya N. Renal handling of carnitine in children with carnitine deficiency and hyperammonemia associated with valproate therapy. J Pediatr 1986: 109, 131-134.
  • 18. Sikma MA, Mier JC, Meulenbelt J. Massive valproic acid overdose, a misleading case. Am J Emerg Med 2008;26:110.e3-6.
  • 19. Eyer F, Felgenhauer N, Gempel K, Steimer W, Gerbitz KD, Zilker T. Acute valproate poisoning: pharmacokinetics, alteration in fatty acid metabolism, and changes during therapy. J Clin Psychopharmacol 2005;25:376-80.
  • 20. Naranjo CA, Busto U, Sellers EM et al.A method for estimating the probability of adverse drug reaction. Clin. Pharmacol. Ther 1981; 30 (2): 239–245.
  • 21. Danan G, Benichou C. Causality assessment of adverse reactions to drugs--I. A novel method based on the conclusions of international consensus meetings: application to drug-induced liver injuries. J Clin Epidemiol. 1993;46(11):1323-30.
There are 20 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Case Report
Authors

Fatih Yılmaz This is me 0000-0003-4599-3299

Feyza Bora This is me 0000-0003-2379-2090

Esin Avşar This is me 0000-0002-7584-2232

Publication Date September 1, 2021
Submission Date October 11, 2019
Published in Issue Year 2021 Volume: 7 Issue: 3

Cite

Vancouver Yılmaz F, Bora F, Avşar E. VALPROİK ASİT KULLANIMINA BAĞLI TROMBOSİTOPENİ VE FULMİNAN KARACİĞER YETERSİZLİĞİ: OLGU SUNUMU. Akd Med J. 2021;7(3):483-6.