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Valproik Asit Zehirlenmesi Olan Çocuk Hastanın Hemodiyaliz ile Başarılı Tedavisi

Year 2019, Volume: 13 Issue: 4, 306 - 309, 30.07.2019
https://doi.org/10.12956/tjpd.2018.401

Abstract



 Valproik asit, epilepsi, duygudurum bozuklukları, migren profilaksisi gibi hastalıklarda yaygın olarak kullanılan bir ilaçtır. Terapötik aralığının dar olması ve kullanım endikasyonlarının genişliği sebebiyle valproik asit zehirlenmeleriyle sıkça karşılaşılmaktadır. Burada valproik asit zehirlenmesi olan ve hemodiyaliz ile tedavi edilen bir olgu bildirilmiştir. Bilinen hiçbir hastalığı olmayan 14 yaşındaki kız hasta intihar amaçlı valproik asit alma sebebiyle çocuk yoğun bakım birimine kabul edildi. Hastanın ilaç alımından üç saat sonra başvurusunda yapılan tetkiklerinde serum valproik asit seviyesi 347.8 μg/mL olarak saptandı. Kan gazında yüksek anyon açıklı metabolik asidoz ve laktat yüksekliği dikkati çekti. Metabolik asidozun kötü prognoza işaret etmesine istinaden, hastaya organ yetmezliği bulguları gelişmeden hemodiyaliz uygulandı. Dört saatlik hemodiyaliz sonrası hastanın uykuya meyili ortadan kayboldu, serum valproik asit seviyesi azalarak normal referans aralıklarına geldi. Hastanın metabolik asidozu düzeldi, laktat yüksekliği ortadan kalktı. Tedavi sonrası bulguları düzelen hasta salah ile taburcu edildi. Yüksek doz valproik asit zehirlenmesi olgularında hemodiyaliz tedavisi başarılı olabilir. Bu olguda yüksek doz valproik asit zehirlenmesi olan hastalarda organ yetmezliği bulguları gelişmeden yapılan hemodiyalizin etkili olabileceği gösterilmiştir. 

References

  • 1. Sztajnkrycer MD. Valproic acid toxicity: Overview and management. J Toxicol Clin Toxicol 2002;40:789-801.
  • 2. Al Aly Z, Yalamanchili P, Gonzalez E. Extracorporeal management of valproic acid toxicity: A case report and review of the literature. Semin Dial 2005;18:62-6.
  • 3. Doyon S. Anticonvulsants. In: Goldfrank LR, Howland MA, Flomenbaum NE (eds). Goldfrank’s Toxicologic Emergencies. 9th ed. New York, NY: McGraw Hill, 2011:47-705,706.
  • 4. Sikma MA, Mier JC, Meulenbelt J. Massive valproic acid overdose, a misleading case. Am J Emerg Med 2008;26:110.e3-6
Year 2019, Volume: 13 Issue: 4, 306 - 309, 30.07.2019
https://doi.org/10.12956/tjpd.2018.401

Abstract

References

  • 1. Sztajnkrycer MD. Valproic acid toxicity: Overview and management. J Toxicol Clin Toxicol 2002;40:789-801.
  • 2. Al Aly Z, Yalamanchili P, Gonzalez E. Extracorporeal management of valproic acid toxicity: A case report and review of the literature. Semin Dial 2005;18:62-6.
  • 3. Doyon S. Anticonvulsants. In: Goldfrank LR, Howland MA, Flomenbaum NE (eds). Goldfrank’s Toxicologic Emergencies. 9th ed. New York, NY: McGraw Hill, 2011:47-705,706.
  • 4. Sikma MA, Mier JC, Meulenbelt J. Massive valproic acid overdose, a misleading case. Am J Emerg Med 2008;26:110.e3-6
There are 4 citations in total.

Details

Primary Language Turkish
Subjects ​Internal Diseases
Journal Section CASE REPORTS
Authors

Ahmet Osman Kılıç This is me

Publication Date July 30, 2019
Submission Date November 13, 2018
Published in Issue Year 2019 Volume: 13 Issue: 4

Cite

Vancouver Kılıç AO. Valproik Asit Zehirlenmesi Olan Çocuk Hastanın Hemodiyaliz ile Başarılı Tedavisi. Türkiye Çocuk Hast Derg. 2019;13(4):306-9.


The publication language of Turkish Journal of Pediatric Disease is English.


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