Literature DB >> 34336460

Rapid Rescue From Hyperammonemic Coma After Valproic Acid Poisoning: Dual Therapy With Continuous Renal Replacement Therapy and L-Carnitine Supplementation.

Shyam Kiran Gandam Venkata1,2, Kenneth Guillotte3, BreeAnna Murphy3, Sai Sruthi Bhuram4, Sudeep Chakravarthy Bhuram5.   

Abstract

Valproic acid is a commonly prescribed drug used in various conditions including seizures, bipolar disorder, mood disorder, and migraine headaches. Confusion and lethargy among patients on valproic acid need urgent attention as it can cause increased levels of ammonia, which can lead to the development of cerebral edema and even cerebral herniation in severe cases. Here, we describe a case of hyperammonemic coma induced by valproic acid toxicity. The condition was rapidly resolved using dual therapy involving extracorporeal removal and levocarnitine.
Copyright © 2021, Gandam Venkata et al.

Entities:  

Keywords:  ammonia; cerebral edema; coma; hyperammonemia; poisoining; sodium valproate; valproic acid toxicity

Year:  2021        PMID: 34336460      PMCID: PMC8317001          DOI: 10.7759/cureus.15968

Source DB:  PubMed          Journal:  Cureus        ISSN: 2168-8184


  8 in total

1.  Cerebral edema following acute sodium valproate overdose.

Authors:  S H Khoo; M J Leyland
Journal:  J Toxicol Clin Toxicol       Date:  1992

2.  Secondary hyperammonaemia: a possible mechanism for valproate encephalopathy.

Authors:  D L Coulter; R J Allen
Journal:  Lancet       Date:  1980-06-14       Impact factor: 79.321

Review 3.  L-carnitine for acute valproic acid overdose: a systematic review of published cases.

Authors:  Jerrold Perrott; Nancy G Murphy; Peter J Zed
Journal:  Ann Pharmacother       Date:  2010-06-29       Impact factor: 3.154

Review 4.  The Role of RRT in Hyperammonemic Patients.

Authors:  Shruti Gupta; Andrew Z Fenves; Robert Hootkins
Journal:  Clin J Am Soc Nephrol       Date:  2016-05-19       Impact factor: 8.237

Review 5.  Carnitine in the treatment of valproic acid-induced toxicity.

Authors:  Philippe E R Lheureux; Philippe Hantson
Journal:  Clin Toxicol (Phila)       Date:  2009-02       Impact factor: 4.467

Review 6.  Valproic acid and the liver.

Authors:  D Cotariu; J L Zaidman
Journal:  Clin Chem       Date:  1988-05       Impact factor: 8.327

Review 7.  Hyperammonemia in the ICU.

Authors:  Alison S Clay; Bryan E Hainline
Journal:  Chest       Date:  2007-10       Impact factor: 9.410

Review 8.  Extracorporeal treatment for valproic acid poisoning: systematic review and recommendations from the EXTRIP workgroup.

Authors:  Marc Ghannoum; Martin Laliberté; Thomas D Nolin; Robert MacTier; Valery Lavergne; Robert S Hoffman; Sophie Gosselin
Journal:  Clin Toxicol (Phila)       Date:  2015-06       Impact factor: 4.467

  8 in total
  1 in total

Review 1.  Novel Therapies for the Treatment of Drug-Induced Liver Injury: A Systematic Review.

Authors:  Mirjana Stanić Benić; Lana Nežić; Vesna Vujić-Aleksić; Liliana Mititelu-Tartau
Journal:  Front Pharmacol       Date:  2022-02-02       Impact factor: 5.810

  1 in total

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