Professional paper
https://doi.org/10.2478/10004-1254-59-2008-1884
Life-threatening Valproate Overdose Successfully Treated with Haemodialysis
Julije Meštrović
; Department of Paediatrics, Paediatric Intensive Care Unit, University Hospital Split, Split, Croatia
Tomislav Filipović
; Department of Internal Medicine, Division of Nephrology, University Hospital Split, Split, Croatia
Branka Polić
; Department of Paediatrics, Paediatric Intensive Care Unit, University Hospital Split, Split, Croatia
Luka Stričević
; Department of Paediatrics, Paediatric Intensive Care Unit, University Hospital Split, Split, Croatia
Ante Omazić
; Department of Paediatrics, Paediatric Intensive Care Unit, University Hospital Split, Split, Croatia
Radenka Kuzmanić-Šamija
; Department of Paediatrics, Division of Neurology, University Hospital Split, Split, Croatia
Joško Markić
; Department of Paediatrics, Paediatric Intensive Care Unit, University Hospital Split, Split, Croatia
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 µg 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.
Keywords
central nervous system depressants; intensive care; thrombocytopenia; toxicity
Hrčak ID:
29563
URI
Publication date:
8.12.2008.
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