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Tubulo-interstitial nephritis caused by sodium valproate
Hideto Yoshikawa1, Toru Watanabe, Tokinari Abe
1Department of Pediatrics, Niigata City General Hospital, 2-6-1 Shichikuyama 950-8739, Japan. hideto@hosp.niigata.niigata.jp
Brain & Development
|March 14, 2002
Summary
Sodium valproate (SV) treatment in a young girl with epilepsy led to Fanconi syndrome and interstitial nephritis. Discontinuing SV improved her renal function and symptoms, highlighting potential adverse renal effects.
Area of Science:
- Nephrology
- Neurology
- Pharmacology
Background:
- Sodium valproate (SV) is a widely used anti-epileptic medication.
- Long-term use of SV can be associated with various adverse effects.
- Renal complications, though less common, warrant careful monitoring.
Observation:
- A 14-year-old girl with epilepsy on long-term SV developed fever and hypokalemia.
- Laboratory findings indicated Fanconi syndrome, characterized by metabolic acidosis, hypouricemia, hypophosphatemia, glycosuria, proteinuria, and aminoaciduria.
- Renal biopsy revealed interstitial nephritis without immuno-deposition.
Findings:
- SV was identified as the likely cause of the observed renal abnormalities.
- Discontinuation of SV resulted in significant clinical improvement and normalization of laboratory parameters.
- Gallium scanning demonstrated marked renal uptake, suggesting active inflammation or damage.
Implications:
- This case underscores the potential for SV to induce Fanconi syndrome and interstitial nephritis.
- Clinicians should be vigilant for renal adverse effects in patients on long-term SV therapy.
- Early recognition and drug withdrawal can lead to favorable renal outcomes.