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Hypoalbuminemia with valproic acid administration.
Thomas A Rugino1, Yvette M Janvier, Janice M Baunach
1Children's Specialized Hospital, Toms River, New Jersey 08755, USA.
Pediatric Neurology
|December 20, 2003
Summary
Valproic acid (VPA) treatment can cause reversible hypoalbuminemia in children and young adults, particularly those with neurological injuries. Discontinuing VPA led to increased serum albumin levels, suggesting a direct link.
Area of Science:
- Pediatric Neurology
- Clinical Pharmacology
- Biochemistry
Background:
- Valproic acid (VPA) and its derivatives are widely used antiepileptic medications.
- Hypoalbuminemia is a potential complication that requires careful monitoring.
Observation:
- Five residents in a long-term care facility developed hypoalbuminemia while on divalproex.
- Serum liver function tests and urinalysis remained normal during the observation period.
Findings:
- Discontinuation of divalproex resulted in a significant increase (17-30%) in serum albumin levels.
- Patients on divalproex had significantly lower serum albumin (3.1 gm/dL) compared to controls (3.8 gm/dL), P < 0.001.
- The hypoalbuminemia was reversible and not attributable to nutritional or other common factors.
Implications:
- Divalproex administration is a contributing factor to reversible hypoalbuminemia in neurologically impaired pediatric patients.
- Further research is needed to elucidate the mechanism and clinical significance of VPA-induced hypoalbuminemia.
- This finding highlights the importance of monitoring albumin levels in pediatric patients receiving VPA.