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Valproic acid-induced hepatopathy: nine new fatalities in Germany from 1994 to 2003
Stephan A Koenig1, Deike Buesing, Elke Longin
1University Children's Hospital Mannheim, Neuropediatric Unit, Mannheim, Germany. stephan.koenig@kikli.ma.uni-heidelberg.de
Purpose:
Valproic acid (VPA) is an antiepileptic drug (AED) commonly used for generalized and focal epilepsies. We provide an update on hepatotoxic side effects in Germany between 1994 and 2003.
Methods:
We mailed a questionnaire to all members of the German Section of the International League Against Epilepsy, asking for VPA-induced side effects, especially severe side effects such as hepatopathy.
Results:
As a result of our questionnaire, we found 31 cases of reversible hepatotoxicity and nine cases of lethal hepatopathies in Germany from 1994 to 2003.
Conclusions:
The outcome of patients with severe hepatotoxicity is better than that in the past. The risk of a VPA-induced hepatopathy is not limited to patients younger than 2 years, receiving polytherapy, or patients with congenital or acquired metabolic diseases.
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