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Metabolic acidosis in a pediatric patient receiving topiramate

Razia Malik1, John Iacoune

  • 1Covenant Medical Center-Children's Hospital, Lubbock, Texas.

The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG
|November 3, 2012
PubMed

Insights

Topiramate, an anticonvulsant, can cause metabolic acidosis in children. This condition resolved after discontinuing the medication, highlighting a potential adverse effect in pediatric patients.

Area of Science:

  • Pediatric Neurology
  • Clinical Pharmacology

Background:

  • Topiramate is an FDA-approved anticonvulsant for managing various seizure types in children over two years old.
  • Common adverse effects in pediatric populations include cognitive dysfunction, nephrolithiasis, weight loss, and paresthesia.

Observation:

  • A 33-month-old child with complex partial seizures and secondary generalization was treated with topiramate (6.2 mg/kg/d) for four weeks.
  • The child developed asymptomatic metabolic acidosis, indicated by decreased bicarbonate levels (HCO3-).

Findings:

  • The metabolic acidosis observed in the child was unresponsive to sodium bicarbonate treatment.
  • Discontinuation of topiramate led to the resolution of metabolic acidosis within 48 hours.

Implications:

  • This case highlights a potential risk of metabolic acidosis associated with topiramate use in young children.
  • Clinicians should monitor for metabolic acidosis in pediatric patients receiving topiramate, especially when other treatments are ineffective.

Keywords:
adverse effectschildmetabolic acidosispediatricstopiramate

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