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Valproic acid intoxication - The importance of toxicological analysis and correct management: A case report
André Valle de Bairros1, Karol Andriely de Vargas Paier1, Leonardo Corrêa Cardoso1
1Nucleus Applied to Toxicology, Federal University of Santa Maria, Santa Maria, Brazil.
Introduction:
Valproic acid (VPA) is an anticonvulsant widely used in treating epilepsy which can occur cases of poisoning in overdose situations.
Case Description:
A 15-year-old girl purposely ingested about 100 drug tablets according to family members. Gastric lavage with activated charcoal was performed at home using a nasogastric tube and patient just was taken to the hospital around 10 h after drug ingestion, arriving in shock state. All laboratorial parameters were altered together a suspect of aspiration pneumonia with the presence of gross perihilar infiltrated in the right lung. Immunoassay screening test did not detect any substance; LC-UV detected quetiapine (> 150 ng/mL) while GC-MS determined 977.96 µg/mL of valproic acid in the patient's plasma, confirming valproic acid intoxication. Appropriate life support was performed in the patient during hospitalization; however, she died two days later, reaching her suicide.
Conclusions:
Prognosis could be favorable if the patient was taken immediately to hospital emergency, considering the complexity of managing poisoning. Patient´s anamnesis must be carefully analyzed by the healthcare professional to avoid false conclusions and toxicological analysis is extremely important to clarify suspected poisoning.
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