Reye-like syndrome associated with valproic acid

A case of a Reye-like syndrome during the course of treatment with VPA was reported. Hyperammonemia and severe liver damage as well as diffuse small droplets in the liver biopsy material were demonstrated. On analysis by gas chromatography/mass spectrometry of the urine immediately after the onset, the metabolites of VPA were detected together with lactate and other substances, and electron microscopic observation of liver biopsy material revealed deformation of mitochondria, disappearance of cristae and electron dense deposits in the matrix.