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Sodium valproate-induced liver injury
The American Journal of Gastroenterology
|November 1, 1982
Summary
Sodium valproate, an anticonvulsant, caused liver injury in a patient, evidenced by centrilobular necrosis. Electron microscopy revealed cellular changes, confirming drug-induced cytotoxic liver damage.
Area of Science:
- Hepatology
- Toxicology
- Pharmacology
Background:
- Sodium valproate is a widely used anticonvulsant medication.
- Liver injury is a known, albeit rare, adverse effect of sodium valproate therapy.
- This case investigates a specific instance of drug-induced liver injury.
Observation:
- A 37-year-old woman developed centrilobular zonal necrosis in her liver after one month of sodium valproate treatment.
- The patient was taking the medication prophylactically following a cranioplasty procedure.
- A positive challenge test indicated sodium valproate as the causative agent.
Findings:
- Ultrastructural examination of hepatocytes showed significant abnormalities.
- Key findings included megamitochondria with crystalline inclusions.
- Disorganization of the rough endoplasmic reticulum was observed, without a compensatory increase in smooth endoplasmic reticulum.
Implications:
- These ultrastructural changes provide direct evidence of sodium valproate-induced cytotoxic liver injury.
- The findings highlight the importance of monitoring liver function in patients receiving sodium valproate.
- This case contributes to understanding the specific cellular mechanisms underlying drug-induced hepatotoxicity.