Duygu Selen CENGİZ, Muhammed Semih GEDİK, Müge GÜLEN, Erdem AKSAY, Hayri ÇINAR, Selen ACEHAN, Akkan AVCI

Hiperamonyeminin Nadir Bir Nedeni: Valproik Asit Zehirlenmesi

Giriş: Valproik asit (VA) epilepsi ve bipolar duygu durum bozukluğu tedavisinde ayrıca migren profilaksisinde yaygın olarak kullanılan geniş spektrumlu bir antiepileptiktir. Yüksek doz alımlar, letarjiden komaya kadar değişen merkezi sinir sistemi (MSS) depresyonuna, solunum yetmezliğine, böbrek yetmezliğine, akut pankreatite, hepatotoksisiteye ve kemik iliği depresyonuna neden olabilmektedir. Olgu Sunumu: Biz bu yazıda akut masif doz VA’ in neden olduğu hiperamonyemik ensefalopatili olgunun L-karnitin ile tedavisini son literatürler ışığında incelemeye çalıştık. Sonuç: Acil servislerde (AS) nadir görülen bir zehirlenme olan VA zehirlenmelerinde; ciddi zehirlenme bulguları ile beraber hiperamonyemi varsa L-karnitin tedavisi akılda tutulması gereken bir tedavi yaklaşımıdır.

Anahtar Kelimeler:

Valproik asit, zehirlenme, hiperamonyemi, L-karnitin

A Rare Reason of Hyperammonemia: Valproic Acid Poisoning

Introduction: Valproic acid (VA) is a broad-spectrum antiepileptic drug that is widely used in the treatment of epilepsy and bipolar affective disorder and also in the prophylaxis of migraine. High doses can cause central nervous system depression ranging from lethargy to coma, respiratory failure, renal failure, acute pancreatitis, hepatotoxicity, and bone marrow depression.Case Report: In this paper, we attempted to examine a case of acute encephalopathy with hyperammonemia caused by high doses of VA and treated with L-carnitine based on the recent literature.Conclusion: In patients with hyperammonemia associated with the severe toxicity symptoms of poisoning, L-carnitine administration is a treatment approach to keep in mind based on the rare types of poisoning observed at emergency services

Keywords:

Valproic acid, poisoning, hyperammonemia, L-carnitine,

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