Development of acute pancreatitis caused by sodium valproate in a patient with bipolar disorder on hemodialysis for chronic renal failure: a case report

BMC Psychiatry

Kazutaka Shimoda¹  Yuji Ozeki¹  Akira Osone¹  Takahiro Shinozaki¹  Hiroaki Okayasu¹ 

[1] Department of Psychiatry, Dokkyo Medical University, Mibu, Tochigi, Japan

关键词: Mood stabilizer;    Bipolar disorder;    Hemodialysis;    Chronic renal failure;    Sodium valproate;    Acute pancreatitis;   

Others  :  1123675
DOI  :  10.1186/1471-244X-14-93

 received in 2013-12-19, accepted in 2014-03-25,  发布年份 2014

【 摘 要 】

Background

Cases of acute pancreatitis caused by sodium valproate (VPA) have been reported by many authors thus far. However, most of these were cases with epilepsy. Chronic renal failure is also regarded as a risk factor for acute pancreatitis. Here, we report a case of acute pancreatitis development due to VPA in a patient with bipolar disorder on hemodialysis for chronic renal failure.

Case presentation

The patient was a 52-year-old Japanese male who was diagnosed as bipolar disorder on hemodialysis for renal failure. He was treated with VPA and manic symptoms gradually stabilized. However, the patient complained of severe abdominal pain. Blood amylase was found to be markedly high, and computed tomography revealed pancreatomegaly and an increased amount of peripancreatic fat. Hence, we diagnosed the case as acute pancreatitis caused by VPA. We discontinued oral medication, and he was started on a pancreatic enzyme inhibitor, antibiotics, and transfusion, and he showed improvement.

Conclusion

It has been reported that acute pancreatitis induced by VPA is caused by intermediate metabolites of VPA. We consider that patients with renal failure are prone to pancreatitis caused by VPA because of the accumulation of these intermediate metabolites. We need close monitoring for serious adverse effects such as pancreatitis when we prescribe VPA to patients with bipolar disorder on hemodialysis for chronic renal failure, although VPA is safer than other mood stabilizers.

【 授权许可】

   
2014 Okayasu et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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