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

Case Report

Kazutaka Shimoda¹  Takahiro Shinozaki¹  Akira Osone¹  Yuji Ozeki¹  Hiroaki Okayasu¹ 

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

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

DOI  :  10.1186/1471-244X-14-93

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

来源: Springer

【 摘 要 】

BackgroundCases 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 presentationThe 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.ConclusionIt 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】

CC BY   
© Okayasu et al.; licensee BioMed Central Ltd. 2014