Evaluation of Cases Followed and Treated Due to Valproic Acid Intoxication in Child Emergency Outpatient Clinic Between 2010 and 2016

Abstract

Objective: Our aim was to determine prognostic factors effecting clinical course of the patients referring to the Child Emergency Service in our hospital with valproic acid (VPA) poisoning. Methods: Patients who had VPA poisoning diagnoses between 2010 and 2016 in our Child Emergency Service were retrospectively examined. Demographical characteristics, clinical findings, laboratory results, treatment methods and effective factors for prognosis were evaluated for the patients. Results: The study were included 114 patients whose avarage age is 9.91+/-4.69 years Sixty-six of the patients were female and forty-eight were male. The most common reason for inclusion has been overdosing (100 patients, 87.72%). Fourteen patients (12.28%) had pure VPA poisoning. VPA serum level median value was 141.80 mu/mL (min-max; 102.20 - 640.38 mu/mL). Central nervous system depression was the most common clinical finding (six patients, 5.2%). Thrombocytopenia was detected in sixteen patients (14.0%) and hyperammoniemia in eighteen patients (15.8%). Average follow-up duration for the patients was 16.14 hours. L-carnitine treatment was applied for six patients (5.3%). Conclusions: In long-term VPA usage, the importance of thrombocytopenia and ammonia level should not be forgotten during prognosis. Supportive treatment still maintains its importance in VPA intoxication and intensive care follow-up and treatment was necessary for two patients in our study and L carnitine was started for patients with suitable indications and preserves its importance in treatment.