Acute hepatic injury in four children with Dravet syndrome: Valproic acid, topiramate or acetaminophen

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• 作者：Joost Nicolai ; Boudewijn Gunning ; Piet L. Leroy ; Berten Ceulemans ; Johan S.H. Vles
• 关键词：Dravet syndrome ; Acetaminophen ; Stiripentol ; Topiramate ; Valproate ; Liver toxicity
• 刊名：Seizure
• 出版年：2008
• 出版时间：January 2008
• 年：2008
• 卷：17
• 期：1
• 页码：92-97
• 全文大小：103 K

文摘

Summary

We describe four children with Dravet syndrome treated with the combination of valproic acid (VPA) and topiramate (TPM) who developed transient liver toxicity. The time-interval between fever, administration of acetaminophen, epileptic status and liver enzyme disturbances in our four cases suggests that accumulation of toxic acetaminophen-metabolites is possibly responsible for liver toxicity. If acetaminophen and its metabolites cause those liver problems in children treated with the combination of VPA and TPM, the advice to use acetaminophen for treating fever in children using this combination, should be changed. Only future clinical observations and research can solve this clinical dilemma.