Acute valproic acid intoxication: Interest of a treatment by extracoporeal elimination combined with L-carnitine
Acute valproic acid intoxication: Interest of a treatment by extracoporeal elimination combined with L-carnitine
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DOI：
10.1016/j.annfar.2011.05.019
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发表时间：
2011-10-01
影响因子：
--
通讯作者：
Canevet, C.
中科院分区：
文献类型：
--
作者：
Alluin, A.;Jezequel, J.;Canevet, C.
我们报告一例24岁女性患者，尝试使用丙戊酸、苯二氮卓类药物和抗精神病药进行自溶。丙戊酸血浆水平非常高（1437 μ g/mL），证实为重度中毒。她表现为急性脑病伴长期癫痫持续状态、乳酸代谢性酸中毒和血液系统疾病，如二血细胞减少症。迅速引入包括左旋卡尼汀和连续性静脉-静脉血液透析（CVVHD）在内的治疗，以预防脑水肿的发生。尽管发生了院内通气急性肺损伤，但进展是有利的。癫痫持续状态延长后，患者出现脑神经运动后遗症，数天后自行消失。(C)2011年Elsevier Masson SAS。All rights reserved.
We present the case of a 24-year-old-female patient, who made an attempt to autolysis with valproic acid, benzodiazepines and neuroleptic. The valproic acid plasma level was very high (1437 mu g/mL), confirming it was a severe intoxication. She presents an acute encephalopathy with prolonged status epilepticus, a lactic metabolic acidosis and hematologic disorders such as bicytopenia. Treatment including L-carnintine and continuous veno-venous haemodialysis (CVVHD) was rapidly introduced to prevent the occurrence of cerebral oedema. The evolution was favourable despite the occurrence of a nosocomial ventilation acute lung injury. The patient had motor sequelae of cranial nerves following status epilepticus extended, which disappeared spontaneously after several days. (C) 2011 Elsevier Masson SAS. All rights reserved.