Hyperammonemia and Coma without Hepatic Dysfunction Induced by Valproate Therapy

The authors report a case of a 41‐year‐old mentally disabled man with bipolar disorder who presented to the emergency department with altered mental status. He was found to have a significantly elevated ammonia level (377 μM/L) with no signs of hepatic insufficiency. His coma and hyperammonemia were...

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Veröffentlicht in:	Academic emergency medicine 2001-10, Vol.8 (10), p.999-1001
Hauptverfasser:	Barrueto, Fermin, Hack, Jason B.
Format:	Artikel
Sprache:	eng
Schlagworte:	Adult ammonia Anticonvulsants - adverse effects bipolar carnitine Coma - chemically induced Coma - complications epilepsy Humans Hyperammonemia - chemically induced Hyperammonemia - complications Liver - drug effects Liver - physiopathology Liver Failure - chemically induced Male valproic acid Valproic Acid - adverse effects Valproic Acid - therapeutic use
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container_title	Academic emergency medicine
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creator	Barrueto, Fermin Hack, Jason B.
description	The authors report a case of a 41‐year‐old mentally disabled man with bipolar disorder who presented to the emergency department with altered mental status. He was found to have a significantly elevated ammonia level (377 μM/L) with no signs of hepatic insufficiency. His coma and hyperammonemia were attributed to his chronic valproate therapy. This patient had the highest serum ammonia level ever reported with a therapeutic valproate level in the absence of any other anticonvulsant therapy, metabolic abnormality, or hepatic dysfunction. The authors discuss this case and review the current literature on hyperammonemia in valproic acid therapy and the use of L‐carnitine in these patients.
doi_str_mv	10.1111/j.1553-2712.2001.tb01102.x
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subjects	Adult ammonia Anticonvulsants - adverse effects bipolar carnitine Coma - chemically induced Coma - complications epilepsy Humans Hyperammonemia - chemically induced Hyperammonemia - complications Liver - drug effects Liver - physiopathology Liver Failure - chemically induced Male valproic acid Valproic Acid - adverse effects Valproic Acid - therapeutic use
title	Hyperammonemia and Coma without Hepatic Dysfunction Induced by Valproate Therapy
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