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International Journal of Advances In Case Reports

Volume 11, Issue 1, 2024
Mcmed International
International Journal of Advances In Case Reports
Issn
XXX-XXXX (Print), 2349 - 8005 (Online)
Frequency
bi-annual
Email
editorijacr@mcmed.us
Journal Home page
http://mcmed.us/about/ijacr
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Abstract
Title
A RARE CASE OF VALPROIC ACID INDUCED HYPERAMMONEMIA IN ELDERLY
Author
Pradeep M. Venkategowda, S Manimala. Rao*, Jaydeep Ray Chaudhary
Email
manimalarao@hotmail.com
keyword
Hyperammonemia, Valproic acid, Seizures, Carnitine, Divalproex sodium.
Abstract
Hyperammonemia is commonly seen in patients with liver failure, porto-systemic shunts, urinary tract infection and parenteral nutrition. Drugs causing hyperammonemia is extremely rare. A 65 year-old male, known case of diabetes, hypertension and old case of intra cerebral (IC) bleed one year back, was taking tablet Divalproex sodium 125mg twice daily since 1 year for seizures after IC bleed. He was brought to our hospital with history of drowsiness and generalized weakness since 2 days. Hyperammonemia secondary to tablet Divalproex sodium was diagnosed. Patient was successfully treated with Inj phenytoin, lactulose syrup, tablet carnitine, adequate hydration and stopping of Divalproex sodium tablet. Serum ammonia levels were normalized on day 5. Patient was discharged home on day 7. This case report mainly highlights the rare cause of hyperammonemia in adult patients on long term treatment with Divalproex sodium with normal liver function. Early diagnosis and treatment can reduce morbidity and mortality.
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