Journal of Pediatric Perspectives

Journal of Pediatric Perspectives

Evaluation of Liver Enzymes Rising in Patients Treated with Sodium Valproate (VPA)

Authors
Javad Akhondian 1
Mohammad Ali Kiani 2
Seyed Ali Jafari 2
Mehran Beiraghi Toosi 3
Mansoureh Mirzaei Najm Abad 4
Hamid Ahanchian 5
Hamidreza Kianifar 5
1 Professor of Pediatric Neurology Ward, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2 Assosiate Professor of Pediatrics Gastroenterology , Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences , Mashhad, Iran.
3 Assistant Professor of Pediatric Neurology Ward, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Resident of Pediatric, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
5 Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
10.22038/ijp.2015.4193
Abstract
Introduction
Valproic acid (VPA, Valproate) is an eight-branch fatty acid and varies from other
antiepileptic drugs. VPA use might lead to mild to severe hepatotoxicity.
The aim of this study was to investigate valproic acid impact on liver transaminases
at the beginning of VPA treatment and after three and six months of it.
Materials and Methods
This study was designed as a cross sectional project in Pediatrics Neurology
ward of a Tertiary Academic Hospital (Ghaem Hospital, Mashhad-Northeastern
Iran). All children who needed valproic acid therapy alone were selected for study.
Liver function test was performed for them at the beginning of VPA administration,
three and six months after VPA, respectively. Data was analyzed by SPSS version 16.
Results
 60 children with mean age of 49±28.6 months were entered the study.
37 of them were male and 23 were female. 5% (3 children) were mental retard
and 11.7% (7 patients) had neurologic or developmental deficit. Mean value of
Aspartate Aminotransferase (AST), Alanine Transferase (ALT) and Alkaline
phosphatase (ALP) were 27, 30.8 and 30.4 and 17.4, 20.7 and 22.8 and 425,
426 and 441 at the beginning of VPA administration, three and six months after
VPA, respectively. In six months of our follow up, only one child (1.7%) had elevated
liver transaminases.  
Conclusion
Regard to our findings and its agreement with previous researches, it is important to
control adverse drug events by measuring liver transaminases during antiepilepsy treatment.
Keywords
Liver failure
Liver transaminases
Valproic acid

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