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Valproic acid triggers acute rhabdomyolysis in a patient with carnitine palmitoyltransferase type II deficiency |
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| Authors: | Kottlors M Jaksch M Ketelsen U P Weiner S Glocker F X Lücking C H |
| Affiliation: | a Department of Neurology, University of Freiburg, 79106 Freiburg, Germany b Stoffwechselzentrum München-Schwabing, Institut für Klinische Chemie, Molekulare Diagnostik und Mitochondriale Genetik, Academic Hospital München-Schwabing, 80804 Munich, Germany c Department of Neuropediatrics and Muscular Diseases, Children's Hospital, 79106 Freiburg, Germany d Department of Medicine, University of Freiburg, 79106 Freiburg, Germany |
| Abstract: | A 47-year-old man suffering from a bipolar disorder and intermittent myoglobinuria presented with acute rhabdomyolysis with renal failure after starting therapy with valproic acid. On morphological examination, skeletal muscle revealed increased lipid storage. Biochemically, decreased enzyme activity of carnitine palmitoyltransferase (CPT) type II with carnitine levels in the lower limit was found. Genetic analysis detected the common Ser113Leu substitution on one allele of the CPT2 gene. We conclude that valproic acid should be avoided in patients with CPT type II deficiency. |
| Keywords: | Carnitine Carnitine palmitoyltransferase deficiency Rhabdomyolysis Valproic acid |
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