丙戊酸镁缓释片致急性胰腺炎

Acute pancreatitis induced by magnesium valproate sustained release tablets

1例22岁男性因双相情感障碍症状复发,在既往丙戊酸镁缓释片500~750 mg/d和富马酸喹硫平400~600 mg/d治疗的基础上,将丙戊酸镁缓释片剂量增加至1000 mg/d,继续富马酸喹硫平600 mg/d治疗。17 d后,患者突发腹痛,急查血淀粉酶4710 U/L,脂肪酶649 U/L,尿淀粉酶9116 U/L;腹部CT检查示胰腺周围模糊。考虑为丙戊酸镁缓释片诱发急性胰腺炎。停用该药,继续给予富马酸喹硫平治疗,同时给予禁食、奥美拉唑、生长抑素和头孢他啶等对症支持治疗。3 d后患者腹痛症状基本消失,10 d后复查血淀粉酶101 U/L,脂肪酶118 U/L。

A 22‑year‑old male patient received magnesium valproate sustained release tablets with increased dosage of 1000 mg/d and quetiapine fumarate 600 mg/d due to recurrence of bipolar disorder,on the basis of previous treatment with magnesium valproate sustained release tablets 500‑750 mg/d and quetiapine fumarate 400‑600 mg/d.Seventeen days later,the patient developed abdominal pain suddenly.Laboratory tests showed blood amylase 4710 U/L,lipase 649 U/L,and urine amylase 9116 U/L.Abdominal CT examination showed blurred images around the pancreas.Acute pancreatitis induced by magnesium valproate sustained release tablets was considered.The drug was discontinued and quetiapine fumarate was continued.At the same time,symptomatic and supportive treatments such as fasting,omeprazole,somatostatin,and ceftazidime were given.Three days later,the patient′s abdominal pain basically disappeared;10 days later,his blood amylase was 101 U/L and lipase was 118 U/L.