PANCREATITIS WITH NORMAL SERUM AMYLASE ASSOCIATED WITH SODIUM VALPROATE - A CASE-REPORT

The patient was a 1-year-old infant with severe postencephalitis syndr ome. Diarrhea and elevation-of the pancreatic enzymes, except for seru m amylase (elastase 1>1, 5000 ng/dl (100-400); lipase, 885 IU/l/37 deg rees C (10-48); trypsin, > 900 ng/ml (110-460)), were observed startin g 70 days after starting valproate (dose, 70 mg/kg; serum level, 83.8 mu g/ml). These findings as well as those obtained by abdominal ultras onography suggested a diagnosis of pancreatitis, which was thought to be caused by sodium valproate. Important signs of valproate-induced pa ncreatitis may be easily overlooked in patients with neurological impa irment, such as in ours. Because the blood half-life of amylase is sho rt, not only amylase but some other pancreatic enzymes should be promp tly investigated when valproate-related pancreatitis is clinically sus pected in physically or mentally handicapped children.