Pancreatitis induced by valproic acid: Report of a case

A 22-year-old woman with intellectual impairment, who had been taking valpr oic acid continuously for 19 years since being diagnosed with epiloia at th e age of 3 years, presented to our hospital following the sudden developmen t of epigastric pain. An abdominal computed tomography scan revealed acute exacerbation of chronic pancreatitis. Conservative treatment was initiated, despite which the pancreatitis became exacerbated, necessitating resection of the pancreatic head and duodenum. Histological examination of the resec ted specimens revealed a large number of pancreatic calculi in the main pan creatic duct, suggesting chronic pancreatitis with fibrosis at the peripher y. The incidence of pancreatitis developing in association with valproic ac id is unclear; however, only 40 such cases have been reported in the Englis h literature. Most of the patients previously described presented with acut e pancreatitis in the initial stage. However, the clinical course of our pa tient, with acute exacerbation following a relatively chronic course, was d ifferent from those previously described, suggesting the presence of chroni c pancreatitis related to valproic acid.