Affiliations: Department of Pediatrics, San Leopoldo Mandic
Hospital, Merate-Lecco, Italy | Scientific Institute E. Medea, Bosisio Parini,
Italy | Department of Pediatrics and Neonatology, Valduce
Hospital, Como, Italy | Department of Pediatrics, Mendrisio and Bellinzona,
Switzerland
Note: [] Correspondence: Alberto Bettinelli, M.D., Department of
Pediatrics, San Leopoldo Mandic Hospital, 23807 Merate (Lecco), Italy. E-mail:
a.bettinelli@ospedale.lecco.it
Abstract: A 10-year-old severely disabled Italian boy on long-term treatment
with valproic acid presented with tubular proteinuria, generalized
aminoaciduria, normoglycemic glucosuria, and phosphate wasting. Since no other
explanation for these renal tubular abnormalities was found, the treatment with
valproic acid was discontinued. The abnormalities resolved within 5 months
after discontinuing this anticonvulsant. We recommend screening patients on
long-term anticonvulsant therapy with valproate periodically for renal tubular
dysfunction, either via urinalysis or via measurement of urinary
lactate/creatinine ratio, if clinical suspicion is high.
