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Valproinsäure pp 197–209Cite as

Veränderungen von Laborparametern unter der Therapie mit Valproinsäure

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Zusammenfassung

Die Therapie mit Valproinsäure (VPA) beeinflu ßt zahlreiche Funktions-und biochemische Systeme, wobei die klinischen Auswirkungen erfreulicherweise gering sind, abgesehen von wenigen schwerwiegenden Komplikationen.

Die Einflüsse der VPA auf das Schilddrüsenhormonsystem sind gering; leichte Erniedrigungen des T4, des freien T4 und des T3 führen kaum zu einer klinisch manifesten Hypothyreose, scheinen aber dosisabhängig zu sein.

Im Gegensatz zu anderen Antiepileptika beeinflußt VPA offenbar die Aktivität der Nebenschilddrüse, den Vitamin-D-Status, die Kalziumabsorption, die Knochenresorption und die 1,25-Dihydroxycholecalceferol- konzentration nicht.

Gewisse Effekte auf den intermediären Kohlehydratstoffwechsel, sowie auf Blutzucker und die Insulinsekretion im Sinne einer Erniedrigung konnten nachgewiesen werden, ohne eindeutige klinische Korrelate.

Geringe, nicht immer eindeutig signifikante Veränderungen der ACTH- und Cortisolsekretion, aber auch der von Prolactin, Wachstumshormon und der Gonadotropine wurden unter VPA beobachtet. Die Melatoninsekretion fanden wir um 25% reduziert. Die Serumenzyme erfahren üblicherweise nur eine geringe Stimulierung ihrer Aktivität, wenn man von den wenigen irreversiblen toxischen Hepatopathien absieht, die in einem anderen Kapitel behandelt werden.

Von den hämatologischen Veränderungen besitzen vor allem die sehr häufigen, dosisabhängigen Thrombopenien und die Verminderungen besonders des Faktor VIII-Komplexes (Induktion eines von WillebrandSyndroms Typ I) klinische Relevanz, weniger die ebenfalls häufige Erniedrigung der Fibrinogenkonzentration.

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Authors
  1. H. Fichsel
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Editors and Affiliations

  1. Neurologische Universitätsklinik, Langenbeckstraße 1, Mainz, 6500, Deutschland

    Günter Krämer

  2. Neuropädiatrische Abteilung, Behandlungszentrum Vogtareuth, Krankenhausstraße 20, Vogtareuth, 8097, Deutschland

    Michael C. Laub

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© 1992 Springer-Verlag Berlin Heidelberg

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Fichsel, H. (1992). Veränderungen von Laborparametern unter der Therapie mit Valproinsäure. In: Krämer, G., Laub, M.C. (eds) Valproinsäure. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-97843-2_19

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  • DOI: https://doi.org/10.1007/978-3-642-97843-2_19

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-97844-9

  • Online ISBN: 978-3-642-97843-2

  • eBook Packages: Springer Book Archive

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