Valproic acid (VPA) is an antiepileptic drug that has been used for various indications. VPA intoxication is frequent because of its narrow therapeutic range and widespread prescription for different clinical situations. We reported a pediatric VPA intoxication case who was treated with hemodialysis. A 14-year-old previously healthy girl was admitted to the pediatric intensive care unit three hours after ingestion of 15 tablets of controlled release VPA (7500 mg) VPA ingestion for suicidal attempt. She was lethargic while other physical examination findings were normal. Serum VPA level was 347.8 μg/mL on admission. Blood gas analysis revealed high anion gap metabolic acidosis and elevation of lactate. Because of metabolic acidosis is indicating poor prognosis, hemodialysis was performed. After four hours of hemodialysis her consciousness was improved and serum VPA level decreased and blood gas analysis revealed normal pH and lactate level. After the first hemodialysis session, the serum VPA level continued to decrease and there was no abnormality on blood gas analysis during follow-up. She was discharged on the third day of her hospitalization. Hemodialysis treatment is effective in VPA intoxication because it removes the drug and treats the acidosis. In this case report, it is shown that in case of high amount of VPA ingestion especially controlled release drug and early initiation of metabolic acidosis, performing hemodialysis before the organ failure symptoms would be protective for further organ failure development.

Keywords: Child, Hemodialysis, Valproic acid, Intoxication