Effect of l -carnitine treatment for valproate-induced hepatotoxicity

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Abstract
The authors analyzed the association of l-carnitine treatment with hepatic survival in 92 patients with severe, symptomatic, valproate-induced hepatotoxicity. Forty-eight percent of the 42 patients treated with l-carnitine survived, but only 10% of the 50 patients treated solely with aggressive supportive care survived (p < 0.001). Early intervention with IV rather than enteral l-carnitine was associated with the greatest hepatic survival. Specifically, all 10 patients who were diagnosed in <5 days and treated with IV l-carnitine survived. Most patients had features of chronic illness and most children appeared to be malnourished.