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Valproic acid as an adjuvant analgesic: adult Fanconi syndrome
  1. Anita Maybach1,
  2. Susan Baro2,
  3. Kaylee Kachurka2 and
  4. Mellar P Davis2
  1. 1 Palliative Care, Geisinger Medical Center, Danville, Pennsylvania, USA
  2. 2 Geisinger Medical Center, Danville, Pennsylvania, USA
  1. Correspondence to Dr Anita Maybach, Palliative Care, Geisinger Medical Center, Danville, Pennsylvania, USA; amiculae{at}


We report an 80-year-old woman who developed severe hypophosphataemia and elevated urinary phosphate levels while started on valproic acid. This occurred within 1–2 days of starting valproic acid. There are rare single-patient reports of the association of valproic acid with adult Fanconi syndrome. This generally occurs after long-term exposure to valproate. This is the first reported experience of Fanconi’s syndrome in an adult with acute exposure to valproic acid. Clinicians should be aware of the possible association.

  • Clinical assessment
  • Clinical decisions
  • Metabolic disorders

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  • Contributors AM was the major writer and editor of the manuscript. KK, SB and MPD were the editing authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.