Fanconi syndrome caused by sodium valproate: report of three severely disabled children.

We report three severely disabled children with epilepsy, a 4-year-old boy, 8-year-old girl and 14-year-old girl, who were treated with sodium valproate from the age of 2 months, 3 months and 7 years, respectively, and who developed Fanconi syndrome. All three patients were bed-ridden and fed by means of a nasogastric or gastrostomy tube. Since Fanconi syndrome was considered to be caused by sodium valproate, it was stopped. After the discontinuation of sodium valproate, renal involvement improved in all patients in 2-12 months. Severely handicapped children may be at risk for sodium valproate-induced renal involvement. Although among the adverse effects of sodium valproate, renal involvement is uncommon, Fanconi syndrome due to valproate therapy has rarely been reported. We have to pay attention to Fanconi syndrome in epileptic children treated with sodium valproate, especially in severely disabled children.