Continuous renal replacement therapy in combination with oXiris haemofilter in a paediatric patient with sodium valproate-induced acute pancreatitis

Some clinical trials have validated a new perspective on continuous renal replacement therapy (CRRT) in combination with oXiris haemofilter to more effectively enhance endotoxins clearance and circulating cytokines adsorption, stabilise vital signs, correct haemodynamic disorders and accelerate the recovery of organ function, thus providing survival benefits. However, no such combination mode has been reported in paediatric patients with sodium valproate (SV)-induced acute pancreatitis (AP). An early childhood boy was admitted to the department of critical care medicine, due to sudden upper abdominal pain lasting for 2 days. The child had a 2-year history of epilepsy and took 120 mg of SV two times per day for more than 2 months, after which he was diagnosed with the first episode of AP, bronchopneumonia and paroxysmal supraventricular tachycardia. The culprit of AP was identified as SV. After admission to the intensive care unit, the child immediately stopped taking SV and received comprehensive treatment for AP, followed by CRRT in combination with oXiris haemofilter. On the 3rd day after admission, a nasojejunal tube was implanted, followed by enteral nutrition, probiotics and levetiracetam. On the 22nd day after admission, the child was discharged from the hospital. At a 3-month follow-up after discharge, the child has returned to normal life without any sequelae. To the best of our knowledge, this is the first clinical case of SV-induced AP in a paediatric patient who achieved complete recovery after undergoing CRRT in combination with oXiris haemofilter, suggesting that this combination mode could be safely and effectively applied in patients with similar pathogenesis mechanisms as adjuvant therapy.