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Ko SH, Kwon HS, Kim SR, Moon SD, Ahn YB, Song KH, et al

Available crystal structures suggest that due to its proximity to the C154-C159 pair, H571 acts as a base for the deprotonation that results in both heightened reactivity and the formation of a thiolate-FAD charge transfer

For many patients, however, the scale is only part of the story

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VPA-induced hepatotoxicity can be characterized into four distinct subtypes: (1) a transient elevation in liver transaminases, (2) reversible hyperammonemia, (3) toxic hepatitis, and (4) a Reye-like syndrome [91,104]