The Effects of Antiepileptic Drugs on Complete Blood Cell Counts in Children with Epilepsy

Yıl 2019, Cilt: 13 Sayı: 6, 429 - 434, 23.12.2019

Sevim Şahin

https://doi.org/10.12956/tjpd.2018.387

Öz

Objective: Since antiepileptic drug use is long-term, it may be important to know their effects on blood cell counts during the management of these patients. However, these effects have not been adequately evaluated in epileptic children. In our study, the effects of valproate, levetiracetam and carbamazepine on complete blood counts were assessed in children. 

Material

and

Methods: Material and methods: Consecutive epilepsy patients under monotherapy were reviewed retrospectively. Eighty patients, whose data were available before the treatment and at 2-6 months and 9-16 months after treatment initiation were included in the study. The ages at the start of the treatment were taken into consideration. Hemoglobin, hematocrit, erythrocyte, platelet and leucocyte counts, leukocyte subset percentages and the mean volume and distribution width of the erythrocytes and thrombocytes were recorded.

Results:
There were no statistically significant differences between the levels at pre-treatment and at 2-6 and 9-16 months after treatment initiation in the patients treated with levetiracetam (n=25) and carbamazepine (n=20). In the valproate group (n=35), there was an increase in mean corpuscular volume and monocyte percentage, and a decrease in platelet counts, in the first six months (p=0.015, p=0.001, p=0.005, respectively). At 9-16 months, the lymphocyte percentage increased while the neutrophil and eosinophil percentages decreased (p=0.016, p=0.014, p=0.01, respectively) in this group.

Conclusion: In our study, valproate caused an increase in the percentage of lympho-monocytes and mean corpuscular volume, and a decrease in the platelet count, neutrophil and eosinophil percentages. These effects seem to be related to the fact that valproate is a histone deacetylase inhibitor.

Epilepsili Çocuklarda Antiepileptik İlaçların Tam Kan Sayımı Üzerine Etkileri

Öz

Amaç: Antiepileptik ilaçların kan hücreleri üzerine etkilerinin bilinmesi, uzun süreli kullanımları nedeniyle hastaların izleminde önemlidir. Bu etkiler, epilepsili çocuklarda yeterince değerlendirilmemiştir. Çalışmamızda; valproat, levetirasetam ve karbamazepin tedavisi alan epilepsili çocukların tam kan sayım üzerine, tedavinin etkileri incelenmiştir. 

Gereç

ve

Yöntemler: Çocuk Nörolojisi polikliniğine ardışık olarak başvuran, idiopatik epilepsi nedeniyle tekli antiepileptik ilaç kullanan hastalar, geriye dönük olarak incelendi. Tedavi öncesi, tedaviden sonraki 2-6 ay ve 9-16 aydaki tam kan sayımı verileri olan 80 hasta çalışmaya alındı. Hastaların tedavi başlangıcındaki yaşları dikkate alındı. Hemoglobin, hematokrit, eritrosit, trombosit, lökosit sayıları, lökosit alt tip (lenfosit, nötrofil, monosit, eozinofil) oranları, eritrosit ve trombositlerin ortalama hacmi ve dağılım genişliği kaydedildi. 

Bulgular: Levetirasetam (25 hasta) ve karbamazepin (20 hasta) grubundaki hastaların, tedaviden 2-6 ay ve 9-16 ay sonrası değerleri ile tedavi öncesi değerleri arasında istatistiksel fark saptanmadı (p>0.05). Valproat (35 hasta) grubunda ise ilk 6 ayda, ortalama eritrosit hacmi ve monosit yüzdesinde artış, trombosit sayısında azalma saptandı (sırasıyla, p=0.015, p=0.001 ve p=0.005). Tedavinin 9-16 aylık döneminde, ek olarak, lenfosit oranında artış, nötrofil ve eozinofil oranında azalma vardı (sırasıyla, p=0.016, p=0.014 ve p=0.01).

Sonuç:
Çalışmamızda, valproat tedavisinin, lenfomonositer hücre oranı ve ortalama eritrosit hacminde artışa; trombosit sayısı, nötrofil ve eozinofil oranında azalmaya neden olduğu saptanmıştır. Valproat tedavisiyle ortaya çıkan bu etkiler, histon deasetilaz inhibitörü olmasıyla ilişkili görünmektedir.

Anahtar Kelimeler

Antiepileptik ilaçlar, Çocuk, Eritrosit, Lökosit, Trombosit

Kaynakça

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