Effect of anticonvulsant drug sodium valproate on hepatic profile in children

Background: Sodium valproate is one of the most common antiepileptic medications used in clinical practice. The period of treatment is commonly associated with benign alternation of the liver enzymes due to drug metabolism. Evaluation of asymptomatic enzymatic changes could be challenging to the expert clinician and may expose patients to unnecessary procedures or expenses. Thus, this article aims to focus on the frequency of liver enzyme abnormalities among epileptic children. Materials & Methods: The current prospective observational study was conducted on children with seizure disorder attending Pediatric OPD of Rajendra Institute of Medical Sciences, Ranchi. Period of study was extended from February 2014 to October 2015. Patient randomly selected from outdoor of department of Pediatric having seizure disorder. All children aged 2 years to 10 years, of either sex having partial or generalized seizure and who have recently started either phenytoin, valproate or carbamazapine were selected for study. Routine investigations like complete blood count, peripheral blood smear, CRP, blood glucose, CT Brain/Spine, EEG and hepatic profile like aspartate aminotransferase (AST/SGOT), alanine aminotransferase (ALT/SGPT), alkaline phosphatase, total serum bilirubin (direct & indirect), prothombin time or international normalized ratio (INR), serum albumin and Australia antigen (HbsAg) on valproate therapy were done. Results: The present study revealed that, the patients treated with valproate have shown significant increase mean ALP level after 1 year of treatment as p values were 0.03, 0.02 and 0.03 respectively. The patients treated with valproate have shown no significant increase mean SGPT and SGOT level after 1 year of treatment. It was also found that there was no significant increase in mean TSB and mean PT. Also there was no significant decrease in mean serum albumin. Conclusion: The significant increase was seen in mean ALP level these increase is probably due to enzyme-inducing or enzyme-inhibiting properties of drugs. SGPT, SGOT levels increases from the initial value but not to significant level. The study recommends obtaining baseline liver enzymes tests prior to commencement of treatment. However, the benefit of routine screening in asymptomatic patients has not proved. Further controlled studies with a large sample size are warranted

Effects of anticonvulsant drug on liver enzymes among children in a tribal state of India: A longitudinal study

Introduction: Epilepsy is a syndrome of various neurological disorders. Idiosyncratic hepatotoxicity is a rare adverse effect associated with antiepileptic drugs (AED) therapy. Antiepileptic drugs may produce hepatic injury as part of a more widespread hypersensitivity reaction. Laboratory monitoring of asymptomatic effects may allow for the early detection of hepatotoxicity. So the present prospective longitudinal study was carried out to determine the effects of Anticonvulsant drug on liver enzymes among Epileptic Children. Materials Methods: A prospective observational study was conducted among children with seizure disorder attending Paediatric outdoor patient Department of Rajendra Institute of Medical Sciences, Ranchi from February 2014 to October 2015. 50 children with newly diagnosed or untreated seizure disorder were included in case and 50 children of both sexes with same age group as cases were selected as control who did not have seizure. Children with age ranging from 2-10 years were included by consecutive sampling technique. Data was analysed using Statistical Package for Social Sciences (SPSS) software version 25(IBM Corp., Armonk, NY, USA). Paired t test was used to compare the mean values of liver enzymes amongst the children.”P-value” was considered to be non – significant if found ≥ 0.05 and significant if P-value was found to be <0.05. Results: In the present study there was no significant alteration of hepatic profile after treatment with valproate except serum alkaline phosphatase which was increased from the initial value than control group and was statistically significantly with P value of less than 0.05. Conclusion: We concluded that these Antiepileptic drugs are safe to use in children up to 1 year