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Aminoaciduria resulting from vigabatrin administration in children with epilepsy
E Lahat1, B Ben-Zeev, J Zlotnik
1Pediatric Neurology Unit, Assaf Harofeh Medical Center, Zerifin, Israel.
Insights
Vigabatrin treatment in children with epilepsy significantly increases urinary excretion of specific amino acids, including beta-alanine and gamma-aminobutyric acid. These changes normalize after discontinuing the antiepileptic drug.
Area of Science:
- Biochemistry
- Clinical Pharmacology
- Pediatric Neurology
Background:
- Vigabatrin is an antiepileptic drug used for drug-resistant epilepsy.
- Previous reports suggest vigabatrin influences urinary excretion of amino and organic acids.
Purpose of the Study:
- To investigate the effect of vigabatrin on urinary amino acid excretion in children.
- To identify specific amino acids affected by vigabatrin treatment.
Main Methods:
- Analysis of urinary amino acids in 14 children before and during vigabatrin treatment.
- Comparison of amino acid profiles between on- and off-medication states.
Main Results:
- All children showed increased urinary excretion of amino acids while on vigabatrin.
- Elevated levels of beta-alanine, gamma-aminobutyric acid, and beta-aminoisobutyric acid were observed.
- These abnormal findings were absent when children were not taking vigabatrin.
Conclusions:
- Vigabatrin significantly alters amino acid metabolism in children.
- Monitoring urinary amino acids is crucial before and during vigabatrin therapy.
- This highlights the importance of metabolic evaluation for pediatric epilepsy treatment.
Abstract:
Vigabatrin (gamma-vinyl gamma aminobutyric acid), a recently developed antiepileptic drug, has been extensively evaluated in the treatment of drug-resistant epilepsy. Several case reports demonstrated that vigabatrin affects urinary excretion of several amino and organic acids. Fourteen children were investigated for the presence of abnormal urinary amino acids before and after treatment with vigabatrin. All demonstrated increased urinary excretion of amino acids, particularly beta-alanine, gamma-aminobutyric acid, and beta-aminoisobutyric acid while on vigabatrin, which were not detected when off medication. These results emphasize the importance of obtaining urine for metabolic evaluation before the administration of vigabatrin.
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