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Platelet count and function in children receiving sodium valproate.

A Verrotti1, R Greco, V Matera

  • 1Department of Pediatrics, University of Chieti, Italy.

Pediatric Neurology
|October 8, 1999
PubMed
Summary
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Valproic acid (VPA) therapy in children can lead to lower platelet counts and impaired platelet function, including reduced adenosine triphosphate (ATP) release and aggregation. These effects occur within normal therapeutic ranges and do not necessitate drug discontinuation.

Area of Science:

  • Pediatric Pharmacology
  • Hematology
  • Neuropharmacology

Background:

  • Valproic acid (VPA) is a widely used antiepileptic and mood-stabilizing drug.
  • Potential hematological side effects, such as thrombocytopenia, warrant investigation.

Purpose of the Study:

  • To prospectively evaluate the effects of VPA monotherapy on platelet count and function in children.
  • To determine if VPA causes thrombocytopenia and impaired platelet aggregation and adenosine triphosphate (ATP) release.

Main Methods:

  • Prospective study of 20 children treated with VPA for 6 months, compared to 15 healthy controls.
  • Assessed platelet counts, platelet aggregation (collagen, ADP, arachidonic acid), and ATP release before and after VPA therapy.
  • Monitored VPA dosage and plasma concentrations.

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Main Results:

  • VPA treatment significantly decreased platelet counts compared to controls (P < 0.01).
  • Significant impairments in platelet aggregation and ATP release were observed in VPA-treated children.
  • Correlations found between VPA dosage/plasma levels and decreased platelet count, aggregation, and ATP release.

Conclusions:

  • VPA monotherapy can cause decreased platelet counts and impaired platelet function (aggregation and ATP release) in children.
  • These hematological changes can occur within 6 months of therapy at therapeutic VPA plasma levels.
  • Clinical symptoms are not consistently associated, and drug discontinuation may not be required.