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Iatrogenic osteomalacia in epileptic children. A controlled therapeutic trial
Insights
Vitamin D supplementation may benefit bone health in epileptic children. Treatment with vitamin D2 increased forearm bone mineral content in epileptic children, while placebo decreased it.
Area of Science:
- Pediatrics
- Endocrinology
- Pharmacology
Background:
- Long-term phenytoin treatment in epileptic children can affect calcium metabolism.
- Bone mineral content (BMC) is a key indicator of skeletal health.
- Epileptic children may be at risk for hypocalcemia and altered bone metabolism.
Purpose of the Study:
- To investigate the effect of vitamin D supplementation on bone mineral content in epileptic children on long-term phenytoin therapy.
- To compare the effects of vitamin D2 versus placebo in epileptic children and healthy controls.
Main Methods:
- A controlled therapeutic trial involving 25 epileptic children and 22 normal children.
- Measurement of forearm bone mineral content (BMC) before and during a 3-month treatment period.
- Administration of vitamin D2 (2000 IU daily) or placebo to study groups.
Main Results:
- Epileptic children treated with vitamin D2 showed a significant 5% average increase in BMC.
- Epileptic children receiving placebo experienced a significant 2% average decrease in BMC.
- Normal children, regardless of vitamin D or placebo treatment, showed no significant change in BMC.
Conclusions:
- Prophylactic vitamin D treatment may be beneficial for maintaining bone mineral content in epileptic children on phenytoin.
- Vitamin D supplementation appears to counteract the negative effects of phenytoin on bone metabolism in children.
Abstract:
Bone mineral content (BMC) ub tge forearms (related to total body calcium) was measured for a controlled therapeutic trial in 25 epileptic children on long-term treatment with phenytoin and in 22 normal children before and during treatment with vitamin D or placebo. In the epileptic children, hypocalcaemia and elevated serum alkaline phosphatase was found in 20% and 16%, respectively. The group of epileptic children treated with vitamin D2 (2000 IU daily) for 3 months showed a significant increase in bone mineral content, 5% on average. The epileptic children treated with placebo showed a significant decrease, 2% on average, while the normal children treated with vitamin D or placebo showed no change in bone mineral content. The results indicate a possible benefit of prophylactic vitamin D treatment in epileptic children.