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Pro- and anticoagulatory factors under sodium valproate-therapy in children

M C Banerjea1, W Diener, G Kutschke

  • 1Department of General Pediatrics, University Children's Hospital, Freiburg, Germany. m_banerjea@hotmail.com

Neuropediatrics
|October 9, 2002
PubMed

Insights

Sodium valproate (VPA) therapy in children significantly reduces platelet counts and alters both procoagulatory and anticoagulatory factors. This VPA-induced hemostatic change may potentially lower bleeding risk in pediatric patients.

Area of Science:

  • Pediatric Hematology
  • Pharmacology
  • Clinical Chemistry

Background:

  • Sodium valproate (VPA) is widely used in pediatric epilepsy management.
  • Hemostatic side effects are a known concern with VPA therapy.
  • Understanding VPA's impact on coagulation is crucial for patient safety.

Purpose of the Study:

  • To investigate the hemostatic side effects of sodium valproate (VPA) in children.
  • To longitudinally assess procoagulatory and anticoagulatory parameters during VPA therapy.

Main Methods:

  • Longitudinal study of 80 children undergoing VPA therapy.
  • Measurement of platelet count, platelet function, von Willebrand factor (vWF) antigen and activity.
  • Assay of procoagulatory factors (e.g., fibrinogen) and anticoagulatory factors (e.g., protein C, antithrombin).

Main Results:

  • VPA significantly reduced platelet count (p=0.007) but did not impair platelet function.
  • VPA therapy decreased vWF antigen but increased its in vivo activity (p=0.01).
  • Significant reductions were observed in fibrinogen (p=0.001), protein C (p=0.005), and antithrombin (p=0.04).

Conclusions:

  • Sodium valproate significantly impacts both procoagulatory and anticoagulatory systems in children.
  • The observed alterations in hemostasis suggest a potential reduction in absolute bleeding risk.
  • Further research is warranted to fully elucidate the clinical implications of VPA-induced hemostatic changes.
Abstract

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