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Bone mineral status in pediatric outpatients on antiepileptic drug monotherapy

Hasan Tekgul1, Gul Serdaroglu, Afig Huseyinov

  • 1Department of Pediatrics, Division of Pediatric Neurology, Ege University Medical Faculty, Izmer, Turkey. htekgul@med.ege.edu.tr

Journal of Child Neurology
|August 12, 2006
PubMed

Insights

Antiepileptic drug monotherapy in children rarely caused osteopenia over two years. Bone mineral density was not linked to vitamin D levels, suggesting other factors may be involved in drug-induced bone loss.

Area of Science:

  • Pediatric Endocrinology
  • Pharmacology
  • Bone Metabolism

Background:

  • Drug-induced osteopenia is a concern in children on long-term antiepileptic drugs.
  • Previous studies focused on institutionalized children, necessitating research on ambulatory outpatients.

Purpose of the Study:

  • To longitudinally assess bone mineral status in pediatric outpatients receiving antiepileptic drug monotherapy.
  • To investigate the relationship between bone mineral density and serum active vitamin D levels.

Main Methods:

  • A 2-year longitudinal study of 30 ambulatory pediatric outpatients on valproic acid, carbamazepine, or phenobarbital monotherapy.
  • Bone mineral density (BMD) measured using dual-energy x-ray absorptiometry (DXA).
  • Assessed serum levels of active vitamin D and biochemical bone markers.

Main Results:

  • A low frequency (6.7%) of osteopenia (BMD Z-scores < -1.5) was observed in two patients (one on carbamazepine, one on phenobarbital).
  • No significant correlation was found between serum active vitamin D levels or biochemical markers and BMD Z-scores.
  • Osteopenia was not attributed to impaired active vitamin D production or hyperparathyroidism.

Conclusions:

  • Antiepileptic drug monotherapy in ambulatory pediatric outpatients has a low risk of inducing osteopenia over two years.
  • The development of osteopenia in this context is not clearly linked to vitamin D deficiency or altered bone turnover markers.

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