Transient decrease in serum albumin concentrations in epileptic children treated with sodium valproate monotherapy.

Area of Science:

• Neurology
• Clinical Biochemistry
• Pediatric Epilepsy

Background:

• Hypoalbuminemia is associated with severe disability and epilepsy.
• Previous studies noted hypoalbuminemia in epilepsy patients on short-term valproate (VPA) therapy.
• Serum albumin levels in children on long-term VPA monotherapy were not previously studied.

Purpose of the Study:

• To determine serum albumin concentrations in ambulatory children with epilepsy on long-term VPA monotherapy.
• To assess changes in serum albumin over 24 months of VPA treatment.
• To evaluate other biochemical markers of liver and renal function during VPA therapy.

Main Methods:

• Serum albumin was measured in 26 children with epilepsy before and at 6, 12, and 24 months of VPA monotherapy.
• Serum total protein, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyltransferase, and creatinine were also monitored.
• Statistical analysis was performed to assess changes over time.

Main Results:

• Serum albumin concentrations decreased significantly at 6 months of VPA treatment (P = 0.007).
• Alanine aminotransferase and aspartate aminotransferase levels increased significantly at 6 and 12 months.
• No significant correlation was found between serum albumin and other parameters at 6 months.

Conclusions:

• Ambulatory children on VPA monotherapy may experience an early, transient decrease in serum albumin.
• Further research is necessary to understand the clinical implications and mechanisms of VPA-induced hypoalbuminemia.
• Monitoring albumin levels during VPA therapy may be warranted.