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Serum biotinidase activity in children treated with valproic acid and carbamazepine

Manuel Castro-Gago1, Carmen Gómez-Lado, Jesús Eirís-Puñal

  • 1Departamento de Pediatría, Servicio de Neuropediatría, Hospital Clínico Universitario, Facultad de Medicina, Universidad de Santiago de Compostela, Santiago de Compostela, Spain. manuel.castro.gago@usc.es

Journal of Child Neurology
|May 22, 2009
PubMed

Insights

Valproic acid treatment in children did not affect serum biotinidase enzyme activity. However, some patients experienced hyperammonemia and hair loss, which improved with biotin supplementation.

Area of Science:

  • Biochemistry
  • Pediatric Neurology
  • Pharmacology

Background:

  • Valproic acid is an antiepileptic drug with potential side effects.
  • Previous studies suggested valproic acid may reduce serum biotinidase enzyme activity.
  • Biotinidase deficiency can lead to serious neurological issues.

Purpose of the Study:

  • To investigate the effect of valproic acid on serum biotinidase enzyme activity in children.
  • To assess other biochemical parameters and clinical signs in children treated with valproic acid and carbamazepine.

Main Methods:

  • Serum concentrations of antiepileptic drugs, transaminases, gamma-glutamyl transferase, ammonia, and biotinidase enzyme activity were measured.
  • A cohort of 57 children treated with valproic acid, 17 with carbamazepine, and 75 healthy controls were analyzed.
  • Clinical observations, including hair loss, were recorded.

Main Results:

  • No significant differences in serum biotinidase enzyme activity were found between valproic acid, carbamazepine, and control groups.
  • Hyperammonemia was detected in 8 patients on valproic acid.
  • Three female patients on valproic acid experienced hair loss, which resolved with biotin (10 mg/day) treatment.

Conclusions:

  • Valproic acid treatment does not appear to alter serum biotinidase enzyme activity in children.
  • Hyperammonemia and hair loss are potential side effects of valproic acid that may respond to biotin.
  • Further monitoring for metabolic disturbances is warranted in children on valproic acid therapy.

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