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Published on: September 20, 2024
Long-term effect of levetiracetam monotherapy on haematological parameters in children with epilepsy: A prospective
Achilleas Attilakos1, Argirios Dinopoulos1, Maria Paschalidou1
1Third Department of Pediatrics, National and Kapodistrian University of Athens, "Attikon" Hospital, Athens, Greece.
Insights
Long-term Levetiracetam (LEV) treatment in children with epilepsy may alter blood cell counts. Levetiracetam significantly decreased lymphocyte counts while increasing neutrophils, haematocrit, and mean corpuscular volume over 12 months.
Area of Science:
- Pediatric Neurology
- Hematology
- Clinical Pharmacology
Background:
- Limited studies exist on Levetiracetam's (LEV) long-term hematological effects in pediatric epilepsy.
- Previous research focused on short-term LEV impacts on blood parameters in children.
Purpose of the Study:
- To investigate long-term changes in hematological parameters in children with epilepsy undergoing LEV monotherapy.
- To assess alterations after 12 months of LEV treatment.
Main Methods:
- Evaluated 20 children (epilepsy) before and after 12 months of LEV monotherapy.
- Measured white blood cell, neutrophil, lymphocyte, monocyte, hemoglobin, hematocrit, MCV, MCH, MCHC, and platelet counts.
Main Results:
- Significant decrease in lymphocyte count (p=0.003) at 12 months; 15% of children had counts below the 10th percentile.
- Significant increase in neutrophils (p=0.046) and significant decrease in platelets (p=0.006).
- Significant increase in hematocrit (p=0.036) and mean corpuscular volume (MCV, p=0.031). No dose association found.
Conclusions:
- Levetiracetam monotherapy over 12 months induces significant changes in lymphocyte, neutrophil, platelet, hematocrit, and MCV counts in children with epilepsy.
- Further large, prospective studies are needed to determine the clinical significance and necessity of monitoring these hematological changes.
Abstract:
Studies evaluating the effect of Levetiracetam (LEV) on haematological parameters in patients with epilepsy are very limited. Short-term effects on haematological parameters in children with epilepsy, at 2 and 6 months of LEV treatment, have been previously reported in the literature. Purpose of the current study was to further investigate the long-term changes on haematological parameters in children with epilepsy during LEV monotherapy. White blood cell, neutrophils, lymphocytes, monocytes, haemoglobin, haematocrit, mean corpuscular volume, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration and platelets were measured in 20 children (11 females, mean age 6,5 ± 4,4 years, range 2-15 years) with epilepsy, before and after 12 months of LEV monotherapy. Lymphocyte count was significantly decreased at 12 months (p = 0.003) of LEV treatment. Three children (15%) at 12 months of treatment had lymphocyte count below 10th percentile for age. Neutrophils counts were significantly increased and platelets counts were significantly decreased at 12 months of treatment (p = 0.046 and p = 0.006, respectively). In addition, haematocrit and mean corpuscular volume were significantly increased at 12 months of treatment (p = 0.036 and p = 0.031, respectively). There were no significant alterations in the other parameters evaluated during the study. No association was found between all parameters and LEV dosage (mg/kg) at 12 months of treatment. Large, prospective studies are needed to investigate the clinical significance of the above haematological changes and whether these parameters should be monitored periodically in children taking LEV.
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