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Antiphospholipid and Antinuclear Antibodies in Children with Idiopathic Epilepsy: A 2-Year Prospective Study
Achilleas Attilakos1, Lambros Fotis2, Argirios Dinopoulos2
1Third Department of Pediatrics, National and Kapodistrian University of Athens, "Attikon" Hospital, Athens, Greece. attilakos@hotmail.com.
Insights
Children with epilepsy have higher rates of antiphospholipid antibodies (aPL) and antinuclear antibodies (ANA). These autoantibodies are linked to the epilepsy itself, not the antiepileptic drugs used for treatment.
Area of Science:
- Pediatric Neurology
- Immunology
- Autoimmunity
Background:
- High prevalence of antiphospholipid antibodies (aPL) and antinuclear antibodies (ANA) observed in epilepsy patients.
- Association of aPL and ANA with epilepsy may stem from the disease or its treatment.
Purpose of the Study:
- To investigate the prevalence of aPL and ANA in children with idiopathic epilepsy.
- To assess antibody levels before and during antiepileptic drug (AED) treatment.
Main Methods:
- Prospective study involving 40 healthy children and 70 children with epilepsy.
- Children with epilepsy received monotherapy with sodium valproate (VPA) or carbamazepine (CBZ).
- aPL and ANA levels were measured at baseline and at 6, 12, and 24 months post-treatment initiation.
Main Results:
- Elevated aPL and ANA positivity rates were found in children with epilepsy compared to controls before treatment.
- No significant associations were found between autoantibody positivity and time points during treatment.
- Sodium valproate (VPA) treatment showed a significant decrease in aPL positivity after 6 months.
Conclusions:
- The increased prevalence of autoantibodies in children with idiopathic epilepsy is strongly associated with the disease itself.
- Findings suggest epilepsy, rather than AEDs, is the primary driver of autoantibody elevation.
Background And Purpose:
The high prevalence of antiphospholipid antibodies (aPL) and antinuclear antibodies (ANA) in patients with epilepsy may be associated with either the disease itself or the antiepileptic treatment. The purpose of this prospective study was to determine the prevalence of aPL and ANA in children with idiopathic epilepsy before and during treatment with antiepileptic drugs.
Methods:
aPL, including both anticardiolipin and anti-β2-glycoprotein I antibodies, and ANA statuses were determined in 40 healthy children, 30 children treated with sodium valproate (VPA) monotherapy, and 20 children treated with carbamazepine (CBZ) monotherapy before and at 6, 12, and 24 months after treatment initiation.
Results:
Fifteen children (50%) in the VPA-treated group and 7 (35%) in the CBZ-treated group showed positivity for aPL before treatment initiation, compared with only 4 of the 40 controls. Nine children (30%) in the VPA-treated group and 4 (20%) in the CBZ-treated group showed positivity for ANA before treatment initiation, compared with only 2 of the 40 controls. The subgroup analysis found nonsignificant associations at the different time points regarding the positivity of all of the autoantibodies. Only patients treated with VPA had a significantly decreased risk of aPL positivity after 6 months of treatment.
Conclusions:
The increased prevalence of autoantibodies in children with idiopathic epilepsy is strongly associated with the disease itself.
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