Marked elevation of alkaline phosphatase in an infant treated with levetiracetam: A case report

Levetiracetam (LEV) is widely used in the treatment of pediatric epilepsy and is typically well tolerated. We hereby present a case involving an infant who exhibited a notable and isolated elevation of alkaline phosphatase (ALP) during a treatment of LEV, with subsequent normalization following drug cessation. Liver function tests and bone turnover markers remained within normal limits, and the patient was asymptomatic. ALP levels returned to normal within four weeks of discontinuing LEV. LEV may cause significant, reversible ALP elevation in children, most likely due to bone origin. Although rare, this potential adverse effect should be considered, particularly during long-term therapy.