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[Folic acid and vitamin B12 in children under long-term anticonvulsant therapy]
E Porras Tejero1, M D Lluch Fernández
1Departamento de Pediatría, Hospital Universitario Virgen Macarena, Sevilla.
Insights
Anticonvulsant medications can lower folic acid (FA) levels in children, potentially increasing mean corpuscular volume (MCV). Regular monitoring of FA is recommended for children on long-term anticonvulsant therapy.
Area of Science:
- Pediatric Medicine
- Clinical Chemistry
- Pharmacology
Background:
- Anticonvulsant drugs are widely used in pediatric populations.
- Potential biochemical alterations associated with anticonvulsant therapy require investigation.
- Folic acid (FA) and vitamin B12 are crucial B vitamins with implications in neurological health.
Purpose of the Study:
- To investigate the impact of anticonvulsant treatment on serum folic acid (FA) and vitamin B12 levels in children.
- To assess the relationship between anticonvulsant use and mean corpuscular volume (MCV).
Main Methods:
- Prospective study involving 110 children on anticonvulsants and 59 healthy controls.
- Serum levels of folic acid (FA) and vitamin B12 were measured.
- Mean corpuscular volume (MCV) was analyzed.
Main Results:
- Children on anticonvulsants exhibited significantly lower serum FA levels compared to controls.
- A statistically significant difference in MCV was observed, with higher values in the anticonvulsant group.
- No significant difference in serum vitamin B12 levels was found between the groups.
- Folate supplementation in children with low FA levels (<3 ng/ml) showed no adverse effects.
Conclusions:
- Anticonvulsant medications are associated with decreased serum folic acid (FA) levels in children.
- Elevated MCV may be an indicator of reduced FA levels in children undergoing anticonvulsant treatment.
- Periodic determination of serum FA is advisable for children on long-term anticonvulsant therapy to prevent potential deficiencies.
Abstract:
Folic acid (FA) and vitamin B12 have been measured prospectively in 110 children that were under treatment with anticonvulsants. The control group consisted of 59 healthy children. A statistically significant difference in levels of serum FA and mean corpuscular volume (MCV) was observed between groups. Children under anticonvulsant treatment had lower serum FA levels and higher MCV. No significant difference was observed between the two groups in levels of serum vitamin B12. All children with serum FA levels lower than 3 ng/ml were given folate and no adverse side effects were observed due to treatment. Anticonvulsant drugs decrease serum FA levels; therefore, FA should be determined periodically in children under long-term anticonvulsant treatment.