Hematologic manifestations and impaired liver synthetic function during valproate monotherapy

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Ex Vivo Expansion of Hematopoietic Stem Cells from Human Umbilical Cord Blood-derived CD34+ Cells Using Valproic Acid
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Ex Vivo Expansion of Hematopoietic Stem Cells from Human Umbilical Cord Blood-derived CD34+ Cells Using Valproic Acid

Published on: April 11, 2019

E Hauser1, R Seidl, M Freilinger

  • 1Department of Pediatrics, University of Vienna, Austria.

Brain & Development
|March 1, 1996
PubMed

Insights

Valproate therapy in children with epilepsy can affect blood counts and liver function. This study observed reduced red blood cells, platelets, and altered liver proteins, suggesting potential impacts on hematopoietic and hepatic systems.

Area of Science:

  • Pediatric Neurology
  • Clinical Chemistry
  • Hematology

Background:

  • Epilepsy is a common neurological disorder in children.
  • Antiepileptic drugs (AEDs) are crucial for managing seizures.
  • Valproate (VPA) is a widely used AED, but its systemic effects require monitoring.

Purpose of the Study:

  • To prospectively evaluate the effects of valproate monotherapy on laboratory parameters in children with new-onset epilepsy.
  • To assess changes in complete blood count, liver function tests, coagulation profiles, and vitamin levels during VPA treatment.

Main Methods:

  • Prospective study of 50 children with new-onset epilepsy commencing valproate therapy.
  • Routine laboratory screening (CBC, serum protein, albumin, liver enzymes, coagulation) performed before and at 3, 6, 9 weeks post-treatment.
  • Serum vitamin B12 and folate levels measured in 29 patients.

Main Results:

  • Significant reduction in red blood cell and platelet counts; increased mean corpuscular volume (MCV).
  • Elevated vitamin B12 levels observed.
  • Transient reduction in alanine aminotransferase (ALT); significant decrease in serum protein and albumin; decreased serum fibrinogen and increased thrombin time.

Conclusions:

  • Valproate therapy may exert a direct toxic effect on hematopoietic stem cells, indicated by altered blood counts.
  • Reduced protein, albumin, and fibrinogen suggest impaired liver synthetic function in children on VPA monotherapy.
  • These laboratory changes highlight the need for vigilant monitoring in pediatric patients receiving valproate.

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