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Growth suppression in children receiving acetazolamide with antiepileptic drugs
Insights
Acetazolamide, used with epilepsy or febrile seizure medications, significantly reduced height and weight in children. This growth suppression is linked to metabolic acidosis, with varying individual susceptibility.
Area of Science:
- Pediatric Endocrinology
- Clinical Pharmacology
- Neurology
Background:
- Acetazolamide is used as an adjunct therapy for epilepsy and febrile convulsions.
- The impact of acetazolamide on pediatric growth requires further clarification.
Purpose of the Study:
- To investigate the effect of clinical acetazolamide dosage on growth in children with epilepsy or febrile convulsion.
- To assess the relationship between acetazolamide administration and changes in height and weight standard scores.
Main Methods:
- Longitudinal comparison of height and weight standard scores in 17 pediatric subjects across four treatment phases.
- Monitoring of serum electrolytes (potassium, chloride) and carbon dioxide levels to assess metabolic changes.
Main Results:
- Significant reductions in height and weight standard scores were observed during acetazolamide administration.
- Metabolic acidosis, indicated by decreased potassium and CO2, and increased chloride, was present during acetazolamide use.
- No correlation found between growth suppression and age, duration, dosage, or concomitant antiepileptic drugs.
Conclusions:
- Acetazolamide administration, potentially via induced metabolic acidosis, suppressed growth in pediatric patients.
- Individual susceptibility to acetazolamide-induced growth suppression varies significantly among patients.
Abstract:
To clarify the effect of the clinical dosage of acetazolamide on growth in children with epilepsy or febrile convulsion, the standard scores of height and weight in 17 subjects receiving acetazolamide as an adjunct to unchanged monotherapy of antiepileptic drug were compared longitudinally through four phases: before antiepileptic drug administration, with monotherapy of antiepileptic drug, with acetazolamide in addition to monotherapy, and after acetazolamide discontinuation. The standard scores of both height and weight in the subjects were significantly reduced during the phase of acetazolamide administration. During this period, serum concentrations of potassium and total CO2 decreased while that of chloride increased, suggesting the existence of metabolic acidosis in the subjects. For both height and weight, there was no correlation between the degree of standard score reduction during acetazolamide administration and age at the time of acetazolamide initiation, duration of acetazolamide administration, dosages of acetazolamide, and variety of antiepileptic drugs concomitantly administered with acetazolamide. We speculate that metabolic acidosis induced by acetazolamide suppressed the growth of the subjects and that there were large individual differences in the susceptibility to acetazolamide for growth suppression among patients receiving acetazolamide.