Study of association of vitamin D levels in children and adolescents on antiepileptics drug therapy

Authors

  • Venugopal Reddy Iragamreddy Department of Pediatrics, Ovum Hospital, Bangalore, Karnataka, India
  • Rajini Chikkamanahally Channegowda Department of Pediatrics, Manipal Hospital, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20231411

Keywords:

Antiepileptic therapy, Population, Investigation, Polytherapy, Epilepsy

Abstract

Background: Epilepsy is a common non-communicable disease that affects both young and the elderly, with a cumulative lifetime incidence of 3%. Bone health may be impacted by prolonged AED use, and the study aims to investigate the relationships between long-term antiepileptic usage, vitamin D levels, and other outcomes.

Methods: Comparative observational research was conducted on 60 children with 30 healthy controls and 30 cases of antiepileptic drug users. Low vitamin D levels were identified based on monotherapy versus polytherapy, treatment duration, and severity of seizure control. 25-hydroxyvitamin D separated from its binding protein during incubation and competed with labelled vitamin D. A wash cycle was used to remove unbound material and a flash chemiluminescent reaction was started. The statistical analysis was done using R software 3.2.2 with a power of 90% and an alpha error of 5%.

Results: An observational comparative study found no significant relationship between vitamin D levels and antiepileptic drug therapy in children aged 4-16 years. Vitamin D levels in AED-treated children with well-controlled seizures and those with poorly controlled seizures were found to be statistically significant, with 77% of patients and none of the controls being vitamin D deficient.

Conclusions: Vitamin D deficiency is linked to antiepileptic medication, length of antiepileptic therapy, and increased risk of vitamin D insufficiency. It is important for pediatric neurologists and paediatricians to pay attention to the vitamin D status of children with epilepsy.

References

Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M. Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Paediatrics. 2008;122:398-417.

Jung-Hyun B, Young-Ho S, Gun-Ha K, Mi-Kyung K, Baik-Lin E. Vitamin D Levels in Children and Adolescents with Antiepileptic Drug Treatment. Yonsei Med J. 2014;55(2):417-21.

Rovner AJ, O'Brien KO. Hypovitaminosis D among healthy children in the United States: a review of the current evidence. Arch Pediatr Adolesc Med. 2008;162:513-9.

Shellhaas RA, Joshi SM. Vitamin D and bone health among children with epilepsy. Pediatr Neurol. 2010;42:385-93.

Pandey S, Singhi P, Bharti B. Prevalence and Treatment Gap in Childhood Epilepsy in a North Indian City A Community-Based Study Health. J Trop Pediatr. 2014;60(2):118-23.

Bindu M, Harinarayan CV. The effect of anti-epileptic drug therapy on serum 25-hydroxyvitamin D and parameters of calcium and bone metabolism-A longitudinal study. Eur J Epilepsy. 2010;19(3):153-8.

Petty SJ, O’Brien TJ, Wark ID. Anti-epileptic medication and bone health. Osteoporosis Int. 2007;18(2):129-421.

Abhijit M, Aggarwal A, Om S, Sangeeta S. Effect of Carbamazepine Therapy on Vitamin D and Parathormone in Epileptic Children. 2010;05.013

Renée AS, Amanda KB, Sucheta MJ. Prevalence and risk factors for vitamin D insufficiency among children with epilepsy. Ann Arbor M. Pediatric Neurol. 2010;42(6):422-6.

Shankar R, Nivedita P. Study of vitamin d levels in epileptic children in age group of 2-16 years. Asian J Pharmaceutical Clin Res. 2015;8(2).

Mikati A, Dib L, Yamout B, Sawaya R, Rahi AC, El-Hajj Fuleihan G. Two randomized vitamin D trials in ambulatory patients on anticonvulsants. Neurology. 2006;67(11):2005-14.

Mintzer S, Boppana P, Toguri J, DeSantis A. Vitamin D levels and bone turnover in epilepsy patients taking carbamazepine or oxcarbazepin. Epilepsia. 2006;47:510-51.

Neeta N. Guidelines for Diagnosis and Management of Childhood Epilepsy. Indian Paediatrics. 2009;46:17.

Unterberger I. Preference of Newer Versus Older AED: Where is the Evidence? Austria Epileptologie. 2015;32.

Satinder A. Newer Anti-epileptic Drugs. Indian paediatrics. 2009;50.

Robert SF, Carlos A. A practical clinical definition of epilepsy. Epilepsia. 2014;55(4):475-82.

Mark PR, David WC, Tim W. Classification and terminology to organise seizures and epilepsies. Institute of Epileptology, King’s College London, 2 Walton Centre for Neurology and Neurosurgery. Chapter 2. 2017.

Sangeeta HR. Antiepileptic drugs in pediatric epilepsy. Pediatricneuro Sciences. 2008;3(1):7-15.

Haroon M, Fitzgerald O Vitamin D Deficiency and its Repletion: A Review of Current Knowledge and Consensus Recommendations. J Arthritis. 2012;1:105.

Maria G. Vogiatzi, Elka Jacobson-Dickman, Mark D. DeBoerVitamin D Supplementation and Risk of Toxicity in Paediatrics: A Review of Current Literature. J Clin Endocrinol Metab. 2014;99(4):1132-41.

El-Hajj Fuleihan G. Hypovitaminosis D in Healthy School children. Paediatrics. 2001;107:4.

Balasubramanian S, K Dhanalakshmi, Sumanthamperayani. Vitamin D deficiency in childhood-A Review of Current Guidelines on Diagnosis and Management. Indian Paediatrics. 2013;50;669-75.

Rathi N, Rathi A. Vitamin D and Child Health in the 21st Century. Indian Pediatr. 2011;48(8):619-25.

Jaishen R, Kebashni T, John MP. Diagnostic approach to the rachitic child. Eur J Pediatric. 2011;170:1089-96.

Carol LW, Frank RG. Prevention of Rickets and Vitamin D Deficiency in Infants, Children, and Adolescents. Ppediatrics. 2008;122:5.

Neville HG, Steven AA. Optimizing Bone Health in Children and Adolescents. Pediatrics. 2014;134:4.

Greta. Determining vitamin D status: a comparison between commercially. Assays. 2010;13:0011555.

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Published

2023-05-08

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Original Research Articles