Beril DİLBER, Nihal YILDIZ, Hüseyin YAMAN, Tulay KAMASAK, Gülnur ESENÜLKÜ, Pınar ÖZKAN, Elif ACAR ARSLAN, Sevim ŞAHİN, Süleyman KARAHAN, Ali CANSU

Levetirasetam Monoterapisi Alan İdyopatik Epilepsili Çocuklarda Hematolojik ve Karaciğer Fonksiyon Testlerinin Uzun Dönem Etkilerinin Değerlendirilmesi

Amaç: Bu çalışmada epilepsi tanısı ile levetirasetam (LEV) tedavisi başlanan çocuklarda tedavi öncesi ve sonrası hematolojik parametreler, karaciğer ve böbrek fonksiyon parametrelerindeki değişiklikler araştırıldı. Metodoloji: Çalışma popülasyonu 6-18 yaş arasında normal büyüme hızına sahip yeni tanı epilepsisi olan, LEV monoterapisi başlanan 114 çocuktan oluşuyordu. Her hastada hematolojik parametreler, B12, ferritin, karaciğer ve böbrek fonksiyon parametreleri, tedavi başlangıcından önce ve bir/üç yıl sonra ölçüldü. Bulgular: Hemoglobin (Hgb) ve hematokrit (Htc) seviyelerinde anlamlı artış ve mutlak lenfosit sayısı (ALC), mutlak nötrofil sayısı (ANC)(p=0.000), monosit yüzdesi (p=0.032) ve ortalama trombosit hacmi görüldü. (MPV)(p=0.000) seviyelerinde anlamlı düşüş görüldü. ALC seviyeleri 6 (%5,3) çocukta önemli ölçüde azaldı. Üç yıllık tedavide ortalama ilaç dozu 30.0±5.6 mg/kg/gün idi. Tedavi öncesi ve sonrası trombosit (PLT) sayıları arasında anlamlı bir fark bulunmadı ve cinsiyet ile hematolojik parametreler arasında anlamlı bir ilişki bulunmadı (her ikisi için p>0.05). Sonuç: LEV monoterapisi epilepsi hastalarının hematolojik parametrelerinde değişikliklere yol açsa da karaciğer fonksiyonlarında anlamlı bir değişiklik gözlenmedi. Epilepsili çocuklarda hematolojik parametreler değerlendirilirken toplumun yatkınlığının göz önünde bulundurulması ve ayrıca LEV tedavisine başlanmadan önce demir eksikliği ve B12 vitamini eksikliği anemisi olan çocukların da muayene edilmesi gerektiğini öneriyoruz. Ayrıca epilepsili çocuklarda uzun süreli LEV monoterapisinin güvenli bir tedavi olduğu ortaya çıktı.

Anahtar Kelimeler:

Kreatinin, Epilepsi, Hematolojik, Levetiresetam, Karaciğer Fonksiyon Testleri

Evaluation of Long-Term Effects of Levetiracetam Monotherapy on Hematological and Liver Function Parameters in Children With Idiopathic Epilepsy

Objective: We aimed this study, investigated the changes in pre- and post-treatment hematological parameters, liver and kidney function parameters in children that were diagnosed with epilepsy and initiated on levetiracetam (LEV) therapy. Methodology: The study population consisted of 114 children (6-18 years) had normal growth percentiles, that were treated for new-onset epilepsy with LEV monotherapy. In each patient, hematological parameters, B12, ferritin, liver and kidney function parameters were measured before and one/three years after the initiation of the therapy.Results: The hemoglobin (Hgb) and hematocrit (Htc) levels showed a significant increase and the absolute lymphocyte count (ALC), absolute neutrophil count (ANC) (p=0.000), monocyte percentage (p=0.032), and mean platelet volume (MPV) (p=0.000) levelsshowed a significant decrease. The ALC levels decreased significantly in 6 (5.3%) children. The mean drug dose at three years of treatment was 30.0±5.6 mg/kg/day. No significant difference was found between pre- and post-treatment platelet (PLT) counts and no significant correlation was found between gender and hematological parameters (p>0.05 for both).Conclusion: Although LEV monotherapy led to changes in the hematological parameters of the epilepsy patients, no significant change was observed in liver function. We suggest that when evaluating the hematological parameters in children with epilepsy, the community’s predisposition should be considered and also children should be examined for iron deficiency and vitamin B12 deficiency anemia before initiating the LEV therapy. It was also revealed that long-term LEV monotherapy is a safe treatment in children with epilepsy.

Keywords:

Creatinine, Epilepsy, Hematological, Levetiracetam, Liver function tests,

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