Taghrid Gamaleldin Abdelrahman
Professor
Carbamazepine-Induced Hematological and Immunological Alterations in Egyptian Children with Idiopathic Generalized Seizures
J Child Sci • 2021
Publication Information
Authors
Ola Samir El-Shimi1 Amina Ali Farag2 Amany Mohammed El-Rebigi3
Taghrid Gamaleldin Kharboush4 Hanaa El-Sayed Bayomy5 Rana Atef Khashaba
Keywords
carbamazepine ; immunological effects;;hematological effects ;children; Egypt
Journal
J Child Sci
Publisher
Georg Thieme Verlag KG, Rüdigerstraße 14, 70469 Stuttgart, Germany
Volume
11
Issue
Not Available
Pages
e 265– e272
publication.type
International
Paper Link
Not Available
Supplementary Materials
Not Available
Abstract
Carbamazepine (CBZ) is one of the oldest antiepileptic drugs (AEDs) that is still used for
the treatment of tonic-clonic seizures in children. Long-term use of AEDs induces
potential toxic effects that may remain undetermined for a long time. Earlier studies
have revealed a wide spectrum of hematological toxicities associated with CBZ. This
study was conducted to unveil the toxic effects of carbamazepine as an antiepileptic
monotherapy on hematological and immunological parameters in a group of Egyptian
pediatric patients using it for different durations. Fifty pediatric epileptics of either sex
were enrolled; 38 were taking CBZ as antiepileptic monotherapy for 6 months and 12
were newly diagnosed untreated patients. Hematological and immunological param-
eters studied were compared with their age and sex-matched 15 controls and among
groups. CBZ was found more toxic for total leukocyte count, lymphocyte count, serum
IgA and IgM levels (p < 0.001, 0.001, < 0.001, < 0.001, respectively). Hemoglobin
level, platelets count, serum C4 level and IgA were negatively correlated with serum
CBZ level (Spearman’srho¼ – 0.62, – 0.42, – 0.34, – 0.13; p < 0.001, 0.008, 0.04, 0.44,
respectively). CBZ treatment duration associated inversely with platelets, lymphoc yte,
and eosinophil counts (p < 0.001, 0.03, 0.01, respectively). Epileptic children on CBZ
monotherapy had their hematologic and immunologic systems affected, which
mandates routine monitoring of these children.
the treatment of tonic-clonic seizures in children. Long-term use of AEDs induces
potential toxic effects that may remain undetermined for a long time. Earlier studies
have revealed a wide spectrum of hematological toxicities associated with CBZ. This
study was conducted to unveil the toxic effects of carbamazepine as an antiepileptic
monotherapy on hematological and immunological parameters in a group of Egyptian
pediatric patients using it for different durations. Fifty pediatric epileptics of either sex
were enrolled; 38 were taking CBZ as antiepileptic monotherapy for 6 months and 12
were newly diagnosed untreated patients. Hematological and immunological param-
eters studied were compared with their age and sex-matched 15 controls and among
groups. CBZ was found more toxic for total leukocyte count, lymphocyte count, serum
IgA and IgM levels (p < 0.001, 0.001, < 0.001, < 0.001, respectively). Hemoglobin
level, platelets count, serum C4 level and IgA were negatively correlated with serum
CBZ level (Spearman’srho¼ – 0.62, – 0.42, – 0.34, – 0.13; p < 0.001, 0.008, 0.04, 0.44,
respectively). CBZ treatment duration associated inversely with platelets, lymphoc yte,
and eosinophil counts (p < 0.001, 0.03, 0.01, respectively). Epileptic children on CBZ
monotherapy had their hematologic and immunologic systems affected, which
mandates routine monitoring of these children.