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.