Bone status of children receiving anticonvulsant therapy

Barden, Howard S.; Mazess, Richard B.; Chesney, R. W.; Rose, Philip G.; Chun, Ruthanne

doi:10.1016/0221-8747(82)90008-x

Cited by 21 publications

(9 citation statements)

References 27 publications

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“…For ambulatory pediatric outpatients, reports of abnormalities of bone metabolism associated with anti‐epileptic drugs are inconsistent and may be difficult to interpret. Changes in BMD were first reported by Barden et al using single photon absorptiometry in the radius, ulna and humerus of epileptic children on long‐term anti‐epileptic treatment 9 . They found bone demineralization (averaging 8%) in patients with no other serious systemic disorders.…”

Section: Discussionmentioning

confidence: 85%

“…It has been reported previously that long‐term anti‐epileptic treatment can lead to disorders of vitamin D, bone and mineral metabolism 1,2 . Despite numerous reports of anti‐epileptic‐associated osteopenia or osteoporosis in adults 3−8 and children, 9−19 the exact mechanism of these pathological changes is still not completely elucidated. Furthermore, there are no studies that have previously evaluated specific markers of bone formation and resorption in children with uncomplicated epilepsy while receiving anti‐epileptic drugs.…”

mentioning

confidence: 99%

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Bone mineral status in ambulatory pediatric patients on long‐term anti‐epileptic drug therapy

Tsukahara

Kimura

Todoroki

et al. 2002

Pediatrics International

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Section: Discussionmentioning

confidence: 85%

mentioning

confidence: 99%

Bone mineral status in ambulatory pediatric patients on long‐term anti‐epileptic drug therapy

Tsukahara

Kimura

Todoroki

et al. 2002

Pediatrics International

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“…It is postulated that drugs can lead to disorders of vitamin D, bone and mineral metabolism, or drugs may act directly on bone cells, including osteoblasts and osteoclasts 8 " 10 . However, vitamin D and calcium supplementation are suggested for children with cerebral palsy who are receiving AED in full-time care 1 '"' 4 . However, vitamin D and calcium supplementation are suggested for children with cerebral palsy who are receiving AED in full-time care 1 '"' 4 .…”

Section: Introductionmentioning

confidence: 99%

Antiepileptic Drug-induced Osteopenia in Ambulatory Epileptic Children Receiving a Standard Vitamin D3 Supplement

Tekgül

Dizdarer²,

Demir³

et al. 2005

Journal of Pediatric Endocrinology and Metabolism

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Dual energy X-ray absorptiometry (DEXA) is a non-invasive, rapid, accurate and highly reproducible method for the assessment of antiepileptic drug (AED)-induced osteopenia in epileptic children. In this study, we investigated bone mineral density (BMD) using DEXA in 56 epileptic children receiving long-term AED treatment for at least 2 years. All children received AED monotherapy or polytherapy plus a standard vitamin D3 supplement (400 U/day). BMD measurements were made from lumbar spine (L2-L4) regions. Age- and sex-specific BMD SD scores were calculated for each child. Osteopenia was defined as SD scores less than -1.5. There was no significant difference in mean BMD values between epileptic children receiving monotherapy or polytherapy. The results were also compared to the age- and sex-specific BMD SD scores obtained from healthy Turkish children. Only three patients (5%) receiving AED therapy had a BMD SD score less than -1.5. This rate is relatively lower than the rates of previous studies conducted on ambulatory children on long-term AED treatment without vitamin D3 supplementation.

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“…

Antiepileptic drugs are known to affect bone mineral status in children and adults. 1,2 Nevertheless, decreased bone mineral density has been shown in children receiving chronic antiepileptic drug treatment. [3][4][5][6][7] Dual-energy x-ray absorptiometry was suggested as a method to monitor the bone mineral density of the trabecular bone in the anterior-posterior lumbar spine for the pediatric population.

…”

mentioning

confidence: 99%

Bone Mineral Status in Pediatric Outpatients on Antiepileptic Drug Monotherapy

et al. 2006

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Drug-induced osteopenia has been reported in institutionalized children on chronic antiepileptic drug therapy. The aim of this study was to assess longitudinally bone mineral status in pediatric outpatients on antiepileptic drug monotherapy. The study group consisted of 30 ambulatory children on a normal diet: 15 on valproic acid, 11 on carbamazepine, and 4 on phenobarbital monotherapy. Bone mineral density, serum active vitamin D (1,25-dihydroxyvitamin D), and certain biochemical markers of bone formation (calcium, phosphorus, alkaline phosphatase, intact parathyroid hormone, osteocalcin, calcitonin, and urinary calcium to serum creatinine and urinary phosphorus to serum creatinine ratios) were studied at the beginning of antiepileptic drug monotherapy and at the end of 2 years of treatment. Age- and sex-specific Z-scores of bone mineral density were measured at anterior-posterior L2-L4 by dual-energy x-ray absorptiometry. Drug-induced osteopenia was defined in only two patients (one on carbamazepine and the other on phenobarbital monotherapy), with Z-scores of bone mineral density less than -1.5. Serum levels of active vitamin D and biochemical markers were not significantly correlated with the Z-scores of bone mineral density. We detected a frequency of antiepileptic drug-induced osteopenia of 6.7% in pediatric outpatients after 2 years of monotherapy. However, osteopenia was not attributed to a defect in serum active vitamin D production owing to hyperparathyroidism in children on antiepileptic drug monotherapy.

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Bone status of children receiving anticonvulsant therapy

Cited by 21 publications

References 27 publications

Bone mineral status in ambulatory pediatric patients on long‐term anti‐epileptic drug therapy

Bone mineral status in ambulatory pediatric patients on long‐term anti‐epileptic drug therapy

Antiepileptic Drug-induced Osteopenia in Ambulatory Epileptic Children Receiving a Standard Vitamin D3 Supplement

Bone Mineral Status in Pediatric Outpatients on Antiepileptic Drug Monotherapy

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