Valproate-Associated Coagulopathies in Children During Short-Term Treatment

Abstract

Valproic acid is one of the most frequently prescribed antiepileptic drugs for the therapy of generalized and focal epilepsies. Valproate induces a variety of hemostatic disorders such as thrombocytopenia, abnormal platelet function, hypofibrinogenemia, and decreased concentrations of von Willebrand factor, and it rarely causes serious bleeding complications. It may also lead to atherosclerosis and thrombosis. However, there is still lack of knowledge about the incidence and occurrence of these particular side effects. In this prospective systematic study, we assessed the early effects of sodium valproate on both pro- and anticoagulatory factors, homocysteine, and lipoprotein (a) in 24 newly diagnosed epileptic children treated with valproate. Valproate causes decreased factor VII levels, platelet count, factor VIII, Protein C, fibrinogen, and increased lipoprotein (a) levels. To the best of our knowledge, our report is the first in the medical literature, which describes that valproate significantly reduces factor VII levels even during short-term therapy.

Postoperative Adverse Outcomes in Intellectually Disabled Surgical Patients: A Nationwide Population-Based Study

“…Lorenzo's oil, as a choice of dietary management for ID patients with adrenoleukodystrophy, may cause thrombocytopenia [35]. Epilepsy was reported to be the most prevalent illness in patients with ID in Taiwan [36]; therefore valproate-associated coagulopathies should not be overlooked, even during short-term epileptic treatment [37], as risk of postoperative bleeding is increased.…”

Neuropsychiatric symptoms accompanying thrombocytopenia following pregabalin treatment for neuralgia: a case report

“…The mechanism by which thrombocytopenia was associated with pregabalin treatment is so far unclear. There are some reports of antiepileptic-associated thrombocytopenia [10,11], but further study is necessary to clarify the relationship.…”

Epigenetic, polymorphic and mutational (Αα167Arg→Lys) contribution to a functionally abnormal fibrinogen

“…Whilst high valproate dosages can cause liver damage [8], there was no elevation of liver enzymes here, or in 74 similarly treated children [5,6]. Also, there was no liver-induced The disulphide ring is indicated by the paired CC residues and the incoming ( ‹ ) and outgoing ( fi ) coils of the Aa chain are indicated.…”