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Changes in platelet counts caused by valproate in children with epilepsy

Korean Journal of Pediatrics 2009;52(1):75-80.
Published online January 15, 2009.
Changes in platelet counts caused by valproate in children with epilepsy
Ju Hee We, Young Mi Kim, Sang Ook Nam
Department of Pediatrics, School of Medicine, Pusan National University, Busan, Korea
소아 간질 환자에서 valproate 투여 후 혈소판 수의 변화
위주희, 김영미, 남상욱
부산대학교 의학전문대학원 소아과학교실
Sang Ook Nam, Email: weareone@pusan.ac.kr
: In adults, valproate (VPA) has been reported to be associated with thrombocytopenia. However, few studies have investigated this association in children, and the factors affecting platelet counts remain controversial. This study was undertaken to investigate changes in platelet counts following VPA therapy and related factors in children with epilepsy.
: Our subjects comprised 75 epileptic children who had received VPA monotherapy for at least 1 year between January 2000 and December 2005. We regularly examined platelet counts at intervals of 6 to 12 months after baseline platelet counts before VPA treatment. We analyzed changes in platelet counts according to several factors such as sex, seizure type, underlying causes of epilepsy, age at the start of medication as well as at the last follow up, duration of VPA administration, VPA dose, serum VPA level, and body weight at the last follow up.
: Overall, the platelet counts decreased significantly after VPA therapy. The average baseline platelet count was 312.5¡¾109.1¡¿106/mL. At the last follow up, the average platelet count was 261.7¡¾72.2¡¿106/mL. We observed the relationship between platelet counts and serum levels of VPA; while children with serum VPA <75 µg/mL showed no change in platelet counts (P=0.102), children with serum VPA >75 µg/mL showed a significant decrease in platelet counts.
: VPA may cause a significantly decreased platelet count in children with epilepsy. High serum VPA levels were associated with development of thrombocytopenia.
Key Words: Children, Platelet count, Valproate, Epilepsy

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