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Thrombophilic risk factors in epileptic children treated with valproic Acid.
Pediatr Neurol 2009; 40(2):102-6PN

Abstract

There are few reports on valproic acid related to thrombophilia. Thrombophilic risk factors were investigated in 21 children (age range, 1-13 years) diagnosed with epilepsy and newly treated with valproic acid monotherapy. None of the children had been previously treated with any anticonvulsant agent. Before starting valproic acid therapy, homocysteine, lipoprotein(a), factor VIII, factor IX, protein C, protein S, antithrombin III levels, and activated protein C resistance levels were evaluated in all patients, with repeat evaluation after 9 months or 1 year of the therapy. Thrombosis gene mutations (factor V Leiden and prothrombin G20210A) were also evaluated in all patients before therapy. There was statistically significant elevation in lipoprotein(a) levels and reduction in fibrinogen levels after treatment. Reduction in protein C levels and elevation in homocysteine levels were also observed, but without statistical significance. Before therapy, no thrombotic event had occurred, despite thrombotic risk factors in some patients. Valproic acid can increase lipoprotein(a) and decrease fibrinogen, which may increase the risk of stroke or other thrombotic events. No clinical adverse effects resulted from changes in the levels or activity of thrombophilic factors associated with valproic acid treatment. Thus, routine investigation of factors implicated in thrombosis prior to initiation of valproic acid is not warranted for all patients. Nonetheless, caution is advised when initiating valproic acid treatment in children who have had prior stroke or thrombotic events.

Authors+Show Affiliations

Department of Pediatric Neurology, Medicine Faculty, Ankara University, Ankara, Turkey. unalozlem@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19135623

Citation

Unal, Ozlem, et al. "Thrombophilic Risk Factors in Epileptic Children Treated With Valproic Acid." Pediatric Neurology, vol. 40, no. 2, 2009, pp. 102-6.
Unal O, Deda G, Teber S, et al. Thrombophilic risk factors in epileptic children treated with valproic Acid. Pediatr Neurol. 2009;40(2):102-6.
Unal, O., Deda, G., Teber, S., Ertem, M., & Akar, N. (2009). Thrombophilic risk factors in epileptic children treated with valproic Acid. Pediatric Neurology, 40(2), pp. 102-6. doi:10.1016/j.pediatrneurol.2008.10.005.
Unal O, et al. Thrombophilic Risk Factors in Epileptic Children Treated With Valproic Acid. Pediatr Neurol. 2009;40(2):102-6. PubMed PMID: 19135623.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Thrombophilic risk factors in epileptic children treated with valproic Acid. AU - Unal,Ozlem, AU - Deda,Gülhis, AU - Teber,Serap, AU - Ertem,Mehmet, AU - Akar,Nejat, PY - 2008/05/12/received PY - 2008/10/06/revised PY - 2008/10/13/accepted PY - 2009/1/13/entrez PY - 2009/1/13/pubmed PY - 2009/3/31/medline SP - 102 EP - 6 JF - Pediatric neurology JO - Pediatr. Neurol. VL - 40 IS - 2 N2 - There are few reports on valproic acid related to thrombophilia. Thrombophilic risk factors were investigated in 21 children (age range, 1-13 years) diagnosed with epilepsy and newly treated with valproic acid monotherapy. None of the children had been previously treated with any anticonvulsant agent. Before starting valproic acid therapy, homocysteine, lipoprotein(a), factor VIII, factor IX, protein C, protein S, antithrombin III levels, and activated protein C resistance levels were evaluated in all patients, with repeat evaluation after 9 months or 1 year of the therapy. Thrombosis gene mutations (factor V Leiden and prothrombin G20210A) were also evaluated in all patients before therapy. There was statistically significant elevation in lipoprotein(a) levels and reduction in fibrinogen levels after treatment. Reduction in protein C levels and elevation in homocysteine levels were also observed, but without statistical significance. Before therapy, no thrombotic event had occurred, despite thrombotic risk factors in some patients. Valproic acid can increase lipoprotein(a) and decrease fibrinogen, which may increase the risk of stroke or other thrombotic events. No clinical adverse effects resulted from changes in the levels or activity of thrombophilic factors associated with valproic acid treatment. Thus, routine investigation of factors implicated in thrombosis prior to initiation of valproic acid is not warranted for all patients. Nonetheless, caution is advised when initiating valproic acid treatment in children who have had prior stroke or thrombotic events. SN - 0887-8994 UR - https://www.unboundmedicine.com/medline/citation/19135623/Thrombophilic_risk_factors_in_epileptic_children_treated_with_valproic_Acid_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0887-8994(08)00531-6 DB - PRIME DP - Unbound Medicine ER -