doiSerbia

Impact of valproates on haemostasis and blood cell count in children

Igrutinović Zoran (Pedijatrijska klinika, Klinički centar, Kragujevac)
Obradović Slobodan (Pedijatrijska klinika, Klinički centar, Kragujevac)
Vuletić Biljana (Pedijatrijska klinika, Klinički centar, Kragujevac)
Marković Slavica (Pedijatrijska klinika, Klinički centar, Kragujevac)

INTRODUCTION Epilepsy is a highly prevalent disease affecting 0.5-1.5% of the world's population. One of the most frequently used antiepileptics are valproates. These medicines show a negative impact on haemostasis and peripheral blood count. OBJECTIVE The objective of the study was to examine the negative impact of valproates on haemostasis and peripheral blood count in children and to analyse whether these disturbances were dependent on the dosage of valproates and drug level in blood. METHOD A two-year research was conducted. The research included: 35 children using valproates, 12 children using the therapy of both valproates and carbamazepine and 30 healthy children. Complete peripheral blood count, screening tests of haemostasis (bleeding time, prothrombin time, prothrombin ratio, activated partial thromboplastin time, fibrinogen) and capacity of thrombocyte aggregation research were done in all the children. RESULTS We found significantly more common frequency of leukopenia and neutropenia in children using valproates in comparison with the healthy children group. We also found the more common frequency of eosinophilia in comparison with healthy children. The children with the valproate therapy have lower approximate values of the number of platelets, fibrinogen and platelet aggregation in comparison with healthy children, but they have a higher approximate value of bleeding time and prothrombin time. These disturbances are in correlation with the dosage and the level of the medicine in blood. CONCLUSION Valproates have a negative effect on certain blood count parameters and haemostasis in children. Drug dosage and blood drug level are correlated with their negative impact on haemostasis parameters.

Keywords: valproates, haemostasis, peripheral blood count, children