Hematological consequences of antiepileptic drug therapy among children with epilepsy
Epilepsy is a chronic neurologic disease that comes third after cerebrovascular and Alzheimer’s
disease. Anti-epileptic drugs may affect certain hematological parameters of epileptic patients. Few researches
investigated hematological adverse effects of antiepileptic drugs in Libya. Thus, the aim was to evaluate
hematological parameters in epileptic children who are on antiepileptic drugs. This retrospective study
included 83 pediatric patients with epilepsy recruited from Benghazi Children Hospital, Department of
Neurology, from December 2017 to April 2018. Data collected included demographic characteristics, types
of epilepsy, anti-epileptic drugs and serum hematological parameters. Hematological parameters recorded
included: hemoglobin, hematocrit, platelet, mean cell volume, mean cell hemoglobin, mean cell hemoglobin
concentration and white blood cell count. In all treated patients, regardless of the number of antiepileptic drugs
therapy used, the average levels of hematological parameters were significantly lower in treated group
compared to control group (11.64 gm per dl, 34.53%, 27.74 pg and 33.13 gm per dl, respectively). A
significant increase (12.12109 per l) in white blood cell counts in treated group was found. Average
hemoglobin, hematocrit and mean cell hemoglobin concentration levels were significantly lower in patients
on poly-therapy compared to mono-therapy and control groups. Average white blood cell counts were
significantly increased in patients on anti-epileptic drugs. In sodium valproate users, levels of hematological
parameters were significantly decreased but significantly increased in white blood cell counts. In diazepam
users, significant increases in white blood cells and platelet but no difference in other parameters observed.
There were no differences in all hematological parameters among patients using carbamazepine except for
platelet counts (significantly decreased). In conclusion, there is substantial effect of the anti-epileptic drugs,
especially sodium valproate, on hematological parameters of children despite the effects were not critical as
the changes were still in the normal range.
