J Korean Pediatr Soc.  1980 Jan;23(1):15-23.

Effect of Long Term Anticonvulsant Therapy on Serum Calcium, Phosphorus and Alkaline Phosphatase in Convulsive Children

• Chung SJ
• Lee SW
• Ahn CI

Abstract

It has been well established that anticonvulsant drugs result in disturbance of Vitamin D Metabolism. The authors made a survey of 47 convulsive children aged from 9 months to 16years old who were diagnosed as convulsive disorder in pediatric department of K. H. U. H. from Dec., 1972 to Feb., 1979. The children were groupedas follows.: Fortyseven children including (control group) who were diagnosed as convulsive disorder, twenty two children including who had been measured serum Ca, P and alkaline phosphates about a month after receiving anticonvulsants, twenty eight children (group I) who received long term Phenobarbital therapy, nineteen children (treated with vitamin D) who had been measured those to supplementation one month later. 1. Comparing the blood levels of control group with those 3~5 weeks after receiving anticonvulsant, was were no significant decreases in serum Ca(from 4.92+/-0.29 to 4.85+/-0.21mEq/L;P>0.05), significant decreases in serum P (control vs 3.86+/-0.29 to 4.85+/-0.21mEq/L;P>0.05), significant decreases in serum P (from 13.8+/-3.2 to 16.1+/-2.7K.A.U.;P<0.05) 2. Group I was associated with the significant decreases in serum Ca(control vs 4.43+/-0.27mEq/L; P<0.001), seurm P (control vs 3.41+/-0.16m mg/100ml; P<0.001) and the significant increases in serum alkaline phosphatase (control vs 35.9*8.5 K. A. U.;P<0.001). 3. Group ll was associated with the significant decreases in serum Ca (control Vs 4.43 +/- 0.27 vs 4.24+/-0.34mEq/L; P<0,001), serum alkaline phosphatase (control vs 41.5+/-6.4 K. A. U. ;P<0.001). 4. Comparing group I with group ll there were significant decreases in serum Ca (4.43+/-0.27 vs 4.24+/-0.34mEq/L in group ll ;P>0.05), and significant decreases in serum alkaline phosphataws (35.9+/-8.5 vs 3. 26+/-0.33mg/100ml in group ll ; P<0.05). 5. Comparing the biochemical changes before vitamin D treatment with those about one month after from treatment, there was significant increases in serum Ca (from 4.26+/-0.35 to 4.58+/-0.33 mEq/L; P>0.05), no significant increases in serum P (from 3.15+/-0.42 to 3.34+/-0.29mg/100ml; P 0.05) and significant decreases in serum alkaline phosphatase (form 45.3+/-7.0 to 33.6+/-7.2 K. A.U. : P<0.01). 6. By the above observation, the expected deficiency of vitamin D seemed to elevate the levels of PTH, which caused accelerated demineralization of the bone as a compensatory mechanism that seemed to be break down accompanied by hypocalcemia in later stage. These data suggest that children with receiving chronic anticonvulsant therapy should be maintained on supplemented vitamin D intake.

MeSH Terms

Alkaline Phosphatase*
Anticonvulsants
Calcium*
Child*
Humans
Hypocalcemia
Metabolism
Phenobarbital
Phosphates
Phosphorus*
Vitamin D
Vitamins
Alkaline Phosphatase
Anticonvulsants
Calcium
Phenobarbital
Phosphates
Phosphorus
Vitamin D
Vitamins