J Clin Neurol.  2020 Jan;16(1):140-144. 10.3988/jcn.2020.16.1.140.

Antiphospholipid and Antinuclear Antibodies in Children with Idiopathic Epilepsy: A 2-Year Prospective Study

• Attilakos
• Fotis L
• Dinopoulos A
• Alexopoulos H
• Theofilopoulou AV
• Tzioufas A
• Mastroyianni S
• Karalexi M
• Garoufi A

• KMID: 2467796
• DOI: http://doi.org/10.3988/jcn.2020.16.1.140

Abstract

BACKGROUND AND PURPOSE
The high prevalence of antiphospholipid antibodies (aPL) and antinuclear antibodies (ANA) in patients with epilepsy may be associated with either the disease itself or the antiepileptic treatment. The purpose of this prospective study was to determine the prevalence of aPL and ANA in children with idiopathic epilepsy before and during treatment with antiepileptic drugs.
METHODS
aPL, including both anticardiolipin and anti-β2-glycoprotein I antibodies, and ANA statuses were determined in 40 healthy children, 30 children treated with sodium valproate (VPA) monotherapy, and 20 children treated with carbamazepine (CBZ) monotherapy before and at 6, 12, and 24 months after treatment initiation.
RESULTS
Fifteen children (50%) in the VPA-treated group and 7 (35%) in the CBZ-treated group showed positivity for aPL before treatment initiation, compared with only 4 of the 40 controls. Nine children (30%) in the VPA-treated group and 4 (20%) in the CBZ-treated group showed positivity for ANA before treatment initiation, compared with only 2 of the 40 controls. The subgroup analysis found nonsignificant associations at the different time points regarding the positivity of all of the autoantibodies. Only patients treated with VPA had a significantly decreased risk of aPL positivity after 6 months of treatment.
CONCLUSIONS
The increased prevalence of autoantibodies in children with idiopathic epilepsy is strongly associated with the disease itself.

Keyword

antibodies; anticardiolipin; antinuclear antibodies; beta 2-Glycoprotein I; children; epilepsy

MeSH Terms

Antibodies
Antibodies, Antinuclear*
Antibodies, Antiphospholipid
Anticonvulsants
Autoantibodies
beta 2-Glycoprotein I
Carbamazepine
Child*
Epilepsy*
Humans
Prevalence
Prospective Studies*
Valproic Acid
Antibodies
Antibodies, Antinuclear
Antibodies, Antiphospholipid
Anticonvulsants
Autoantibodies
Carbamazepine
Valproic Acid
beta 2-Glycoprotein I

Figure

• 

  Fig. 1 Positivity for aPL (including both ACL and anti-β2-GPI) and ANA among patients treated with sodium VPA (Group A) and CBZ (Group B) before treatment initiation, as well as in age-matched healthy controls. Fisher's exact test was used to compare groups (Groups A and B vs. controls). ACL: anticardiolipin antibodies, ANA: antinuclear antibodies, anti-β2-GPI: anti-β2-glycoprotein I antibodies, aPL: antiphospholipid antibodies, CBZ: carbamazepine, VPA: valproate.

• 

  Fig. 2 Trends of positivity for aPL, ACL IgG and IgM, anti-β2-GPI IgG, and ANA among patients treated with VPA (A) and CBZ (B) before and at 6, 12, and 24 months after treatment initiation. ACL: anticardiolipin antibodies, ANA: antinuclear antibodies, anti-β2-GPI: anti-β2-glycoprotein I antibodies, aPL: antiphospholipid antibodies, CBZ: carbamazepine, Ig: immunoglobulin, OR: odds ratios, VPA: valproate.

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