BONE DENSITOMETRY VERSUS URINARY
DEOXYPYRIDINOLINE AS MARKERS OF BONE RESORPTION IN EPILEPTIC CHILDREN
Hoda L. El Sayed, Omar
Hussein*, Wael El Garf**
Pediatric and *Diagnostic Radiology
Departments, Faculty of Medicine - Ain Shams University, **National
Research Centre, Cairo, Egypt
Objective: to assess the resorptive bone status by
BMD versus urinary/free deoxpyridinoline (u/f-DPD) in epileptic children
receiving valproate (VPA) and/or carbamazepine (CBZ) either as mono-or
polytherapy.
Methods: Forty seven 1ry epileptic patients on
long term anticonvulsants were subjects of this study. They were divided
into three groups; Group I : monotherapy VPA treated patients (n=27), Group
II: monotherapy CBZ treated patients (n=8) and Group III: polytherapy treated
patients, VPA + CBZ (n=12). Twenty healthy subjects served as controls and
formed Group IV. Patients and controls were subjected to history taking,
clinical examination, lumbar spine osteodensitometry and laboratory
investigations: serum Calcium (Ca), phosphorus (P), total alkaline
phosphatase, 25(OH) cholecalciferol and u/f-DBD. Serum trough levels of the drugs, brain CT scan and EEG
were done for all patients.
Results: Showed significant reduction in weight
and height percentiles, serum Ca, P and 25(OH)D3 in epileptic patients
compared to controls. Total serum alkaline phosphatase was significantly
higher in epileptics compared to controls. Spinal osteodensitometry showed
significant bone resorption in epileptics whereas u/f-DPD did not show any
significant detective value.
Conclusion: long-term anticonvulsant therapy leads
to bone resorption and that imaging is better than u/f-DPD as a chemical
marker in the detection of bone resorption of growing children. Hence
vitamin D or calcitriol administration is recommended in epileptics on
long-term anticonvulsants.