Attilakos Achilleas, Dinopoulos Argirios, Paschalidou Maria, Tsirouda Maria, Karalexi Maria, Prasouli Alexia, Garoufi Anastasia
Third Department of Pediatrics, National and Kapodistrian University of Athens, "Attikon" Hospital, Athens, Greece.
Third Department of Pediatrics, National and Kapodistrian University of Athens, "Attikon" Hospital, Athens, Greece.
Epilepsy Res. 2018 Sep;145:160-162. doi: 10.1016/j.eplepsyres.2018.07.001. Epub 2018 Jul 6.
Studies evaluating the effect of Levetiracetam (LEV) on haematological parameters in patients with epilepsy are very limited. Short-term effects on haematological parameters in children with epilepsy, at 2 and 6 months of LEV treatment, have been previously reported in the literature. Purpose of the current study was to further investigate the long-term changes on haematological parameters in children with epilepsy during LEV monotherapy. White blood cell, neutrophils, lymphocytes, monocytes, haemoglobin, haematocrit, mean corpuscular volume, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration and platelets were measured in 20 children (11 females, mean age 6,5 ± 4,4 years, range 2-15 years) with epilepsy, before and after 12 months of LEV monotherapy. Lymphocyte count was significantly decreased at 12 months (p = 0.003) of LEV treatment. Three children (15%) at 12 months of treatment had lymphocyte count below 10th percentile for age. Neutrophils counts were significantly increased and platelets counts were significantly decreased at 12 months of treatment (p = 0.046 and p = 0.006, respectively). In addition, haematocrit and mean corpuscular volume were significantly increased at 12 months of treatment (p = 0.036 and p = 0.031, respectively). There were no significant alterations in the other parameters evaluated during the study. No association was found between all parameters and LEV dosage (mg/kg) at 12 months of treatment. Large, prospective studies are needed to investigate the clinical significance of the above haematological changes and whether these parameters should be monitored periodically in children taking LEV.
评估左乙拉西坦（LEV）对癫痫患者血液学参数影响的研究非常有限。先前文献中已报道过LEV治疗2个月和6个月时对癫痫儿童血液学参数的短期影响。本研究的目的是进一步调查癫痫儿童在接受LEV单药治疗期间血液学参数的长期变化。对20例癫痫儿童（11例女性，平均年龄6.5±4.4岁，范围2 - 15岁）在LEV单药治疗12个月前后测量白细胞、中性粒细胞、淋巴细胞、单核细胞、血红蛋白、血细胞比容、平均红细胞体积、平均红细胞血红蛋白、平均红细胞血红蛋白浓度和血小板。LEV治疗12个月时淋巴细胞计数显著降低（p = 0.003）。治疗12个月时有3例儿童（15%）淋巴细胞计数低于年龄的第10百分位数。治疗12个月时中性粒细胞计数显著增加，血小板计数显著降低（分别为p = 0.046和p = 0.006）。此外，治疗12个月时血细胞比容和平均红细胞体积显著增加（分别为p = 0.036和p = 0.031）。研究期间评估的其他参数无显著变化。治疗12个月时所有参数与LEV剂量（mg/kg）之间未发现关联。需要进行大规模的前瞻性研究来调查上述血液学变化的临床意义，以及服用LEV的儿童是否应定期监测这些参数。
