生酮饮食的并发症。

Complications of the ketogenic diet.

作者信息

Ballaban-Gil K, Callahan C, O'Dell C, Pappo M, Moshé S, Shinnar S

机构信息

Comprehensive Epilepsy Management Center, and Department of Neurology, Albert Einstein College of Medicine, Bronx, New York 10467-2490, USA.

出版信息

Epilepsia. 1998 Jul;39(7):744-8. doi: 10.1111/j.1528-1157.1998.tb01160.x.

DOI:10.1111/j.1528-1157.1998.tb01160.x

PMID:9670903

Abstract

PURPOSE

The ketogenic diet has been successfully used in treatment of pediatric epilepsy for >70 years. Few serious complications caused by the diet have been reported. We report complications that have been experienced by children receiving the ketogenic diet.

METHODS

In a 22-month period, we treated 52 children with the classic ketogenic diet and monitored them in a prospective manner.

RESULTS

Five children (10%) experienced serious adverse events (AE) after initiation of the diet. Four patients (80%) were treated with valproate (VPA) in addition to the diet, as compared with 25 (53%) of the other 47 children. Two patients developed severe hypoproteinemia within 4 weeks of initiation of the diet, and 1 of them also developed lipemia and hemolytic anemia. A third child developed Fanconi's renal tubular acidosis within 1 month of diet initiation. Two other children manifested marked increases in liver function tests, 1 during the initiation phase and the other 13 months later.

CONCLUSIONS

Clinicians who wish to use the ketogenic diet must be aware of the potential of serious AE and possible interactions of the diet with VPA.

摘要

目的

生酮饮食已成功用于治疗小儿癫痫70多年。据报道，由该饮食引起的严重并发症很少。我们报告了接受生酮饮食的儿童所经历的并发症。

方法

在22个月的时间里，我们用经典生酮饮食治疗了52名儿童，并对他们进行了前瞻性监测。

结果

5名儿童（10%）在开始饮食后经历了严重不良事件（AE）。4名患者（80%）在饮食之外还接受了丙戊酸（VPA）治疗，而其他47名儿童中有25名（53%）接受了该治疗。2名患者在开始饮食后4周内出现严重低蛋白血症，其中1名还出现了脂血症和溶血性贫血。第三名儿童在开始饮食后1个月内出现范科尼肾小管酸中毒。另外两名儿童肝功能检查结果显著升高，1名在开始阶段出现，另1名在13个月后出现。