Rickets in children receiving anticonvulsant drugs. Biochemical and hormonal markers
J. L. Winnacker, H. Yeager, J. A. Saunders, B. Russell and C. S. Anast
Forty-one epileptic children, aged 2 to 16 years, receiving combinations of
phenobarbital, phenytoin, and primidone, and 39 control children were
studied. The epileptics demonstrated slight but significant reductions in
serum calcium, phosphorus, and 25-hydroxyvitamin D concentrations, and a
significant increase in serum alkaline phosphatase values. No significant
difference in serum immunoreactive parathyroid hormone levels was noted.
Further analysis of the data revealed that patients whose drug therapy
included primidone had the lowest serum levels of calcium and
25-hydroxyvitamin D. They had also received the largest number of drugs for
the longest duration, and had serum phenobarbital levels that were
significantly higher than those of other patients. The minimal degree of
vitamin D deficiency in our epileptic children contrasts with the results
of other investigations and warrants emphasis. The reasons for this
difference are not apparent.
