[Evaluation of bone atrophy by microdensitometry and effect of active vitamin D3 (1 alpha-OH-D3) administration in patients receiving anticonvulsants].
Attention has been paid to bone atrophy caused by oral anticonvulsants. Bone atrophy has been judged on X-ray picture in combination with measuring bio-chemical parameters such as serum calcium (Ca), phosphorus (P) and alkaline phosphatase (Alp), and assessing X-ray findings such as bone density and morphological findings of bone. However, the conventional techniques based on these parameters and findings do not always permit diagnosing the disease. Microdensitometric (MD) method, recently developed by Inoue et al. as a method to assess the grades of severity of bone atrophy on X-ray picture of the metacarpal bone II, has been improved in its exactitude and widely applied in clinical practice for diagnosis of bone atrophy. In 174 patients receiving anticonvulsants, the severity of bone atrophy was quantitatively assessed by the MD method. 1 microgram/day of active vitamin D3 (1 alpha-OH-D3) was administered to patients presenting abnormal MD findings indicative of bone atrophy, and the results were as follows: 1. Bone atrophy of grades initial to III was noted in 46 patients (26.4%). There was no sex-difference in incidence of bone atrophy. 2. In patients receiving valproic acid (VPA) for two years or longer, there was no correlation between the duration of VPA treatment and the severity of the disease as assessed by MD method or its incidence, nor between the mean blood level of VPA and the severity. 3. Bone atrophy was found in 25 (29.1%) of the patients receiving anticonvulsants even for less then two years. Five of these 25 patients were alcoholism , and 9 patients received steroids.(ABSTRACT TRUNCATED AT 250 WORDS)
Takeno
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Department of Neurosurgery, Fukuoka Red Cross Hospital, Japan.
D015502:Absorptiometry, Photon / Q000379:methods; D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000009:adverse effects*; D001284:Atrophy; D015519:Bone Density / Q000187:drug effects; D001851:Bone Diseases, Metabolic / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy; D001842:Bone and Bones / Q000187:drug effects / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006887:Hydroxycholecalciferols / Q000627:therapeutic use*; D008297:Male; D008663:Metacarpus / Q000000981:diagnostic imaging; D008875:Middle Aged; D014635:Valproic Acid / Q000009:adverse effects
D000927:Anticonvulsants; D006887:Hydroxycholecalciferols; D014635:Valproic Acid; C008088:alfacalcidol