Effect of sodium valproate monotherapy on serum uric acid concentrations in ambulatory epileptic children: a prospective long-term study.
OBJECTIVE
Hyperuricemia has been shown to be related to cardiovascular morbidity and mortality. There is controversial data about the effect of sodium valproate (VPA) monotherapy on serum uric acid concentrations. The purpose of this study was to investigate by a long-term, prospective method, whether treatment with VPA monotherapy may alter serum uric acid concentrations and liver function tests in ambulatory epileptic children.


METHODS
Serum uric acid concentrations were determined in 28 ambulatory epileptic children before and at 6, 12 and 24 months of VPA monotherapy. Serum concentrations of biochemical markers of liver and renal function, such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), gamma-glutamyltransferase (gamma-GT) and creatinine (Cr) were also measured before and at 6, 12 and 24 months of VPA monotherapy. Serum VPA concentrations remained within the therapeutic range (50-100 mg/L) during the period of study.


RESULTS
No statistically significant changes in serum uric acid concentrations were found at 6, 12 or 24 months of treatment. Serum ALT concentrations were significantly increased at 6 and 12 months of treatment, AST concentrations at 6 and 12 months of treatment and LDH concentrations at 12 months of treatment.


CONCLUSIONS
VPA monotherapy does not have a significant effect on serum uric acid concentrations in ambulatory epileptic children. Further studies are needed to definitively address whether it would be useful for physicians to routinely check for elevated serum uric acid levels in children treated with VPA.
Attilakos
Achilleas
A
Second Department of Pediatrics, University of Athens, P&A Kyriakou Children's Hospital, Athens, Greece. attilakos@hotmail.com
Voudris
Konstantinos A
KA
Garoufi
Anastasia
A
Mastroyianni
Sotiria
S
Dimou
Stamatia
S
Prassouli
Alexia
A
Katsarou
Eustathia
E
D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D051341:Dependent Ambulation; D004827:Epilepsy / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008099:Liver / Q000187:drug effects / Q000503:physiopathology; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D013997:Time Factors; D000637:Transaminases / Q000097:blood; D014527:Uric Acid / Q000097:blood*; D014635:Valproic Acid / Q000627:therapeutic use*
D000927:Anticonvulsants; D014527:Uric Acid; D014635:Valproic Acid; D000637:Transaminases