Thyroid dysfunction associated with increased low-density lipoprotein cholesterol in epileptic children treated with carbamazepine monotherapy: a causal relationship?
OBJECTIVE
Lipid abnormalities and thyroid dysfunction have been reported in patients treated with antiepileptic drugs. The aim of this study was to evaluate prospectively the association between thyroid and lipid profile in children treated with carbamazepine (CBZ) monotherapy.


METHODS
Thyroid function was evaluated in 18 epileptic children, previously reported with CBZ-induced changes in serum lipid profile, before and at 6, 12 and 24 months of CBZ monotherapy.


RESULTS
All children had normal thyroid function before the initiation of CBZ treatment. During CBZ therapy thyroid dysfunction, with increased thyrotropin (TSH) and decreased thyroxine (T4), free thyroxine (FT4) and triiodothyronine (T3) was found, while, significant association was revealed between serum low-density lipoprotein cholesterol (LDL-C) and TSH levels at 6 (r=0.469; p=0.043) and 12 (r=0.730; p=0.001) months of treatment.


CONCLUSIONS
Lipid abnormalities may be associated with thyroid hormone disturbance in children treated with CBZ monotherapy. Since thyroid dysfunction and hypercholesterolemia are both associated with a higher atherosclerotic risk special attention and further studies are needed in epileptic patients treated with CBZ monotherapy.
Attilakos
Achilleas
A
Second Department of Pediatrics, University of Athens, Panagiotis and Aglaia Kyriakou Children's Hospital Athens, 1 Dimitsanis Street, Marousi, 15125 Athens, Greece. attilakos@hotmail.com
Garoufi
Anastasia
A
Voudris
Konstantinos
K
Mastroyianni
Sotiria
S
Fotinou
Aspasia
A
Papadimitriou
Dimitrios T
DT
Gavalakis
Nikolaos
N
Prassouli
Alexia
A
Katsarou
Eustathia
E
D000293:Adolescent; D000927:Anticonvulsants / Q000009:adverse effects*; D002220:Carbamazepine / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D008078:Cholesterol, LDL / Q000097:blood*; D004827:Epilepsy / Q000188:drug therapy; D005260:Female; D006801:Humans; D007118:Immunoassay; D008297:Male; D013223:Statistics as Topic; D013959:Thyroid Diseases / Q000097:blood / Q000139:chemically induced*; D013960:Thyroid Function Tests; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D014284:Triiodothyronine / Q000097:blood
D000927:Anticonvulsants; D008078:Cholesterol, LDL; D014284:Triiodothyronine; D002220:Carbamazepine; D013972:Thyrotropin; D013974:Thyroxine