title: Analysis of acylcarnitine levels by tandem mass spectrometry in epileptic children receiving valproate and oxcarbazepine.
abstract: This prospective study was designed to investigate whether or not monotherapy with sodium valproate (VPA) or oxcarbazepine (OXC) affects plasma levels of fatty acylcarnitine esters in children with epilepsy. A total of 56 children with idiopathic partial or generalised epilepsy were included in the study. Patients were assigned to receive either VPA or OXC monotherapy. Free carnitine (C0) and acylcarnitine profiles of the patients were investigated using tandem mass spectrometry at baseline and at six and 18 months after commencement of therapy. For patients receiving VPA or OXC monotherapy, there were no significant differences in plasma levels of C0, compared with baseline, at six and 18 months (p>0.05). Treatment with VPA for six and 18 months correlated with a significant increase in 3-hydroxy-isovalerylcarnitine (C5-OH) (six months: +23%; 18 months: +73%), and significant decreases in the following acylcarnitines: C6-acylcarnitine (six months: -60%; 18 months: -66%), C14-acylcarnitine (six months: -25%; 18 months: -38%), C16-acylcarnitine (six months: -73%; 18 months: -73%), and C18:1-OH-acylcarnitine (six months: -60%; 18 months: -70%), compared with baseline (p<0.05). In patients receiving OXC monotherapy, on the other hand, plasma concentrations (μmol/L) of acylcarnitines (from C2 to C18:1-OH) fell within the normal reference range. The results of this study indicate that there are significant biochemical changes in acylcarnitines in ambulatory children on VPA monotherapy but these are not clinically significant. OXC monotherapy had no effect on acylcarnitine metabolism in ambulatory children.
authors.affiliation: Department of Pediatric Neurology, Karadeniz Technical University Faculty of Medicine, Trabzon. acansu2003@yahoo.com
authors.forename: Ali
authors.initials: A
authors.lastname: Cansu
authors.forename: Ayse
authors.initials: A
authors.lastname: Serdaroglu
authors.forename: Gursel
authors.initials: G
authors.lastname: Biberoglu
authors.forename: Leyla
authors.initials: L
authors.lastname: Tumer
authors.forename: Tugba Luleci
authors.initials: TL
authors.lastname: Hirfanoglu
authors.forename: Fatih Suheyl
authors.initials: FS
authors.lastname: Ezgu
authors.forename: Alev
authors.initials: A
authors.lastname: Hasanoglu
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000009:adverse effects* / Q000097:blood / Q000627:therapeutic use*; D002220:Carbamazepine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000097:blood / Q000627:therapeutic use; D002331:Carnitine / Q000031:analogs & derivatives* / Q000097:blood; D002648:Child; D002675:Child, Preschool; D002851:Chromatography, High Pressure Liquid; D004827:Epilepsy / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D000078330:Oxcarbazepine; D011446:Prospective Studies; D012640:Seizures / Q000145:classification / Q000209:etiology; D053719:Tandem Mass Spectrometry; D014635:Valproic Acid / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*
chemical_list: D000927:Anticonvulsants; C116917:acylcarnitine; D002220:Carbamazepine; D014635:Valproic Acid; D002331:Carnitine; D000078330:Oxcarbazepine