title: [The association of hypocarnitinemia with enteral diets and antiepileptic drugs in children and adults with severe physical and mental disabilities].
abstract: OBJECTIVE
  To examine the risk factors of hypocarnitinemia and hypocarnitinemic symptoms in children and adults with severe physical and mental disabilities.
  
  
  METHODS
  The status of hypocarnitinemia as well as the related symptoms were assessed in a total of 78 children and adults with severe physical and mental disabilities who were admitted to National Hospital Organization Iou National Hospital. Their enteral diets and the medication of antiepileptic drugs were evaluated.
  
  
  RESULTS
  Markedly decreased blood carnitine levels were noted in patients undergoing an enteral diet without carnitine supplementation as well as in those receiving a combination of valproate sodium (VPA) and phenobarbital (PB). These hypocarnitinemic patients tended to have more frequent episodes of hypoglycemia and hyperammonemia.
  
  
  CONCLUSIONS
  Supplemental L-carnitine is needed in patients receiving an enteral diet free of carnitine, those with combination therapy of VPA and PB under oral feeding conditions, and those who develop hyperammonemia during VPA therapy. Patients who received a carnitine-supplemented enteral diet maintained their serum carnitine levels with a relatively low supplemental dose of carnitine.
authors: Department of Pediatrics, National Hospital Organization Iou Hospital, Kanazawa, Ishikawa. awaki@ioudom.hosp.go.jp
authors: Akiko
authors: A
authors: Wakisaka
authors: Yo
authors: Y
authors: Niida
authors: Shinya
authors: S
authors: Yamada
authors: Takanori
authors: T
authors: Tsuji
authors: Nami
authors: N
authors: Nakamura
authors: Keiko
authors: K
authors: Maruhashi
authors: Ichiro
authors: I
authors: Ohno
authors: Hidetoshi
authors: H
authors: Seki
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D002331:Carnitine / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D022124:Hyperammonemia / Q000209:etiology*; D007223:Infant; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D002331:Carnitine