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Duration of valproic acid monotherapy correlates with subclinical thyroid dysfunction in children with epilepsy
Author(s) -
Ilić Violeta,
Bogićević Dragana,
Miljković Branislava,
Ješić Maja,
Kovačević Marijana,
Prostran Milica,
Kovačević Sandra Vezmar
Publication year - 2016
Publication title -
epileptic disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.673
H-Index - 53
eISSN - 1950-6945
pISSN - 1294-9361
DOI - 10.1684/epd.2016.0821
Subject(s) - valproic acid , subclinical infection , medicine , triiodothyronine , endocrinology , hormone , thyroid , epilepsy , thyroid stimulating hormone , psychiatry
Aim . To identify potential risk factors for the development of subclinical hypothyroidism following long‐term valproic acid monotherapy in children with epilepsy. Methods . Serum levels of thyroid‐stimulating hormone, free thyroxine, free triiodothyronine, thyreoglobulin antibodies, and thyroid peroxidase antibodies were determined in 41 patients and in 41 sex‐ and age‐matched healthy children. Results . Mean valproic acid treatment duration was 2.80±1.96 years. The valproic acid group had higher serum thyroid‐stimulating hormone ( p <0.001) and free triiodothyronine ( p <0.05) levels compared to the control group. Serum thyroid‐stimulating hormone and free triiodothyronine were above the upper limit for healthy controls in 34% and 32% of patients, respectively, and no clinical features of thyroid dysfunction were observed. Duration of valproic acid monotherapy for less than four years was a risk factor for elevated thyroid‐stimulating hormone levels. Conclusion . One third of children with normal range serum valproic acid levels may have elevated serum thyroid‐stimulating hormone and free triiodothyronine levels, especially in the first four years of treatment.