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CC BY 4.0 · Journal of Child Science 2021; 11(01): e265-e272
DOI: 10.1055/s-0041-1736156
Original Article

Carbamazepine-Induced Hematological and Immunological Alterations in Egyptian Children with Idiopathic Generalized Seizures

Ola Samir El-Shimi 
1   Department of Clinical and Chemical Pathology, Faculty of Medicine, Benha University, Benha, Egypt
,
Amina Ali Farag
2   Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Benha University, Benha, Egypt
,
Amany Mohammed El-Rebigi
3   Department of Pediatrics, Faculty of Medicine, Benha University, Benha, Egypt
,
Taghrid Gamaleldin Kharboush
4   Department of Microbiology and Immunology, Faculty of Medicine, Benha University, Benha, Egypt
,
Hanaa El-Sayed Bayomy
5   Department Public Health and Community Medicine, Faculty of Medicine, Benha University, Benha, Egypt
,
Rana Atef Khashaba
1   Department of Clinical and Chemical Pathology, Faculty of Medicine, Benha University, Benha, Egypt
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Abstract

Carbamazepine (CBZ) is one of the oldest antiepileptic drugs (AEDs) that is still used for the treatment of tonic-clonic seizures in children. Long-term use of AEDs induces potential toxic effects that may remain undetermined for a long time. Earlier studies have revealed a wide spectrum of hematological toxicities associated with CBZ. This study was conducted to unveil the toxic effects of carbamazepine as an antiepileptic monotherapy on hematological and immunological parameters in a group of Egyptian pediatric patients using it for different durations. Fifty pediatric epileptics of either sex were enrolled; 38 were taking CBZ as antiepileptic monotherapy for ≥ 6 months and 12 were newly diagnosed untreated patients. Hematological and immunological parameters studied were compared with their age and sex-matched 15 controls and among groups. CBZ was found more toxic for total leukocyte count, lymphocyte count, serum IgA and IgM levels (p < 0.001, 0.001, < 0.001, < 0.001, respectively). Hemoglobin level, platelets count, serum C4 level and IgA were negatively correlated with serum CBZ level (Spearman's rho = – 0.62, – 0.42, – 0.34, – 0.13; p < 0.001, 0.008, 0.04, 0.44, respectively). CBZ treatment duration associated inversely with platelets, lymphocyte, and eosinophil counts (p < 0.001, 0.03, 0.01, respectively). Epileptic children on CBZ monotherapy had their hematologic and immunologic systems affected, which mandates routine monitoring of these children.

Keywords

carbamazepine - immunological effects - hematological effects - children - Egypt


Publication History

Received: 16 March 2021

Accepted: 08 August 2021

Article published online:
19 October 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
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