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
