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March 1977

Rickets in Children Receiving Anticonvulsant Drugs: Biochemical and Hormonal Markers

Author Affiliations

From the Departments of Child Health (Drs Yeager, Saunders, Russell, and Anast) and Medicine (Dr Winnacker), University of Missouri School of Medicine, and Harry S Truman Memorial Veterans Hospital (Drs Winnacker and Anast) Columbia.

Am J Dis Child. 1977;131(3):286-290. doi:10.1001/archpedi.1977.02120160040005

• Forty-one epileptic children, aged 2 to 16 years, receiving combinations of phenobarbital, phenytoin, and primidone, and 39 control children were studied. The epileptics demonstrated slight but significant reductions in serum calcium, phosphorus, and 25-hydroxyvitamin D concentrations, and a significant increase in serum alkaline phosphatase values. No significant difference in serum immunoreactive parathyroid hormone levels was noted. Further analysis of the data revealed that patients whose drug therapy included primidone had the lowest serum levels of calcium and 25-hydroxyvitamin D. They had also received the largest number of drugs for the longest duration, and had serum phenobarbital levels that were significantly higher than those of other patients. The minimal degree of vitamin D deficiency in our epileptic children contrasts with the results of other investigations and warrants emphasis. The reasons for this difference are not apparent.

(Am J Dis Child 131:286-290, 1977)