Buradasınız

Anasayfa » Content

Uzun süreli antiepileptik ilaç tedavisine bağlı osteomalazi

Osteomalacia Due to Long-term Treatment With Antiepileptic Drugs

Journal Name:

  • Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 2005

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Osteomalacia is a preventable and treatable disease. Many immobil and elderly patients are at risk of developing osteomalacia as they rarely go out in the sun. A poor diet, malabsorbsiyon, poor hydroxylation of vitamin D in the liver and poor renal function are other contributory factors. Another predisposing association is long term anticonvulsant therapy. The measurement of 25-hydroxycholecalciferol levels is considered to be the best indicator of the vitamin-D status. To investigate of chronic antiepileptic treatment on the bone metabolism 50 adult epileptics and 15 healthy controls were enrolled in the study. None of the patients had symptoms or signs suggestive of osteomalacia. Serum alkaline phosphatase levels were significantly increased (p=0,001) and serum 25(OH) vitamin D levels were significantly decreased (p=0,000) in the patients compared with controls. Our findings indicate that though the ambulatory epileptic patients with adequate diet and sunlight exposure clinically irrelevant impairment of bone metabolism (osteomalacia) might seen. It has been suggested that epileptic patients should be screned for anticonvulsant osteomalacia and possibly should receive prophylactic treatment with vitamin D.
Bookmark/Search this post with
Abstract (Original Language): 
Osteomalazi önlenebilir ve tedavi edilebilir bir hastalıktır. Bir çok immobil ve yaşlı hasta güneş ışığına seyrek olarak çıkmaları nedeniyle osteomalazi gelişmesi yönünden risk altındadırlar. Diyetle yetersiz alım, malabsorbsiyon, karaciğerde vitamin D'nin zayıf hidroksilasyonu ve yetersiz renal fonksiyonlar diğer faktörlerdir. Başka bir predispozan faktörse uzun süreli antikonvulzan kullanımıdır. 25-hidroksikolekalsiferol seviyelerinin ölçülmesi vitamin D eksikliğini saptamada en iyi belirleyicidir. Uzun süreli antiepileptik kullanımının kemik metabolizması üzerine etkisini araştırmak üzere osteomalazi semptom ve bulgusu olmayan 50 epileptik hasta ve 15 sağlıklı kontrol çalışmaya dahil edildi. Kontrol grubu ile karşılaştırıldığında hasta grubunda anlamlı olarak serum alkalen fosfataz düzeyleri yüksek (p=0,001) ve serum 25(OH) D düzeyleri düşük (p=0,000) bulundu. Bulgularımız yeterli diyet ve güneş ışığı alan ambulatuvar epileptik hastalarda klinik olarak belirti ve bulgu vermeyen kemik metabolizması bozukluğunun (osteomalazi) görülebileceğini göstermektedir. Sonuç olarak epileptik hastalar antikonvulzanlara bağlı osteomalazi yönünden taranmalı ve vitamin D ile proflaktik olarak tedavi edilmeleri de uygun olabilir.
FULL TEXT (PDF): 
PDF icon arastirmax-uzun-sureli-antiepileptik-ilac-tedavisine-bagli-osteomalazi.pdf
  • 2
34-37
  • Turkish

REFERENCES

References: 

1. Tanniradorn P, Epstein S. Drur-induced bone loss. Osteoporoslnt2000; 11: 637-59
2. Keck E, Gollinick B, Reinhardt D, Karch D, Peerenboom H,Krüskemper HL. Calcium metabolism and vitamin D metabolite levels inchildren receiving anticonvulsant drugs. Eur J Pediatr 1982;139:52-5
3. Jubitz W, Hauslerr M, McCain T, Tolman K. Plasma 1.25-dihydroxyvitamin D levels in patients receiving anticonvulsant drugs.J Clin Endocrinol Metab
1977;44:617-21
4. Ecevit Ç, Aydogan A, Kavakli T, Altinöz S. Effect of carbamazepine and valproate on bone mineral density. PediatrNeurol2004;31: 279-82
5. Akkuþ S., Tamer M.N. ve Yorgancýgil H. A case of osteomalacia mimicking ankylosing spondylitis. Rheumatol Int, 2001; 20, 239-42
6. Reginato AJ, Falasca GF, Pappu R, McKnight B, Agha A. Musculoskeletal manifestations of osteomalacia: report of 26 cases and literature review. Semin Arthritis Rheum 1999; 28: 287-304
7. Dent CE, Richens A, Rowe DJ, Stamp TC.
S.D.Ü. Týp pak.
Derg
. 2005:12(2)/ 34-37
Yürekli, osteomalazi ve antiepileptikler
37
Osteomalacia with long-term anticonvulsant therapy in epilepsy. Br Med J 1970;4: 69-72
8. Pack AM, Morrell MJ. Epilepsy and bone health in adults. EpilepsyBehavior2004: S24-S29
9. Gough H, Goggin T, Bissessar A, Baker M, Crowley M, Callaghan N. A comparative study ofthe relative influence ofdifferent anticonvulsant drugs, UV exposure and diet on vitamin D and calcium metabolism in out-patients with epilepsy. Q J Med. 1986; 59 (230):
569-77
10. Hoikka V, Alhava EM, Karjalainen P, Keranen T, Savolainen KE, Riekkinen P, Korhonen R. Carbamazepine and bone mineral metabolism. Acta Neurol Scand. 1984;70(2):77-80
11. Bogliun G, Beghi E, Crespi V, Delodovici L, d'Amico P. Anticonvulsant drugs and bone metabolism. Acta Neurol Scand. 1986;74(4): 284-8
12. Tomita S, Ohnishi J, Nakano M, Ichikawa Y. The effects of anticonvulsant drugs on vitamin D3-activating cytochrome P-450-linked monooxygenase systems. J SteroidBiochemMolBiol. 1991;39(4A): 479-85
13. Reichel H, Koeffler HP, Norman AW. The role ofthe vitamin D endocrine system in health and disease. N EnglJMed. 1989;320(15):980-91
14. Holick MF. Vitamin D: importance in the prevention ofcancers, type 1 diabetes, heart disease, and osteoporosis. Am J Clin Nutr 2004;79: 362-71
15. Weisman Y, Andriola M, Reiter E, Gruskin A, Root A. Serum concentrations of25-hydroxyvitamin D in Florida children: effect of anticonvulsant drugs. South MedJ. 1979;2(4):401-8
16. Williams C, Netzloff M, Folkerts L, Vargas A, Garnica A, Frias J. Vitamin D metabolism and anticonvulsant therapy: effect of sunshine on incidence of osteomalacia. SouthMedJ. 1984;77(7):836-42
17. Gullu S, Erdoðan MF, Uysal AR, Baskal N, Kamel N, Erdogan G. A potential risk for osteomalacia due to sociocultural lifestyle in Turkish Women. Endocr J 1998;45:675-8
18. Hunt PA, Wu-Chen ML, HandalNJ, Chang CT, Gomez M, Howell TR, Hartenberg MA, Chan JC. Bone disease induced by anticonvulsant therapy and treatment with calcitriol (1,25-dihydroxyvitamin D3). Am J Dis Child. 1986 Jul;140(7):715-8
19. Christiansen C, Rodbro P, Lund M. Incidence of anticonvulsant osteomalacia and effect ofvitamin D: controlled therapeutic trial. Br Med J. 1973 Dec
22;4(5894):695-701
20. Pack AM, Morrell MJ. Epilepsy and bone health in adults. EpilepsyBehavior2004; 5: S24-S29.

Thank you for copying data from http://www.arastirmax.com