Abstract
In order to evaluate the bone disease induced by the anticonvulsants, dilantin and phenobarbitol, we reviewed the medical records of all institutionalized oligophrenic children. Out of the 339 who required anticonvulsants, 56 were found to have serum alkaline phosphatase elevated above two standard deviations of normal. Radiological evidence of bone disease in those with elevated alkaline phosphatase was common (58 percent) and manifested primarily as osteoporosis.
Anticonvulsants impair calcium homeostasis directly, but also via stimulation of hepatic microsomal enzymes to hydroxylase vitamin D and metabolites. To achieve rapid healing of the bone disease, we elected to use 1,25-dihydroxyvitamin-D at 0.25-1.00 meg per day, with the following results:
Our data suggest that the dystrophic process is reversed in 27.1 (SEM 3.6)% of cases as judged by decreases in serum alkaline phosphatase and less so as determined by radiological examinations. The complication of hypercalcemia was one episode per 48 patient-months of treatment.
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Hunt, P., Wu-Chan, M., Handel, N. et al. 1681 BONE DISEASE INDUCED BY ANTICONVULSANTS AND TREATMENT WITH 1,25-DIHYDROXYVITAMIN-D. Pediatr Res 19, 391 (1985). https://doi.org/10.1203/00006450-198504000-01705
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DOI: https://doi.org/10.1203/00006450-198504000-01705