Haematological features in children on anti-epileptic drugs at a referral hospital in Zimbabwe: a cross sectional study

Abstract

Introduction: Epilepsy is a neurological disorder in which brain activity is disrupted leading to seizures or periods of unusual behavior. It can affect any person regardless of age, gender or race, and it is most common in children and the elderly. The number of people with epilepsy varies by region and it affects about fifty million people worldwide with eighty percent of them in developing countries. The quality of life for epileptic children has been greatly improved by use of anti-epileptic drugs. However, use of these drugs is often associated with adverse drug reactions, some of which can be life threatening haematological abnormalities.
Objectives: The objective of this was study is to determine haematological feature in children on antiepileptic drug treatment who were attending a major referral hospital in Zimbabwe.
Materials and Methods: Aclinical and laboratory based cross sectional study was carried out from the end of December 2018 to end of March 2019 to determine haematological features in children between 1 and 16 years of age, on commonly used antiepileptic drugs. Approval to do the study was granted by the Joint Research Ethical Committee of the Parirenyatwa Group of Hospitals and the University of Zimbabwe, College of Health Sciences (JREC/284/18).
Results: A total of 101 full blood counts of children with epilepsy on treatment were performed during the study period, of whom 54 (53%) were males and 47 (47%) females. Eighty (79%) and 21 (21%) were in the age groups of 1-7 and 8-15years, respectively. The median haematology results were within normal reference ranges for paediatric population, except for lymphocytes and eosinophils. The relative (%) 3 3 lymphocyte count was high, at 48%, while the absolute (10 /ul) lymphocyte count was low at 3.1 x 10 /ul. The 3 relative (%) eosinophil count was normal at 2.4%, while the absolute (10 /uL) eosinophil count was low at 3 0.14 x 10 /uL. Leukopaenia was the most common haematological disorder. All the antiepileptic drugs were associated with two or more haematological disorders, except levetiracetum which was not associated with any abnormal haematology.
Conclusions: The median haematologyresults of children on antiepileptic drugs appeared to be normal. The commonly used antiepileptic drugs were associated with two or more haematological disorders, except levetiracetum which had normal haematology. Haematology laboratory results may beuseful in monitoring antiepileptic treatment.