It is still not completely clear whether carbamazepine causes alterations in vitamin D status and in bone metabolism. The objective of this study was to investigate the effects of carbamazepine on serum levels of 25-hydroxyvitamin D and on biomarkers of bone formation and resorption in healthy rats. Levels of calcium, 25- hydroxyvitamin D, parathormone, C-telopeptide, bone specific alkaline phosphatase and osteocalcin were measured in 3 groups of rats consisting of controls (n=10), isotonic saline solution group (n=10) and carbamazepine group (n=10). Mean calcium levels were found to be significantly lower in healthy controls in comparison to isotonic saline solution and carbamazepine groups (10.0±0.24, 10.81±0.16, 10.93±0.22 mg/dL, respectively, p<0.05). Mean levels of 25- hydroxyvitamin D, were found to be significantly higher in control group compared to isotonic saline solution group (25- hydroxyvitamin D; 25.91±1.12, 19.99±0.99 ng/mL, respectively, p<0.01). Mean levels of parathormone and osteocalcin were found to be significantly higher in control group compared to isotonic saline solution group and carbamazepine group. Parathormone levels were measured as 3.46±0.83, 1.08±0.08, 0.94±0.02 pg/mL, respectively (p<0.01). Osteocalcine levels were measured as 1.66±0.001, 1.32±0.002, 1.32±0.001 ng/mL, respectively (p<0.001). A significant difference in terms of mean serum bone specific alkaline phosphatase and C-telopeptide levels among groups was not observed. The main outcome of this prospective study in healthy rats showed no change in biochemical parameters of bone turnover during treatment with carbamazepine.
EDTA-dependent pseudothrombocytopenia is the mismeasurement of the thrombocyte count in EDTA anticoagulated blood, due to aggregation of these cells. The situation may be mistaken with true thrombocytopenia and may lead to incorrect diagnosis and treatment, and to loss of power and time. The aim of this case report was to draw attention to EDTA-dependent pseudotyhrombocytopenia, which is one of the possible causes of thrombocytopenia. Case; isolated thrombocytopenia was detected in the EDTA blood sample sent to our laboratory, which had been obtained from a patient hospitalized with the diagnosis of epilepsy in the red area of the emergency medicine unit of our hospital. Another blood sample was collected into Na-citrate, in which the thrombocyte count was observed to be within the normal ranges. Furthermore, thrombocyte aggregations were observed in the peripheral blood smears prepared from the sample with EDTA, whereas no aggregation was observed from the sample with citrate.
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