This study provides reference curves for OC, BALP, CTX, ICTP, and TRAP5b in healthy children. Taller and heavier individuals for age had greater bone marker concentrations, likely reflecting greater growth velocity. SDS for markers of bone formation, collagen degradation, and phosphatases were each independently correlated, suggesting they derive from the same biological processes. The possibility of calculating SDS will facilitate monitoring of antiresorptive therapy or disease progression in children with metabolic bone disease.

OFG with the sub-entities MRS and cheilitis granulomatosa is an etiological obscure disease process with various possible therapeutic interventions potentially alleviating the disease course but to broaden treatment knowledge further study in randomized controlled trials is needed.

Women are more prone to gain weight during VPA therapy though higher frequency of diet and sociopsychological burden than men, which might possibly be related to leptin-resitance and a higher frequency of carbohydrate craving.

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AIM The aim of this study was to determine the influence of chronic monotherapy with antiepileptic drugs (AEDs) on vitamin D levels, bone metabolism, and body composition.METHOD Eighty-five children (38 males, 47 females; mean age 12y 5mo, SD 3y 4mo) were treated with valproate and 40 children (28 males, 12 females; mean age 11y 10mo, SD 3y) were treated with other AEDs (lamotrigine, sulthiame, or oxcarbazepine), comprising the non-valproate group. Forty-one healthy children (29 males 12 females; mean age 12y 1mo, SD 3y 5mo) served as a comparison group. Height, weight, body impedance analysis, 25-hydroxyvitamin D, calcium, phosphate, two bone resorption markers (receptor activator of nuclear factor jB ligand [RANKL] and tartrate-resistant acid phosphatase 5b [TRAP5b]), osteoprotegerin, and leptin were measured. RESULTS No child was vitamin D deficient as defined by a 25-hydroxyvitamin D (25OHD) level ofless than 25nmol ⁄ l (<10ng ⁄ ml). Leptin, body fat, weight standard deviation score (SDS), and body mass index (BMI) SDS were all significantly higher (each p<0.001) in valproate-treated children than in the non-valproate group, as were calcium (p=0.027) and RANKL (p=0.007) concentrations. Similarly, leptin was significantly higher in the valproate group than in control participants (p<0.001), as were body fat (p=0.023), weight SDS (p=0.046), BMI SDS (p=0.047), calcium (p<0.001), and RANKL (p<0.001), whereas TRAP5b concentrations were significantly lower in the valproate-treated group (p=0.002). Furthermore, calcium and RANKL levels were significantly higher in the non-valproate group than in comparison participants (p<0.001 and p=0.016 respectively).INTERPRETATION Non-enzyme-inducing or minimal enzyme-inducing AED monotherapy does not cause vitamin D deficiency in otherwise healthy children with epilepsy. Valproate therapy is associated with increases in weight, body fat, and leptin concentration, as well as with a bone metabolic profile that resembles slightly increased parathyroid hormone action.Chronic antiepileptic drug (AED) therapy has been associated with vitamin D deficiency, low bone mass, increased fracture risk, and altered bone turnover.1 The underlying pathophysiological mechanisms are poorly understood but are probably multifactorial. Most older AEDs (e.g. phenobarbital, phenytoin, and carbamazepine) are strong cytochrome P450 (CYP450) enzyme inducers, thereby causing altered steroid and vitamin D metabolism, whereas valproic acid (valproate) and the newer AEDs such as lamotrigine and oxcarbazepine are non-enzyme inducers or minimal enzyme inducers. Some, but not all, studies in adults treated with new AEDs have observed vitamin D deficiency (as defined by a 25-hydroxyvitamin D [25OHD] level <25nmol ⁄ l [<10ng ⁄ ml]) and low bone mineral density (BMD).2-4 Studies on the effect of chronic AED therapy on bone metabolism in children have produced conflicting results. Valproate monotherapy was first reported to reduce BMD in children. 5 Since then, most studies have failed to demonstrate low bone ma...

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Enoxaparin can be safely used for anticoagulation during CVVH resulting in higher filter lifespan compared with unfractionated heparin.