IgA in epileptics receiving anticonvulsant therapy

Abstract

Epilepsy is a common disorder and requires long-term drug treatment. Epileptics on anticonvulsant therapy have often been reported to have a depressed immune system, especially an IgA deficiency. An association with clinical manifestations has not yet been clearly explored. So far investigations have been performed in Whites only. The objectives of this study were to assess if there is a racial difference in the immune response to anticonvulsants between Blacks and Whites and to establish the clinical significance of the IgA deficiency. Our results showed normal IgA values in Black and White epileptics on anticonvulsant therapy. This implies, at least at the present stage, that patients do not require immunological monitoring or protective measurements. Further studies including the determination of secretory IgA might help to explain the discrepancy between our findings and the literature and should provide deeper insight into the correlation between potential immune disturbances and clinical implications.

Effect of Chronic Anticonvulsant Monotherapy on Lymphocyte Subpopulations in Adult Epileptic Patients

“…Besides its ability to produce IgA deficiency, Figure 3 Distribution of individual values of OKT8+ lymphocyte subset as percentage of total lymphocytes observed in epileptic patients undergoing chronic treatment with phenytoin (DPH), phenobarbital (PB) and carbamazepine (CBZ) for less (0) or more (0) than 1 year and in healthy subjects (·). Horizontal lines indicate mean ± SD which is still controversial (Meissner et al, 1983), phenytoin is believed to be involved in the development of more complex lymphoproliferative disorders, and the possible correlation between drug administration and the development of systemic lupus erythematosus (Alarcon-Segovia & Palacios, 1981), pseudolymphoma (Rosenthal et al, 1982), malignant lymphoma (Li et al, 1975) and Tcell leukaemia (Newcom & Kadin, 1979) is at present under investigation. A disorder of immunoregulatory T-lymphocytes, with a specific reduction in the number or function of the T-suppressor cells is suggested to be involved in these reactions (Dosch et al, 1982;Rosenthal et al, 1982).…”

Immunological Adverse Effects of Anticonvulsants

“…To make the picture more confusing, several studies have found normal (Basaran et al 1989;Burks et al 1989;Eeg-Olofsson et al 1986;Marcoli et al 1985;Meissner et al 1983) or even increased (Valli et al 1982) serum IgA levels. These discrepancies are not easily explained.…”