Abstracts

Rationale: There are several studies on the presence of immunological alterations in patients with epilepsy and the effects of anti-epileptic drugs (AED) on the immune system; however, their mechanism of action is still unclear. Currently, there are approximately 23 different AEDs in use in Japan. Thus, controlling the side effect of these drugs is very important for patients, especially children. It has been reported that there is a relationship between changes of immunoglobulin levels and drug-induced hypersensitivity syndrome (DHIS). Our group performed a clinical study on how AEDs act on the immune system in epileptic children.The aim of this study was to investigate the change in immunoglobulin levels in epileptic children treated with AEDs including Carbamazepine (CBZ), Lamotrigine (LTG), and Levetiracetam (LEV). Methods: In total, 175 outpatients (all children, both genders) from the Department of Pediatrics, Tokyo Medical University, aged 0-20 years from October 1st, 2010 - October 31st, 2015, were included. The patients had been treated with either CBZ (n = 107), LTG (n = 26) or LEV (n = 42) monotherapy. Patients treated with LTG were included in the CBZ group. The control data included the common data of the children, classified by age. The serum samples were taken at four points: before treatment and after 1 month, 6 months, and 1 year. IgG, IgA, and IgM measurement were performed using an ELISA. We assessed an increase of immunoglobulin as more than 2 standard deviations (SD) and a decrease of immunoglobulin as less than 2 SDs. Results: IgA, IgG, and IgM levels increased or decreased with treatment of CBZ (n = 13, 12.1%), LTG (n = 6, 23.1%), and LEV (n = 9, 21.4%). IgM levels were elevated with CBZ, LTG, and LEV treatment. Although, the immunoglobulin levels were most influenced by LEV treatment, most of the changes in immunoglobulin levels were within normal ranges. Conclusions: In our study, the changes in immunoglobulin levels in children treated with AEDs produced no symptoms. The results of this study are inconsistent with the current literature. The assessment of serum immunoglobulin levels is recommended for epileptic patients, especially children and infants, who are being treated with AEDs. Funding: This study was supported by the Supporting Positive Activities for Female Researchers of Tokyo Medical University, Japan.