J Korean Pediatr Soc.  1994 Mar;37(3):368-375.

The Effect of Long-term Phenobarbital Administration on the Bone Mineral Density of Children

• Suh YS
• Kim YG
• Lee JH
• Yoo KH
• Lee JW
• Tockgo YC

Abstract

The long term administration of anti-convulsants on children with convulsive disorders may cause osteomalacia, depending on the dosage, duration, type and combination of anti-convulsants administred. Fifteen children, comprising 10 male and 5 female, dignosed with convulsive disorders and administered with phenobarbital for a long term period of more than 9 months but less than 84 months and 15 healthy children of a similar age-group were selected for the investigation the density of she spinal backbone of each individual was measured by means of the "QDR-2000 X-ray bone densitometer's (made by Hologic company) which uses the double energy X-ray absorption technique. The levels of serum calcium, phosphrus and alkaline phosphatase for each child were also measured for comparative analysis. The results were as follows: 1) The mean bone density for the healthy group of chlidren was 0.69+/-0.09g/cm(2) and that for the group of children administered with phenobarbital was 0.59+/-0.07cm(2) indicating a significant decrease in density for the latter group (p<0.05). 2) As for the relationship between the duration of phenonbarbital and the decrease in bone mineral density, 5 of 6 patients(83%) administered with phenobarbital for more than 4 years showed a decrease in bone mineral density and 5 of 9 patients (56%) administered with phenobarbital for less than 4 years showed a decrease in bone mineral density. 3) the mean vitamin D level for the healthy group of chlidren was 26.8+/-2.5pg/ml indicating a significant decrease in vitamin D3 level for this group(p<0.05). 4) The mean serum alkaline phospatase evel for the health group of children was 240+/-50u/L and 462+/-110u/L for those administered with phenobarbital. This indicate a significant increase in ALP for phenobarbital group(p<0.05). 5) The posphorus and calcium levels were within the normal range for all the groups of children.

MeSH Terms

Absorption
Alkaline Phosphatase
Bone Density*
Calcium
Child*
Cholecalciferol
Female
Humans
Male
Osteomalacia
Phenobarbital*
Reference Values
Vitamin D
Alkaline Phosphatase
Calcium
Cholecalciferol
Phenobarbital
Vitamin D