Bone metabolism abnormalities in children with epilepsy at Red Cross War Memorial Children's Hospital, Cape Town, South Africa

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dc.contributor.authorKija, Edward Nkingwaen_ZA
dc.date.accessioned2018-01-25T14:06:15Z
dc.date.available2018-01-25T14:06:15Z
dc.date.issued2017en_ZA
dc.description.abstractIntroduction: Epilepsy is the most common neurological condition worldwide. Literature on the antiepileptic medications and biochemical markers of bone metabolism has revealed inconsistent results. Most of these studies were undertaken in Europe and America where the burden and the associated comorbidities are different to the ones in Africa. Methods: A hospital based case control study was undertaken at Red Cross War Memorial Children's Hospital where children were recruited from a dedicated Epilepsy clinic and controls were obtained from a day surgical ward. Blood and urine samples were taken for the assessment of markers of bone metabolism. Results: Seventy-five cases and 75 controls were recruited. The median age for the children with epilepsy was 9 years with a range of 1 to 17 and controls 3 years with a range of 1 to 12. Vitamin D deficiency was present in 11(16.2%) of children with epilepsy compared to 6(8.8%) in the control group. Vitamin D insufficiency was present in 30(44.1%) in children with epilepsy compared to 27(39.7%) in the control group. Children with epilepsy on enzyme inducing AEDs had lower mean Vitamin D levels (24.67±11.4 vs 30.72±7.4, p=0.08), lower mean Vitamin D2 (0.25±0.07 vs 0.4±0.17,p=0.0018),lower mean Vitamin D3 (1.61±1.06 vs 2.58±0.86,p=0.004), lower mean serum phosphate levels (1.39±0.2 vs 1.76±0.7,p=0.000) and a higher mean parathyroid hormone levels (4.47±2.33 vs 2.7±0.97, p=0.03) compared to the control group. Children with Epilepsy on enzyme inhibitors had higher mean Vitamin D2 (0.44±0.37 vs 0.25±0.07,p=0.000004) and mean Vitamin D3 (2.26±0.86 vs 1.61±1.06,p=0.028) compared to children on enzyme inducers. Dietary intake and ancestry did not influence Vitamin D levels between the cases and controls. Conclusion and Recommendations: Vitamin D deficiency is common in children with epilepsy on AEDs. Children on enzyme inducing AEDs should be investigated for vitamin D deficiency and managed accordingly.en_ZA
dc.identifier.apacitationKija, E. N. (2017). <i>Bone metabolism abnormalities in children with epilepsy at Red Cross War Memorial Children's Hospital, Cape Town, South Africa</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Division of Urology. Retrieved from http://hdl.handle.net/11427/27013en_ZA
dc.identifier.chicagocitationKija, Edward Nkingwa. <i>"Bone metabolism abnormalities in children with epilepsy at Red Cross War Memorial Children's Hospital, Cape Town, South Africa."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Division of Urology, 2017. http://hdl.handle.net/11427/27013en_ZA
dc.identifier.citationKija, E. 2017. Bone metabolism abnormalities in children with epilepsy at Red Cross War Memorial Children's Hospital, Cape Town, South Africa. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Kija, Edward Nkingwa AB - Introduction: Epilepsy is the most common neurological condition worldwide. Literature on the antiepileptic medications and biochemical markers of bone metabolism has revealed inconsistent results. Most of these studies were undertaken in Europe and America where the burden and the associated comorbidities are different to the ones in Africa. Methods: A hospital based case control study was undertaken at Red Cross War Memorial Children's Hospital where children were recruited from a dedicated Epilepsy clinic and controls were obtained from a day surgical ward. Blood and urine samples were taken for the assessment of markers of bone metabolism. Results: Seventy-five cases and 75 controls were recruited. The median age for the children with epilepsy was 9 years with a range of 1 to 17 and controls 3 years with a range of 1 to 12. Vitamin D deficiency was present in 11(16.2%) of children with epilepsy compared to 6(8.8%) in the control group. Vitamin D insufficiency was present in 30(44.1%) in children with epilepsy compared to 27(39.7%) in the control group. Children with epilepsy on enzyme inducing AEDs had lower mean Vitamin D levels (24.67±11.4 vs 30.72±7.4, p=0.08), lower mean Vitamin D2 (0.25±0.07 vs 0.4±0.17,p=0.0018),lower mean Vitamin D3 (1.61±1.06 vs 2.58±0.86,p=0.004), lower mean serum phosphate levels (1.39±0.2 vs 1.76±0.7,p=0.000) and a higher mean parathyroid hormone levels (4.47±2.33 vs 2.7±0.97, p=0.03) compared to the control group. Children with Epilepsy on enzyme inhibitors had higher mean Vitamin D2 (0.44±0.37 vs 0.25±0.07,p=0.000004) and mean Vitamin D3 (2.26±0.86 vs 1.61±1.06,p=0.028) compared to children on enzyme inducers. Dietary intake and ancestry did not influence Vitamin D levels between the cases and controls. Conclusion and Recommendations: Vitamin D deficiency is common in children with epilepsy on AEDs. Children on enzyme inducing AEDs should be investigated for vitamin D deficiency and managed accordingly. DA - 2017 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2017 T1 - Bone metabolism abnormalities in children with epilepsy at Red Cross War Memorial Children's Hospital, Cape Town, South Africa TI - Bone metabolism abnormalities in children with epilepsy at Red Cross War Memorial Children's Hospital, Cape Town, South Africa UR - http://hdl.handle.net/11427/27013 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/27013
dc.identifier.vancouvercitationKija EN. Bone metabolism abnormalities in children with epilepsy at Red Cross War Memorial Children's Hospital, Cape Town, South Africa. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Division of Urology, 2017 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/27013en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDivision of Urologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherPaediatric Neurologyen_ZA
dc.titleBone metabolism abnormalities in children with epilepsy at Red Cross War Memorial Children's Hospital, Cape Town, South Africaen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMPhilen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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