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Asymptomatic children with epilepsy

Little benefit from screening for anticonvulsant-induced liver, blood, or renal damage

Department of Pediatrics, Dalhousie University and the I.W. Killam Hospital for Children, Halifax, Nova Scotia.

In a prospective study of 199 asymptomatic children receiving anticonvulsant drugs, we evaluated routine screening for liver, renal, and hematologic toxicity. Urinalysis, CBC, differential, platelets, SGOT, bilirubin, and alkaline phosphatase (plus amylase and fibrinogen in patients taking valproate) were obtained between 0 and 24 months. Compliance was excellent. Urine was always normal. Six percent of patients had transient minor abnormalities of blood studies necessitating rechecks. All were normal on repeat. Two children had major blood abnormalities recognized, leading to drug changes that proved to have been unnecessary. Baseline determinations and prompt attention to symptoms of toxicity should replace routine screening of blood and urine.

Address correspondence and reprint requests to Dr. Camfield, I.W. Killam Hospital for Children, P.O. Box 3070, Halifax, Nova Scotia, B3J 3G9, Canada.

Supported in part by a grant from Abbott Laboratories, Canada.

Accepted for publication October 14, 1985.

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