All issues > Volume 37(3); 1994

Original Article

J Korean Pediatr Soc. 1994;37(3):368-375. Published online March 15, 1994.

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

Yoon Suck YS Suh¹, Young Guk YG Kim¹, Jung Hwa JH Lee¹, Kee Hwan KH Yoo¹, Joo Won JW Lee¹, Young Chang YC Tockgo¹

¹Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea

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 the spinal backbone of each individual was measured by means of the 멡DR-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 children was 0.69¡¾0.09g/cm2 and that for the group of children administered with phenobarbital was 0.59¡¾0.07g/cm2 indicating a significant decrease in density for the latter group (p<0.05). 2) As for the relationship between the duration of phenonbarbital administration 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 children was 26.8¡¾2.5pg/ml indicating a significant decrease in vitamin D3 level for this group (p<0.05). 4) The mean serum alkaline phosphatase level for the health group of children was 240¡¾50u/L and 462¡¾110u/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.

Keywords :Bone mineral density, Phenobarbital