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2017, Number 5

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Rev Med Inst Mex Seguro Soc 2017; 55 (5)

Prevalence of subclinical hypothyroidism in pediatric patients with drug-resistant epilepsy

Aparicio-Claure AL, Rayo-Mares JD, Nishimura-Meguro E, Herrera-Márquez JR, Muñoz-Montúfar JP, Núñez-Enríquez JC

Language: Spanish
References: 20
Page: 579-586
PDF size: 350.78 Kb.


ABSTRACT

Background: In several studies it has been reported a high prevalence of subclinical hypothyroidism in children with epilepsy secondary to the use of monotherapy with valproic acid, carbamazepine and phenytoin. The aim of this article is to determine the prevalence of subclinical hypothyroidism in children with drug-resistant epilepsy treated at the Pediatric Neurology Service of the Hospital de Pediatría, Centro Médico Nacional Siglo XXI in Mexico City.
Methods: We conducted a descriptive cross-sectional study. All pediatric patients with drug-resistant epilepsy and without structural alteration seen at the pediatric neurology service of our hospital between January 1 and June 1 2015 were included.
Results: Prevalence of subclinical hypothyroidism in our sample was of 25%, with most patients receiving polytherapy with valproic acid.
Conclusions: The intentional searching for subclinical hypothyroidism in pediatric patients with drug-resistant epilepsy without structural alteration might be considered as part of routine medical care and patients receiving combination therapy with valproic acid they should be considered as a subgroup with an increased risk of developing such comorbidity.


REFERENCES

  1. Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross JH, Elger CE et al. ILAE oficial report: a practical clinical definition of epilepsy. Epilepsia. 2014;55(4):475-82.

  2. Rubio DF, Reséndiz AJC, Sentíes MH, Alonso VM, Salgado LP, Ramos PJ. Epilepsia. Programa prioritario de epilepsia. Sector Salud; 2007.

  3. Reséndiz JC, Aguirre E. Epilepsia, magnesio y valproato. Revista Mexicana de Neurociencia. 2008;9(3):206-214.

  4. Urrestarazu E, Viteri C. Optimización del tratamiento antiepiléptico. Revista del Grupo de Epilepsia de la SEN. 2009;5:14-23.

  5. Berg AT, Testa FM, Levy SR. Complete remission in non syndromic childhood onset epilepsy. Ann Neurol. 2011;70:566-573.

  6. Kwan P, Arzimanoglou A, Berg A, Brodie MJ, Hauser WA, Mathern G et al. Special report. Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia. 2010;51:1069-77.

  7. Castro-Gago M, Novo-Rodríguez MI, Gómez-Lado C, Rodríguez-García J, Rodríguez-Segade S, Eirís- Puñal J. Evolution of subclinical hypothyroidism in children treated with antiepileptic drugs. Pediatr Neurol. 2007;37(6):426-30.

  8. Yılmaz U, Yılmaz TS, Akıncı G, Korkmaz HA, Tekgül H. The effect of antiepileptic drugs on thyroid function in children. Seizure. 2014;23(1):29-35.

  9. Eirís-Puñal J, Del Río-Garma M, Del Río-Garma MC, Lojo-Rocamonde S, Novo-Rodríguez I, Castro-Gago M. Long-term treatment of children with epilepsy with valproate or carbamazepine may cause subclinical hypothyroidism. Epilepsia. 1999;40(12):1761-6.

  10. Mikati MA, Tarabay H, Khalil A, Rahi AC, El Banna D, Najjar S. Risk factors for development of subclinical hypothyroidism during valproic acid therapy. J Pediatr. 2007;151(2):178-81.

  11. Kim SH, Chung HR, Kim SH, Kim H, Lim BC, Chae JH et al. Subclinical hypothyroidism during valproic acid therapy in children and adolescents with epilepsy. Neuropediatrics. 2012;43(3):135-9.

  12. Catli G, Abaci A, Büyükgebiz A, Bober E. Subclinical hypothyroidism in childhood and adolescense. J Pediatr Endocrinol Metab. 2014;27(11-12):1049-57.

  13. Surks MI, Ortiz E, Daniels GH, Sawin CT, Col NF, Cobin RH, Franklyn JA et al. Subclinical thyroid disease: Scientific review and guidelines for diagnosis and management. JAMA. 2004;291(2):228-38.

  14. Gross G, Brodde OE, Schümann HJ. Effects of thyroid hormone deficiency on pre and post-synaptic noradrenergic mechanisms in the rat cerebral cortex. Arch Int Pharmacodyn Ther. 1980;244(2):219-30.

  15. Semm P, Demaine C, Vollrath L. Electrical responses of pineal cells to thyroid hormones and parathormone. A microelectrophoretic study. Neuroendocrinology. 1981;33(4):212-7.

  16. Giné E, Morales-García JA, Pérez-Castillo A, Santos A. Developmental hypothyroidism increases the expression of kainate receptors in the hippocampus and the sensitivity to kainic acid-induced seizures in the rat. Endocrinology. 2010;151(7):3267-76.

  17. Berg AT, Vickrey BG, Testa FM, Levy SR, Shinnar S, DiMario F, Smith S. How long does it take for epilepsy to become intractable? A prospective investigation. Ann Neurol. 2006;60(1):73-9.

  18. Stroink H, Brouwer OF, Arts WF, Geerts AT, Peters AC, van Dorselaar AC. The first unprovoked, untreated seizure in childhood: A hospital based study of the accuracy of the diagnosis, rate of recurrence, and long term outcome after recurrence. Dutch study of epilepsy in childhood. J Neurol Neurosurg Psychiatry. 1998;64:595-600.

  19. Biondi B, Cooper DS. The clinical significance of subclinical thyroid dysfunction. Endocr Rev. 2008;29(1):76-131.

  20. Małecka-Tendera: Natural history of subclinical hypothyroidism in children and adolescents. Thyroid Research. 2013;6(Suppl 2):A41.




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