It was reported that plasma PIVKA-II(protein induced by vitamin K absence or antagonist II) levels in infants born to mothers treated with antiepileptic drugs during pregnancy increased markedly, but little has been studied on the effect of the
drugs on
plasma PIVKA-II in epileptic patients
We measured PIVKA-II levels by means of latex agglutination method in epileptic children receiving a variety of antiepileptic drugs, and assessed the incidence of PIVKA-II positivity(plasma levels above 1μg/ml) together with a correlation
between
the
plasma level of PIVKA-II and the particular anticonvulsant taken, duration of the treatment, age of patients, and the values of liver function test.
The study included 97 epileptic patients(54 males, 43 females; ages 5-23 years) who were divided into four antiepileptic drug-treated groups : valproic acid monotherapy(n=18), carbamazepine monotherapy (n=38), valproic acid polytherapy(n=20) and
other
antiepileptic drugs(n=21), and a control group of 52 children(33 males, 19 females: ages 8-19 years).
@ES The results were as follows;
1) The incidence rate of PIVKA-II positivity was 21.0% in 97 patients of four antiepileptic drug-treated groups.
2) There was neither correlation between PIVKA-II positivity and any specific antiepileptic drugs nor between PIVKA-II positivity and the duration of the treatment.
3) There was an inverse correlation between the age of the patients and PIVKA-II levels(P=0.028).
4) Among the biochemical studies of liver function, only the level of blood ammonia was correlated with the level of PIVKA-II(P<0.00001).
It could be concluded that the raised PIVKA-II level in patients on antiepileptic treatment was presumptive evidence for subclinical coagulation defect, similar to that found in vitamin K deficiency, and the measurement of blood ammonia may be
the
useful adjuvant method to predict raised plasma PIVKA-II level.
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