Keywords
Valproic Acid
Thyroid Function Test
Subclinical Hypothyroidism
How to Cite
Abstract
Objective: To assess the effect of valproic acid therapy on thyroid function tests including FT4 and TSH in children with newly diagnosed epilepsy.
Study Design: Descriptive case series.
Place and Duration of Study: Department of Paediatrics Medicine, PGMI Shaikh Zayed Hospital, Lahore, conducted over a period of six months from July 2024 to Jan 2025.
Methodology: This study included eighty children aged between 3 to 12 years who were diagnosed with epilepsy for the first time. Patients were enrolled through non probability consecutive sampling. Thyroid function tests including FT4 and TSH were measured at baseline before starting treatment. Valproic acid was initiated at a dose of 15 mg per kg per day. After one month of continuous therapy, thyroid function tests were repeated. All collected data was entered and analyzed using SPSS version 22. Paired t test was applied to compare baseline and post treatment values and a p value of 0.05 or less was taken as statistically significant.
Results: The mean age of the children was 7.2 plus minus 2.6 years. Out of the total patients, 46 were males and 34 were females. Mean baseline FT4 level was 1.31 plus minus 0.19 ng per ml which showed a decline to 1.18 plus minus 0.17 ng per ml after one month of valproic acid therapy and this change was statistically significant. Mean baseline TSH level was 3.12 plus minus 1.36 micro IU per ml which increased to 4.42 plus minus 2.21 micro IU per ml after treatment, also showing statistical significance. Subclinical hypothyroidism was noted in 14 patients which accounted for 17.5 percent of the study population. No child developed overt hypothyroidism during the study period.
Conclusion: Valproic acid therapy in children with epilepsy results in noticeable changes in thyroid function, mainly an increase in TSH levels with relatively normal FT4. Although most patients remain asymptomatic, a significant number develop subclinical hypothyroidism. Regular monitoring of thyroid function should be considered in children receiving valproic acid especially during early months of therapy.