HAEMATOLOGIC PROFILE AND SERUM FOLATE LEVELS OF CHILDREN AGED 2 – 14 YEARS WITH EPILEPSY AT THE UNIVERSITY OF ILORIN TEACHING HOSPITAL, ILORIN

Abstract

Children suffering from epilepsy are maintained on antiepileptic drugs (AED) to ensure a
reasonable quality of life. These drugs however, are not without side effects. Notable among which
are haematologic abnormalities and interference with the metabolism of folate. This study was
carried out to determine the haematologic profile and serum folate levels of epileptic children seen
at the University of Ilorin Teaching Hospital (UITH).
The study is a descriptive cross sectional study involving children with epilepsy aged 2 – 14 years
attending the Paediatric Neurology Clinic of UITH, Ilorin.
A total of 140 epileptic and 140 age-and-sex-matched non-epileptic children as controls were
recruited into the study. The male: female ratio and the mean ages were comparable in the two
groups (p = 0.888).
The mean MCV in subjects was 78.8 ± 6.4fl which was significantly higher than 77.2 ± 6.3 in
controls (p = 0.038). The mean MCH and MCHC were also significantly higher in subjects than in
controls (p < 0.001). Mean white blood cell (WBC) and lymphocyte count were significantly
higher in subjects than in controls (p < 0.035), while the mean neutrophil count was comparable in
subjects and controls. Only three subjects (2.1%), and 4 (2.9%) controls had leucopenia.
Neutropenia occurred in 5.7% of the subjects and 4.3% of controls. Severe neutropenia
(agranulocytosis) was not noted in this study (0%). The mean haemoglobin concentration and mean
platelet counts were significantly lower in subjects than controls (p < 0.05). Anaemia and
thrombocytopenia respectively were found in only 3 (2.1%) and 6 (4.3%) subjects. Corresponding
values in controls were 4 (2.9%) each for anaemia and thrombocytopenia.
Subjects on phenobarbitone had significantly lower mean WBC, neutrophil count and MCH compared to
those on carbamazepine and sodium valproate (p < 0.05). Significantly lower platelet count was reported in
anti epileptic drug (AED) users compared to newly diagnosed subjects who were yet to commence AED (p = 0.007). The duration on AED correlated negatively with the WBC, lymphocyte count, platelet count and
reticulocyte percentage (r = 0.352, -0.432, -0.280 and -0.296 respectively and p < 0.001, < 0.001, = 0.004
and = 0.002 respectively), and positively with the MCV, MCH and haemoglobin concentration (r = 0.266,
0.234 and 0.200 respectively with p = 0.006, 0.017 and 0.042 respectively).
Mean serum folate levels in subjects of 6.3 ± 1.6ng/mL was significantly lower than 7.5 ± 1.5ng/mL
in controls (p = 0.001). The mean serum folate level in subjects on AED was comparable with the
value in AED naïve subjects. There was no correlation between the duration of AED use and the
mean serum folate levels (r = -0.180; p = 0.069).
It is concluded that epileptic children on AED have altered haematologic paremeters and reduced
serum folate. Routine check of haematologic profile and serum folate levels of these children by
clinicians is advocated as these haematologic abnormalities may not be without attendant clinical
implications.

HAEMATOLOGIC PROFILE AND SERUM FOLATE LEVELS OF CHILDREN AGED 2 – 14 YEARS WITH EPILEPSY AT THE UNIVERSITY OF ILORIN TEACHING HOSPITAL, ILORIN