Hubungan Lama Penggunaan Asam Valproat terhadap Kejadian Trombositopenia pada Penderita Epilepsi Anak di RSUP H. Adam Malik Medan

Abstract

Background : Epilepsy is the most common cause of morbidity in pediatric neurology. Valproic acid is the most commonly used therapy because it is almost suitable for all types of epilepsy. Long term use of valproic acid is believed to cause various side effects, including thrombocytopenia. Objective : To determine the relationship between duration of use valproic acid with incidence of thrombocytopenia in children with epilepsy. Merhods : The cross sectional study was conducted on pediatric epilepsy patients aged 1 month – 18 years who had been diagnosed with epilepsy and had taken valproic acid as maintenance therapy with or without other antiepileptic drugs. Furthermore, the patient underwent routine blood test to see the value of platelets. Data taken in addition to demographic data were duration of valproic acid use (divided into ≤ 2 years, and >2 years), type of treatment (single and combination), and dose of valproic acid (≤ 30mg/kg/day and >30mg/kg/day). Analysis was perform using Fisher’s exact test to assess the relationship between duration, type and dose of valproic acid on thrombocytopenia. Spearman’s test was also carried out to see the correlation between duration and dose on platelet count value. Result : there were 72 samples of epileptic children who took valproic acid, and 4 of them is thrombocytopenia. From the test results, there was no relationship between the duration of valproic acid use, type of treatment, and also the dose of valproic acid on thrombocytopenia (p=0,350 , p=0,458 , p=0,189). But, from the Spearman’s test, there was a significant negative correlation between duration of use and the dose of valproic acid on platelet count value. More longer use valproic acid, can make more decrease platelet count (p= 0,032 , r=-0,254). Likewise, more higher dose of valproic acid, can make more decrease platelet count (p=0,014 , r=-0,289). Conclusion : There is no relationship between duration of use valproic acid with the incidence of thrombocytopenia.