{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T07:25:09Z","timestamp":1791876309769,"version":"4.3.4"},"reference-count":29,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Arch Dis Child"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Long-term therapy with phenytoin and carbamazepine is known to cause hyperhomocysteinaemia. We evaluated the prevalence of hyperhomocysteinaemia in North Indian children receiving phenytoin or carbamazepine monotherapy for &gt;6\u2005months duration and the effect of folic acid supplementation on plasma homocysteine.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this cross-sectional observational study we enrolled consecutive children aged 2\u201312\u2005years with epilepsy who had received phenytoin or carbamazepine monotherapy for &gt;6\u2005months. Plasma total homocysteine, folic acid, vitamin B12 and antiepileptic drug concentrations were measured. Healthy age- and sex-matched controls were recruited. Children with homocysteine &gt;10.4\u2005\u00b5mol\/L received folic acid supplementation for 1\u2005month and homocysteine and folic acid concentrations were measured after 1\u2005month follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 112 children receiving antiepileptic monotherapy for &gt;6\u2005months were enrolled. Hyperhomocysteinaemia was present in 54 children (90%) receiving phenytoin, 45 children (90%) receiving carbamazepine therapy and 17 (34%) controls (p&lt;0.05). Mean plasma homocysteine concentrations were significantly higher (18.9\u00b110.2 vs 9.1\u00b13\u2005\u00b5mol\/L) and serum folic acid concentrations (10.04\u00b18.5\u2005ng\/ml vs 12.6\u00b14.8 p&lt;0.001) and vitamin B12 concentrations (365\u00b1155\u2005pg\/mL vs 474\u00b1332\u2005pg\/mL, p=0.02) were significantly lower in the study group compared with the control group. Duration of antiepileptic drug therapy correlated significantly with elevated homocysteine and reduced folic acid concentrations (p&lt;0.05). Supplementation with folic acid for 1\u2005month led to a reduction in plasma homocysteine concentrations in the study group (from 20.9\u00b110.3\u2005\u00b5mol\/L to 14.2\u00b18.2\u2005\u00b5mol\/L, p&lt;0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Phenytoin or carbamazepine monotherapy for &gt;6\u2005months duration is associated with hyperhomocysteinaemia in 90% of North Indian children. Elevated homocysteine concentrations were normalised in these children with folic acid supplementation.<\/jats:p><\/jats:sec>","DOI":"10.1136\/archdischild-2016-311436","type":"journal-article","created":{"date-parts":[[2016,11,8]],"date-time":"2016-11-08T03:44:30Z","timestamp":1478576670000},"page":"346-351","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Hyperhomocysteinaemia in children receiving phenytoin and carbamazepine monotherapy: a cross-sectional observational study"],"prefix":"10.1136","volume":"102","author":[{"given":"Saravanan","family":"Chandrasekaran","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sooraj","family":"Patil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renu","family":"Suthar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Savita Verma","family":"Attri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jitendra Kumar","family":"Sahu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naveen","family":"Sankhyan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mini","family":"Tageja","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratibha","family":"Singhi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2016,11,7]]},"reference":[{"key":"key-10.1136\/archdischild-2016-311436-1","first-page":"1","article-title":"The natural history of homocystinuria due to cystathionine beta-synthase deficiency","volume":"37","author":"Mudd","year":"1985","journal-title":"Am J Hum Genet"},{"key":"key-10.1136\/archdischild-2016-311436-2","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1385\/NMM:6:2-3:117","article-title":"Screening for C677 T and 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