Low Serum Biotinidase Activity in Children with Valproic Acid Monotherapy

    October 2001 in “ Epilepsia ”
    K. H. Schulpis, George A. Karikas, Joanna Tjamouranis, Spyros Regoutas, Stylianos Tsakiris
    TLDR Children taking higher doses of valproic acid had lower biotinidase activity, which may lead to biotin deficiency, but biotin supplements could help.
    The study evaluated 75 children with seizures treated with valproic acid (VPA) and found that higher doses of VPA were linked to significant decreases in serum biotinidase activity and increases in liver enzymes and NH3 levels. Clinical symptoms such as seborrheic skin rash, hair loss, and pruritus were more common in those on higher doses and improved with biotin supplementation. The study suggested a potential link between VPA treatment and acquired biotinidase deficiency, contributing to these dermatologic side effects, and emphasized the importance of monitoring and managing biotin levels in patients on VPA therapy.
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