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All Journal Sari Pediatri Paediatrica Indonesiana Syntax Literate: Jurnal Ilmiah Indonesia Jurnal Ilmiah Mahasiswa Kedokteran Medisia AVERROUS: Jurnal Kedokteran dan Kesehatan Malikussaleh Budapest International Research in Exact Sciences (BirEx Journal) Narra J JKKI : Jurnal Kedokteran dan Kesehatan Indonesia The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Narra X
Sulaiman Yusuf
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Risk factors for increased transaminase enzymes in children with epilepsy using valproic acid Sari, Ina Julia; Anidar, Anidar; Akbar, Zaki; Yusuf, Sulaiman; Bakhtiar, Bakhtiar; Ismy, Jufitriani
Paediatrica Indonesiana Vol. 66 No. 2 (2026): March 2026
Publisher : Indonesian Pediatric Society

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Abstract

Background Valproic acid (VPA) is a commonly used first-line medication for generalized epilepsy. Hepatotoxicity, manifested by elevations in transaminase enzymes, is a serious, life-threatening adverse effect of VPA use. Objective To determine the prevalence and risk factors for elevated transaminase enzymes in children with epilepsy receiving VPA. Methods A cross-sectional study was conducted at Zainoel Abidin General Hospital, Banda Aceh, Indonesia on 50 children with epilepsy aged 1 month to 18 years who received VPA and experienced elevations in serum aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT). We compared clinical characteristics Results  Of 294 children with epilepsy, 50 children (17%) met the study criteria. Elevated AST was found in 31 (62%) subjects and elevated ALT in 35 (70%) subjects. Bivariate analysis revealed a significant negative association between elevated AST and duration of treatment (OR=0.925; P=0.044) and a positive association between elevated ALT and number of antiepileptic drugs (AEDs) received (OR=7.691; P=0.022). Nutritional status was significantly associated with elevated ALT (OR=0.412; P=0.041). Multivariate analysis showed that the number of AEDs was he only significant risk factor for elevated AST (OR=4.663; P=0.040), and VPA dose was the most significant only significant factor for elevated ALT (OR=1.183; P=0.029). Conclusion In children receiving VPA for the treatment of epilepsy, the number of AEDs received is a risk factor for elevated ALT, while VPA dose is a risk factor for elevated AST.
Co-Authors Adrian, Riki Akbar, Zaki Al-shather, Zain Amna, Eka Yunita Anidar Anidar Anidar Anidar, Anidar Arsa, Iwan Sabardi Badriul Hegar Badriul Hegar Bakhtiar Bakhtiar Carolina, Infra Yunita Cut Zahara Phoenna Darnifayanti Darnifayanti Darnifayanti, Darnifayanti Dora Darussalam Dora Darussalam, Dora Edward, Eka Destianti Fajri, Fauzan Feliatra Fitria Fitria Harrika, Fenny Hasan, Denny I. Herlina Dimiati, Herlina Heru Noviat Herdata Heru Noviat Herdata, Heru Noviat Intan Chaharunia Mulya Ismy, Jufitriani Isra Firmansyah, Isra Jufitriani Ismy Liza Salawati, Liza Muliana, Cut Mulya Safri, Mulya Muntadhar, Muntadhar Muslim Akmal Muslim Muslim Muzakkir, Yumna Nadia, Nurul Nora Sovira, Nora Nuriyanto, Alivia R. Nurul Maghfirah Octavina Susanti Raihani, Rifa Ramadhan, Muhammad Haris Rusdi Andid Rusdi Andid, Rusdi Sari, Eva Devita Sari, Ina Julia Sentosa, Sukmawan F. Siti Hajar Sri Rezeki Susanti, Nurhayani D. Syafruddin Haris Syafruddin Haris, Syafruddin Syahrun Nur T.M. Thaib Thaib, Teuku Muhammad Zuhaira, Zuhaira