Effect of levatirecetam monotherapy on complete blood count, immunoglobulin levels and lymphocyte subsets in children and adolescents with epilepsy

Epilepsy is one of the most serious neurological condition in children and adolescents that affects 1-3% of the population. Levatirecetam is broad-spectrum, new generation antiepileptic drug that was shown to be effective and well-tolerated in children and adolescents. There are limited number of studies that report increased incidence of upper respiratory tract infection in patients on levatirecetam treatment which explained by leukopenia, lymphopenia and changes in humoral or cellular immunity. The aim of this study is to investigate the effects of levatirecetam monotherapy on complete blood count parameters, immunoglobulin levels and lymphocyte subsets in children and adolescents with epilepsy. A total of 31 children and adolescents with epilepsy (23 generalized, 8 focal seizures; age range, 4-16 years; mean, 8,82 ± 3,92) and 43 aged- and sex- matched controls were included in the study. All the patients were investigated for frequency and types of infections in the past month and past year. Complete blood count parameters (haemoglobin, lymphocyte, leukocyte, neutrophil, platelet), immunoglobulin levels (IgA, IgM, IgG, IgE) and lymphocyte subsets (CD3, CD4, CD8, CD4/CD8 ratio, CD19, CD56, NKT cells and Treg cells) were measured in patients with epilepsy and those in controls. Both groups were similar in terms of frequency and types of infections in the past month and past year. There were no significant differences in complete blood count parameters, lymphocyte subsets, and immunglobulin levels between patients with epilepsy and those in controls. In the epilepsy group, while complete blood count parameters and immunglobulin levels were similar in patients with focal and generalized seizeure, CD4/CD8 ratio was significantly lower in patients with focal seizure (p=0,006). In conclusion, this is the first study which evaluate the effect of levatirecetam monotherapy both on complete blood count, humoral and cellular immunity during interictal period in children and adolescents with epilepsy. It was shown that levatirecetam monotherapy did not increase the incidence of infection and there were no significant effects on humoral or cellular immune system in epileptic children and adolescents.