Is ketogenic diet treatment hepatotoxic for children with intractable epilepsy?

Arslan N, Guzel O, Kose E, Yılmaz U, Kuyum P, Aksoy B, Çalık T. Is ketogenic diet treatment hepatotoxic for children with intractable epilepsy? Seizure. 2016 Nov 13;43:32-38.

Abstract

PURPOSE:

Long-term ketogenic diet (KD) treatment has been shown to induce liver steatosis and gallstone formation in some in vivo and clinical studies. The aim of this retrospective study was to evaluate the hepatic side effects of KD in epileptic children.

METHOD:

A total of 141 patients (mean age: 7.1±4.1years [2-18 years], 45.4% girls), receiving KD at least one year for intractable epilepsy due to different diagnoses (congenital brain defects, GLUT-1 deficiency, West syndrome, tuberous sclerosis, hypoxic brain injury, etc.) were included in the study. Serum triglyceride, cholesterol, aminotransferase, bilirubin, protein and albumin levels and abdominal ultrasonography were recorded before and at 1, 3, 6, and 12 months following after diet initiation.

RESULTS:

The mean duration of KD was 15.9±4.3months. At one month of therapy, three patients had elevated alanine and aspartate aminotransferase levels. These patients were receiving ketogenic diet for Doose syndrome, idiopathic epilepsy and GLUT-1 deficiency. Hepatosteatosis was detected in three patients at 6 months of treatment. Two of these patients were treated with KD for the primary diagnosis of tuberous sclerosis and one for Landau Kleffner syndrome. Cholelithiasis was detected in two patients at 12 months of treatment. They were receiving treatment for West syndrome and hypoxic brain injury sequelae.

CONCLUSION:

Long-term ketogenic diet treatment stimulates liver parenchymal injury, hepatic steatosis and gallstone formation. Patients should be monitored by screening liver enzymes and abdominal ultrasonography in order to detect these side effects.

________________________________________________________________________

Methods

In the study, 141 patients (mean age: 7.1 ± 4.1 years [2–18 years], 45.4% girls), receiving KD at least 1 year for intractable epilepsy due to different diagnoses (congenital brain defects, GLUT-1 deficiency, West syndrome, tuberous sclerosis, hypoxic brain injury, etc.) were included.

The authors recorded serum triglyceride, cholesterol, aminotransferase, bilirubin, protein and albumin levels and abdominal ultrasonography before and at 1, 3, 6, and 12 months following after diet initiation.

Results

In this study, the mean duration of KD was 15.9 ± 4.3 months.

3 patients had elevated alanine and aspartate aminotransferase levels at 1 month of therapy.

These patients were getting ketogenic diet for Doose syndrome, idiopathic epilepsy and GLUT-1 deficiency.

At 6 months of treatment, hepatosteatosis was detected in 3 patients.

2 of these patients were treated with KD for the primary diagnosis of tuberous sclerosis and 1 for Landau Kleffner syndrome.

At 12 months of treatment, cholelithiasis was detected in 2 patients and they were receiving treatment for West syndrome and hypoxic brain injury sequelae.

https://www.mdlinx.com/neurology/medical-news-article/2016/12/02/aminotransferase-children-epilepsy-fatty-liver-gallstone/6941027/?category=latest&page_id=1