Evaluation of Hematological Parameters in the Genetic Prospective in Epileptic Patients of Khyber Pakhtunkhwa

Figures & data

Figure 1 Patients treated with carbamazepine as monotherapy or in combination with other antiepileptic drugs.

Figure 2 (A) C677T exon. 1c, 2c, 3c control undigested PCR products. 1, 50bp ladder, 2,3,5, 6 MTHFR (677CC), 4, MTHFR (677TT). (B) MTHFR A1298C exon. 50 pb, 1,3 MTHFR (1298AC), 2, 4 MTHFR (1298AA), 1c.2c.3c control undigested PCR products.

Table 1 Demographic Features of Epileptic Patients Using Carbamazepine

Group	Gender		Mean Age (Years)	Mean Dose of Carbamazepine
	Male	Female
Phase 1 (n=79)	38 (47.44%)	41 (52.56%)	18.24±0.39	451.28±15.45 mg/day (200–800 mg/day)
Phase 2 (n=68)	32 (46.48%)	35 (53.52%)	17.84±0.97	453.52±16.39 mg/day (200–800 mg/day)
Phase 3 (n=58)	25 (43.55%)	33 (56.45%)	18.08±1.10	454.83±17.15 mg/day (200–800 mg/day)

Table 2 Changes in the Level of All Parameters of Complete Blood Count in Gender During Different Phases of Study

Parameters	Gender (n=79)
	Male			Female			P value (C)
	1st Phase (n=38)	2nd Phase (n=32)	3rd Phase (n=25)	1st Phase (n=41)	2nd Phase (n=35)	3rd Phase (n=33)
Hb (g/dL)	13.58	12.43	12.15	13.19	11.95	11.03	0.04*
HCT (%)	45.27	43.66	42.92	44.71	43.89	42.82	0.03*
MCV (fl)	89.57	87.28	88.04	88.32	88.37	88.24	0.51
MCH (pg)	29.03	28.94	29.20	28.68	28.40	28.85	0.02*
MCHC (%)	34.22	34.28	34.18	34.16	33.87	33.90	0.55
TLC (cells/µL)	5139	5345	5238	4993	5046	4982	0.03*
Plts (cells/µL)	395,324	415,581	388,440	382,707	405,686	384,576	0.02*
Neutrophils (%)	61.35	59.65	59.96	59.46	60.31	59.67	0.81
Lymphocytes (%)	34.76	36.35	36.04	36.73	35.66	36.33	0.90
Monocytes (%)	2.24	1.710	1.920	1.95	1.972	2.061	0.56
Eosinophil (%)	1.83	2.031	2.172	2.23	2.031	1.893	0.99

Note: *Two-way ANOVA was used and it was found that the changes were significant at the last stage of therapy and change was higher in female compared to male patients in the last stages of treatment.

Table 3 Effect of Different Doses of Carbamazepine on the Level of All Parameters of Complete Blood Count During Treatment

Parameters	Dose (mg/day) (n=79)
	200 (mg/day)			400 (mg/day)			600 (mg/day)			800 (mg/day)			P value
	1st (n=4)	2nd (n=3)	3rd (n=3)	1st (n=54)	2nd (n=46)	3rd (n=39)	1st (n=16)	2nd (n=12)	3rd (n=12)	1st (n=5)	2nd (n=5)	3rd (n=4)
Hb (g/dL)	13.33	12.33	12.80	13.42	13.13	13.11	13.29	13.21	12.57	11.66	11.82	11.35	0.002*
HCT (%)	42.75	45.00	46.00	45.25	45.87	45.31	43.25	42.50	41.08	42.40	41.20	38.00	0.035*
MCV (fl)	87.00	88.00	89.67	89.06	87.21	88.26	88.56	90.50	86.17	84.00	83.40	83.50	0.025*
MCH (pg)	31.25	30.67	32.00	30.04	28.74	28.95	29.38	28.00	27.33	29.60	28.20	26.75	0.024*
MCHC (%)	34.43	33.57	33.80	34.22	34.10	33.97	34.05	34.03	33.69	34.10	34.06	34.20	0.234
TLC (cells/µL)	5000	4767	4733	5128	5300	5167	5009	5100	5083	4580	4600	4663	0.002*
Plts (cells/µL)	468,250	419,333	412,667	388,528	414,391	379,359	376,125	406,083	400,083	367,000	377,800	392,000	0.112
Neutrophils (%)	57.75	62.67	63.33	61.13	59.61	59.00	59.63	60.17	61.17	56.60	61.60	60.75	0.767
Lymphocytes (%)	38.25	33.33	32.67	35.06	36.37	37.00	36.81	35.83	34.83	38.40	34.40	35.25	0.767
Monocytes (%)	1.954	2.250	2.000	2.038	1.891	2.077	2.125	1.583	1.750	2.000	1.800	2.000	0.461
Eosinophil (%)	2.000	1.982	1.893	1.925	2.134	1.981	1.313	2.000	2.257	2.000	2.761	1.873	0.619

Note: *Two-way ANOVA was used followed by a post hoc test. Changes in hematological parameters were significant at high dose while the change was also significant at the third phase of the study but the changes were within normal indexes.

Table 4 Effect of Different Genotypes of MTHFR (C677T) Gene on Complete Blood Count

Parameters	MTHFR C677T (n=79)
	CC			CT			TT			P value
	1st Phase (n=61)	2nd Phase (n=49)	3rd Phase (n=41)	1st Phase (n=11)	2nd Phase (n=10)	3rd Phase (n=10)	1st Phase (n=7)	2nd Phase (n=7)	3rd Phase (n=7)
Hb (g/dL)	13.45	13.11	13.15	13.25	12.99	12.24	12.39	12.34	11.79	0.012*
HCT (%)	44.64	45.66	45.68	42.80	42.40	42.30	41.86	41.57	39.71	0.008*
MCV (fl)	88.98	87.34	88.59	89.30	88.60	87.00	87.71	90.43	87.29	0.98
MCH (pg)	29.74	29.20	29.10	29.10	28.70	28.20	28.43	28.57	27.44	0.01*
MCHC (%)	34.22	34.15	33.96	33.96	34.00	34.05	34.23	33.51	34.34	0.89
TLC (cells/µL)	5116	5227	5118	4870	5320	5260	4871	4714	4700	0.078
Plts (cells/µL)	381,754	407,755	392,488	427,500	430,600	396,200	393,714	399,429	335,429	0.109
Neutrophils (%)	60.36	59.69	60.00	59.60	61.10	59.20	61.43	60.57	59.43	0.712
Lymphocytes (%)	35.79	36.29	36.00	36.30	34.90	36.80	35.14	35.43	36.57	0.827
Monocytes (%)	2.131	1.780	2.000	2.100	2.000	2.000	1.714	2.143	2.000	0.879
Eosinophil (%)	1.921	2.000	1.9083	1.873	1.753	1.928	2.000	1.743	1.943	0.567

Note: *Two-way ANOVA was used followed by a post hoc test. Changes were significant with respect to passage of time.

Table 5 Effect of Genotypes of MTHFR (A1298C) Gene on Complete Blood Count

Parameters	MTHFR A1298C (n=79)
	AA			AC			CC			P value
	1st Phase (n=63)	2nd Phase (n=52)	3rd Phase (n=46)	1st Phase (n=10)	2nd Phase (n=9)	3rd Phase (n=8)	1st Phase (n=6)	2nd Phase (n=5)	3rd Phase (n=4)
Hb (g/dL)	13.3	13.06	13.11	13.29	12.94	12.49	13.15	12.72	11.88	0.07
HCT (%)	44.8	45.92	45.41	45.80	45.22	47.25	44.33	43.00	39.75	0.12
MCV (fl)	89.3	88.04	88.33	88.00	87.11	86.75	86.33	86.33	89.00	0.64
MCH (pg)	28.9	28.30	29.20	30.87	30.67	28.13	29.50	28.80	27.25	0.25
MCHC (%)	34.2	34.01	33.99	33.80	34.44	33.88	34.27	33.98	34.68	0.94
TLC (cells/µL)	5040	5152	5029	4990	5122	5313	5417	5660	5375	0.037*
Plts (cells/µL)	389,532	402,135	389,239	403,300	432,222	378,875	355,667	456,200	366,500	0.12
Neutrophils (%)	60.56	60.02	59.67	57.90	59.33	60.50	62.33	61.00	59.75	0.96
Lymphocytes (%)	35.58	35.96	36.33	38.30	36.67	35.50	33.83	35.00	36.25	0.98
Monocytes (%)	2.032	1.811	1.913	2.300	2.222	2.500	2.333	1.600	2.000	0.17
Eosinophil (%)	1.973	2.141	2.001	1.983	1.783	1.951	2.000	2.371	1.892	0.60

Note: *Two-way ANOVA was used followed by a post hoc test. Changes become significant with the passage of time.