PEDIATRICS Vol. 57 No. 6 June 1976, pp. 979-980
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Dr. Crosley Replies

Carl J. Crosley M.D.1

1 State University of New York, Upstate Medical Center, 750 East Adams, Street, Syracuse, New York 13210

Drs. Livingston and Pauli have again raised questions about the now frequently reported relationship between anticonvulsant therapy and rickets. Our study demonstrates that the biochemical abnormalities associated with rickets occur frequently in patients on anticonvulsant medications for more than three months. Hahn and co-workers1,2 have shown that the alkaline phosphatase elevations found in children and adults on anticonvulsants are of hepatic origin. While there are few instances of hypocalcemia in our study population, the children on chronic anticonvulsants did have a relative hypocalcemia (treated 9.49 mg/100 ml vs. control 9.76 mg/100 ml; P < .001).