Pancreatic Affection in Children on Ketogenic Diet

Abstract Background The ketogenic diet (KD), a high-fat, low-carbohydrate, adequate-protein diet is an established, effective non-pharmacological treatment for children with drug resistant epilepsy (DRE). Relatively few serious complications have been reported in the more than 70 years use of KD. Hypertriglyceridemia, malnutrition, vit D and vit A deficiency are known complications of KD and are considered risk factors for pancreatitis as well. Aim of the Study The aim was to highlight the pancreatic affection during KD use in treatment of pediatric DRE patients. Patients and Methods This is a prospective observational (pilot) study conducted at pediatric ketoclinic, Ain Shams university children’s hospital, Cairo, Egypt during the period from September 2022 till October 2023. Twenty pediatric patients with DRE who were assigned to start KD were followed up for possibility of pancreatic affection. Pancreatic enzyme levels (amylase/lipase) were measured initially and after 3 and 6-months. Results In the current study, serum amylase and lipase levels increased significantly after 3- months interval (p value <0.001), and then decreased after 6-months KD usage, and was not significantly higher than baseline. However, there were no documented cases of clinical pancreatitis in our patients during the study period time. Conclusion Our study found that KD use in children with DRE led to significant increases in serum amylase, lipase, particularly in the first three months. Although no cases of pancreatitis were observed, close monitoring and further research are needed to assess the long-term safety of KD in this population.