DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20180606

Association of iron deficiency states and febrile seizures in children-a case control study

A. M. Shaikh, N. R. Inamdar, D. K. Singh

Abstract


Background: Iron deficiency being a potentially modifiable and treatable cause of febrile seizures.  Objectives of Study was to identify Iron Deficient States or Anemia in children with febrile seizures as evidenced by low hemoglobin, altered RBC indices and altered Iron profile, and to determine the association of Iron deficiency states or anemia with febrile seizures.

Methods: This was a Case control study done between July 2013 to June 2014, on 50 indoor cases of febrile seizures in the age group of 6-60 months and 50 age and sex matched controls (fever without seizure) in department of Paediatrics, Hindu Hriday Samrat Balasaheb Thackrey Medical College (HBTMC) and Dr R.N. Cooper Hospital, Mumbai. Detailed clinical history and examination findings were noted.  Cases and control were investigated with complete blood count, RBC indices, peripheral smear, S. Ferritin, S. Iron and TIBC. SPSS software package was used for statistical analysis. P<0.05 was considered as significant.

Results: 74% of cases and 66% of controls had low hemoglobin. MCV was low in 54% of cases and 34% of controls. RDW was raised in 46% of cases and 26% of controls. Iron deficiency anemia was prevalent among both cases and controls. Latent iron deficiency state suggested by low S. Iron and high TIBC in cases and control group was not significant in our study. However statistically significant lower Median S. Ferritin was noted in the febrile seizure group versus the controls (Cases-153.5, Control-173.0, p=0.0195) suggesting significant prevalence of prelatent iron deficiency state among cases.

Conclusions: Prelatent iron deficient state in children are more prone for febrile seizures.


Keywords


Anemia, Child, febrile, Convulsion, Iron deficiency

Full Text:

PDF

References


Xiaoxi Z, Wu T. Iron supplementation for iron deficiency anemia in children. Cochrane Database of Syst Rev. 2007;(2):CD006465.

Akman M, Cebeci D, Okur V, Angin H, Abali O, Akman AC. The effects of iron deficiency on infants' developmental test performance. Acta Paediatrica. 2004;93(10):1391-6.

White KC. Anemia is a poor predictor of iron deficiency among toddlers in the United States: for heme the bell tolls. Pediatrics. 2005;115(2):315-20.

Nancy C Andrews, Christina KU llrich, Mark D Fleming. Disorders of iron metabolism and sideroblastic anemia. In: Nathan DG and Oski FA, editors. Hematology of infancy and childhood. 4th ed. Mexico:Saunders;521-70.

Hagar W, Theil E, Vichinsky EP. Diseases of iron metabolism. Ped Clin N Am. 2002;49:893-909.

Hill JM, Switzer RC. The regional distribution and cellular localization of iron in the rat brain. Neurosci. 1984;11(3):595-603.

Johnston MV. Seizures in childhood: Febrile seizures. In: Behrman RE, Kliegman RM, Jenson HB, editors. Nelson’s Textbook of Pediatrics. 18th ed. Pennsylvania:Saunders; 2008:2457-8.

Pisacane A, Sansone R, Impagliazzo N, Coppola A, Rolando P, D’Apuzzo A, et al. Iron deficiencyanemia and febrile convulsion: Case control study in children under 2 years. BMJ. 1996;313(7053):343.

Daoud AS, Batieha A, Abu-Etiesh F, Gharaibeh N, Ajlouni S, Hijazi S. Iron status: a possible risk factor for first febrile seizure. Epilepsia. 2002;43(7):740-3.

Naveed-ur R, Billoo AG. Association between iron deficiency anemia and febrile seizures. J Coll Physicians Surg Pak. 2005;15(6):338-40.

Hartfield DS, Tan J, Yager JY, Rosychuk RJ, Spady D, Haines C, et al. The association between iron deficiency and febrile seizures in childhood. Clin Pediatr (Phila). 2009;48(4):420-6.

Vaswani RK, Dharaskar PG, Kulkarni S, Ghosh K. Iron deficiency as a risk factor for first febrile seizure. Indian Pediatr. 2010;47(5):437-9.

Kumari PL, Nair MK, Nair SM, Kailas L, Geetha S. Iron deficiency as a risk factor for simple febrile seizures-a case control study. Indian Pediatr. 2012;49(1):17-9.

Abdurrahman KN, Al-Atrushi AM. The association between iron deficiency anemia and first febrile seizure: a case control study. Duhok Med J. 2010:4(1):60-6.

Amirsalari S, Keihani Doust ZT, Ahmadi M, Sabouri A, Kavemanesh Z, Afsharpeyman SH, et al. Relationship between iron deficiency anemia and febrile seizures. Iran J Child Neurol. 2010;4(1):27-30.

Bidabadi E, Mashouf M. Association between Iron deficiency and first febrile convulsion: A case control study. Seizure. 2009;18(5):347-51.