Study of iron deficiency as a risk factor for first episode of simple febrile siezure

Authors

  • Rakesh Kumawat Department of Pediatrics, J. L. N. Medical College, Ajmer, Rajasthan, India
  • Pukhraj Garg Department of Pediatrics, J. L. N. Medical College, Ajmer, Rajasthan, India
  • B. S. Karnawat Department of Pediatrics, J. L. N. Medical College, Ajmer, Rajasthan, India
  • Ishwari P. Verma Department of Pediatrics, J. L. N. Medical College, Ajmer, Rajasthan, India
  • Akansha Arora Department of Pediatrics, J. L. N. Medical College, Ajmer, Rajasthan, India
  • Mukesh Sonkaria Department of Pediatrics, J. L. N. Medical College, Ajmer, Rajasthan, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20173804

Keywords:

MCV, RDW, Simple febrile seizure, TIBC

Abstract

Background: Febrile seizure are seizure that occur between the age of 6 month to 60 months with a temperature of 100.4f or higher, that are not the result of central nervous system infection or any metabolic imbalance and that occur in the absence of a history of prior afebrile seizure. Febrile seizures are the commonest cause of seizures in children, occuring in 2-5% of children. The maximum age of febrile convulsion occurrence is 14-18 months, which overlap with the maximum prevalence of iron deficiency anaemia which is 1-2 year old. 7 So far, the dilemma of cause of febrile seizure could not be solved. Standard text book still mention iron deficiency is associated with an increased risk of febrile seizure, thus screening for that problem and treating it appears appropriate.

Methods: This case control study was done from June 2015 to December 2016. 60 cases of first episode of simple febrile seizure in age group of 6 month to 5 years were included in the study. A control group was selected from age and sex matched children admitted with febrile illness but without seizure. In all cases detailed clinical history, anthropometry, clinical sign of iron deficiency, CNS examination, CBC, PBF, Red cell indices, serum iron, serum ferritin and serum TIBC level was done. These were analysed in three groups mild, moderate, severe deficiency of anemia. A clinical correlation is tried to establish between overt and subtle iron deficiency with seizure.

Results: Majority of subjects with first episode of simple febrile seizure were males (63.3%). Majority of cases of febrile seizure occur in the 6-24 months age group (83.3%). Incidence of anemia among case group subjects was 90.0% whereas the same in control group was 30 %. Mean RDW and TIBC levels in cases were significantly higher as compared to that in controls. MCV, Mean Serum ferritin and Serum Iron levels in cases were significantly lower as compared to that in controls.

Conclusions: The findings in present study established an association between iron deficiency anemia and first episode of simple febrile seizures. 

References

Mikati MA, Hani AJ. Seizures in childhood. In: Kleigman RM, Behrman RE, Jenson HB, Stanton BP. Nelson Text Book of Pediatrics first South Asian ed. Saunders Elsevier; 2016;3:2829.

American Academy of Pediatrics. Febrile seizures. Pediatrics. 2008;121:1281-6.

American Academy of Pediatrics, Steering Committee on Quality Improvement and Management. Classifying recommendations for clinical practice guidelines. Pediatrics. 2004;114:874-7.

American Academy of Pediatrics. Committee on Quality improvement, Subcommittee on Febrile Seizures. The long -term management of a child with simple febrile seizures. Pediatrics. 1999;103:1307-9.

Lynnet GS, Ingrid ES. Febrile seizures. BMJ. 2007;334:307-11.

Waruiru C, Appleton R. Febrile seizures: an update. Arch Dis Child. 2004;89:751-6.

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

Pisacane A, Sansone R, Impagliazzo N, Coppola A, Rolando P, D’Apuzzo A, et al. Iron deficiency anaemia and febrile convulsions: case–control study in children under 2 years. BMJ. 1996;313:343.

Kobrinsky NL, Yager JY, Cheang MS, Yatscoff RW, Tenenbein M. Does iron deficiency raise the seizure threshold? J Child Neurol. 1995;10(2):105-9

Madan N, Rusia U, Sikka M, Sharma S, Shankar N. Developmental and neurophysiologic deficits in iron deficiency in children. Indian J Pediatr. 2011;78:58-64.

Kumari PL, Nair MKC, Nair SM, Kailas L, GeethaS. Iron deficiency as a risk factor for simple febrile seizures: A case control study. Indian Pediatr. 2011;48:444-8.

Rajwanti KV, Praveen GD, Swati K, Ghosh K. Iron deficiency as a risk factor for first febrile seizure. Indian Pediatr. 2010;47:437-9.

AL-Zwaini EJ, AL-Ani SS, AL-Khalidi MJ, AL-Ta’ie MF. Risk factors for febrile seizures: a matched case control study. Iraqi Postgraduate Med J. 2006;5,(3):353-8.

Daoud A. Febrile convulsion: review and update. J Pediatr Neurol. 2004;2:9-14

Kugler SL, Johnson WG. Genetics of the febrile seizure susceptibility trait. Brain Dev. 1998;20:265-74.

Doose H, Maurer A. Seizure risk in offspring of individuals with a history of febrile convulsions. Eur. J Pediatr. 1997;156:476-81.

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

Modaresi M, Mahmoudian T, Yaghini O, Kelishadi R, Golestani H. Iron insufficiency associated with febrile seizure? experience in an Iranian Hospital. J Comprehensive Pediatr. 2012;3(1):21-4.

Derakhshanfar H, Abaskhanian A, Alimohammadi H, ModanlooKordi M. Association between iron deficiency anemia and febrile seizure in children. Med Glas Ljek komore Zenicko-doboj kantona 2012;9(2):239-242.

Downloads

Published

2017-08-23

Issue

Section

Original Research Articles