Correlation between Iron Status and Simple Febrile Seizures in Children

Abstract

Background: Febrile seizures are non-epileptic types of seizure that occur frequently during early childhood. Multiple factors are implicated in the pathogenesis of these types of seizures. Iron deficiency might play as an etiological or, at least, augmenting factor in the development of febrile seizures.Objective: To study iron status among children with simple febrile seizures, and to estimate the prevalence of iron deficiency between them. Patients and methods: A case-control study included 100 febrile children aged 6 months to 60 months, and were ascribed to 2 groups; 50 children with simple febrile seizures [case group], and 50 children who had febrile disease without occurrence of seizures [control group]. Venous samples were obtained for the analysis of complete blood count, and iron indices [serum ferritin, serum iron and total iron binding capacity]. Results: The peak temperature was significantly elevated among the case group [P=0.03]. Regarding iron profile, compared to controls, the case group had significantly lower iron [54.24±16.04 vs. 62.6±16.02; P=0.011], and lower ferritin [37.612±19.85 vs. 80.624±31.57; P <0.001]. Correlation analysis revealed a significant negative correlation between serum ferritin and frequency of febrile seizures [P=0.025]Conclusions: Iron deficiency and iron deficiency anemia were more common among children with simple febrile seizures, and they were associated with increase in the duration and frequency of seizures. Special attention should be paid for the assessment of iron status among children with febrile seizures.

Associative Patterns Between Iron Deficiency Anemia and Febrile Seizures in the Five to 60 Months Age Group: A Comprehensive Systematic Review

“…A predominant trend emerges in the comprehensive analysis of articles within this research, strongly supporting the significant relationship between ferritin levels and FS [ 5 - 9 , 11 , 12 , 19 , 21 , 24 , 26 , 27 ]. Nevertheless, there were notable exceptions among the findings.…”

“…Among the 23 studies analyzed, five of which were conducted by Sharif et al, Yarigarravesh et al, Shaikh et al, Jang et al, and Tripathy et al reported that Hb exhibited no statistically significant association, with corresponding p-values of 0.06, 0.37, 0.44, 0.77, and 0.35, respectively [ 10 , 17 , 19 , 20 , 22 ]. The statistical significance of mean Hb levels was observed in all the studies except the one mentioned earlier [ 5 - 9 , 11 - 16 , 21 , 23 - 27 ].…”

“…Across the majority of studies, it was observed that the mean MCH and MCHC values were lower in the FS group when compared to those with febrile illness and no seizures. However, statistical significance was found for MCH in only eight out of the 16 studies that measured it [ 5 , 7 , 9 , 11 , 13 , 15 , 24 , 27 ], and for MCHC, it was significant in five out of the 10 studies that examined it [ 5 , 7 , 9 , 15 , 27 ].…”

Anemia and Poor Iron Indices Are Associated With Susceptibility to Febrile Seizures in Children: A Systematic Review and Meta-analysis

“…44,45 It is fortunate that the majority of our included studies used a 30-μg/L cutoff to define iron deficiency anemia. [10][11][12][15][16][17][18]22,24,25,29,31 This meta-analysis indicates that ferritin levels have a poor sensitivity but a good specificity in accordance with the diagnostic test accuracy meta-analysis. Thus, it is better utilized to rule in rather than rule out the probability of the aforementioned outcome of interest.…”

“…9 Several investigations support the concept that the risk of febrile seizures is much greater in individuals with iron deficiency than in the control group. [9][10][11][12][13] Other studies, on the other hand, have determined that the risk of febrile seizures in anemic children does not appear to be statistically significant when compared to children who do not have febrile convulsions. [14][15][16][17][18] Nonetheless, iron deficiency anemia is a worldwide condition that requires intervention because it is a pervasive nutritional issue that may be avoided by screening and proper therapeutic interventions.…”