Effect of Iron Supplementation in Anaemic Children with Breath Holding Spells at a Tertiary Care Hospital (KGH - Visakhapatnam) in Southern India

Abstract

BACKGROUND Breath holding spells (BHS) are common, non-epileptic paroxysmal events that occur in children below 6 years, whose diagnosis is made many times clinically. Exact aetiology is not known, but iron deficiency was one among many proposed aetiological factors. Very few studies were published till date to determine role and effect of iron supplementation in children with breath holding spells. Hence the present study was taken up to assess the presence of iron deficiency and the effect of iron supplementation in children with breath holding spells. METHODS This prospective interventional study was performed from May 2012 to April 2017. 125 children below six years of age brought with the complaint of breath holding spells were screened for presence of anaemia and other systemic illnesses. Ten children were excluded with other organic causes and only 85 children were found to have anaemia and were supplemented with 6 mg/kg/day of ferrous sulphate for 3 months and followed up for a total period of 6 months. Response to iron supplementation was assessed in these children by measuring total number of attacks of BHS before starting iron supplementation, after supplementation of iron for three months and also at the end of follow-up period. The results were analysed by using Microsoft Office Excel. RESULTS 76.52 % (85/115) of patients had anaemia and were supplemented with 6 mg/kg/day of ferrous sulphate for 3 months. The remaining 27 cases had normal Hb % & red blood cells (RBC) indices and were not included. Response to iron therapy was assessed in anaemic children with breath holding spells and we found complete response in 78.41 %, partial response in 15.91 % and no response in 5.7 %. CONCLUSIONS This study proved the role of iron therapy in anaemic children with breath holding spells. KEYWORDS Breath Holding Spells (BHS), Iron Deficiency, Anaemia, Haemoglobin