Iron Deficiency Anemia in Children with Febrile Convulsions: A Case–control Study at Sohag University Hospital

Abstract

Background: Iron is necessary for healthy growth and development, and iron deficiency has been linked to behavioural problems, mental impairment, and reduced immunological function in children. Iron deficiency anemia (IDA) affects 48.5 percent of Egyptian preschoolers (aged 6 to 59 months). Objective: The aim of this study was to evaluate the iron status in children with first febrile seizure (FFS). Patients and Methods: This was a case-control hospital-based study that included children with febrile convulsion as case group and children with febrile illness without convulsion as controls, aged from 6 months to 6 years at Sohag University Hospital. Our study included 110 children, 55 as case group and 55 as controls from June 2019 to December 2020. Results: Pallor observed in 28% only of case group against only 17% of control group. The mean temperature at which children start to convulse was 39.36±51. The mean Hb level of case group was statistically significantly lower than normal and was 10.73±1.44 versus 11.77±1.24 for control group. The mean of serum ferritin was statistically significantly lower than normal and was 13.41±11.71 versus 30.18±8.9 for control group. The mean of total iron binding capacity (TIBC) was statistically significantly higher than normal and was 430.91±87.8 versus 362.73±63.81 for control group. Conclusion:The result suggests that iron deficiency anemia may be a risk factor for febrile seizures. Thus screening for IDA should be considered in children with febrile seizures. Fever can worsen the negative effect of anemia or iron deficiency on the brain and a seizure can occur as a consequence. This suggests that iron deficient children are more prone to 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 ].…”

“…A high RDW means they differ in size more significantly, a characteristic of IDA [29]. Among the 23 studies analyzed, five of which were conducted by Out of the 18 studies that conducted MCV measurements, 13 of them reported that the mean MCV value was lower in the FS group when compared to the group with febrile illnesses but no seizures with p-value <0.005 [5][6][7]9,[11][12][13][14][15]21,24,26,27]. 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.…”

“…Notably, it's worth mentioning that the peak ages for FS and IDA coincide [5]. While certain studies identified a link between FS and anemia resulting from iron deficiency [6][7][8][9][10][11][12][13][14][15][16], other research yielded divergent findings [17][18][19][20]. The primary objective of this study is to find the association between IDA and FS in children by doing a systematic review of the literature of the last 10 years.…”