DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20173126

A study of febrile seizures in children in relation to iron deficiency anemia

Gautam Shah, Ritesh Parmar

Abstract


Background: Febrile seizures are the most common cause of convulsions in children between 6 months to 5 years, occurring in 2-5% of children. Iron deficiency is postulated as a risk factor for febrile seizures in children and it is an easily correctable condition. The objective of the study was to study the clinical profile and risk factors of febrile convulsions and to establish an association between febrile seizure and iron deficiency anemia.

Methods: The study was carried out in Department of Pediatrics, Dhiraj General Hospital, Piparia, a tertiary care teaching hospital. 34 cases and 34 controls were included in the study. Controls were children of same age group presenting with short febrile illness but without any seizures. Febrile seizures were defined according to the AAP (American Academy of Pediatrics) criteria. Iron deficiency was diagnosed by hematologic investigations of haemoglobin value < 11 g/dl, MCV <70 fL and RDW > 15.6%.

Results: Iron deficiency anemia was present in 23.52% (8/34) of cases as compared to 17.64% (6/34) in the control group. Odds ratio was 1.436 (95% CI 0.439-4.669, p value 0.549), which suggest there is no significant association of iron deficiency anemia with febrile convulsions. Subgroup analysis for association of iron deficiency anemia with simple febrile convulsion cases showed Odds ratio of 1.11 (95% CI 0.298-4.138), which suggests there is poor association of iron deficiency anemia with simple febrile convulsions. Subgroup analysis for association of iron deficiency anemia with complex febrile convulsion cases showed Odds ratio of 2.809 (95% CI 0.521-15.041), which suggests there is poor association of iron deficiency anemia with complex febrile convulsions. Wide confidence interval indicates less sample size. Study with large sample size is required for reliable interpretation.

Conclusions:The study reveals iron deficiency anemia is not a significant risk factor in children presenting with febrile seizures. Further study with large sample size is required. 


Keywords


Febrile seizures, Haemoglobin, Iron deficiency

Full Text:

PDF

References


Mewasingh LD, Clinical Evidence-Febrile Seizures. BMJ Publishing Group Ltd. 2008;5(324):1-11.

Verity CM. Do seizures damage the brain? The epidemiological evidence. J Arch Dis Child. 1998;78:78-84.

Hesdorffer DC, Shinnar S, Lewis DV, Nordli DR, Pellock JM, Moshé Sl et al. Risk Factors for Febrile Status Epilepticus: A Case-Control Study. J Pediatr. 2013;163(4):1147-51.

Seizures overview- AAP.org. Available form; https://pediatrics.aappublications.org/content/127/2/389.full.pdf.

Mahyar AM, Ayazi, PA, Fallahi MF, Javadi AJ. Risk Factors of the First Febrile Seizures in Iranian Children. Int J Pediatr. 2010;2010:1-3.

Erenberg G, Morris HH. Febrile Seizures. Epilepsy Electro Clinical Syndromes. Springer-Verlag Berlin and Heidelberg GmbH and Co K; 1987:93-4.

Parks YA, Wharton BA. Iron deficiency and the brain. Acta. Paediatr Scand. 1989;55(361):71-7.

Pisacane A, Sansone R, Impagiiazzo 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.

Kumari PL, Nair MK, Nair SM, Kailas L, Geetha S. Iron Deficiency as a Risk Factor for Simple Febrile Seizures-A Case Control Study. J Indian Pediatr. 2011;49:17-9.

Hartfield DS, Tan J, Yager JY, Rosychuk RJ, Spady D, Haines C. The Association Between Iron Deficiency and Febrile Seizures in Childhood. Clin Pediatr (Phila). 2009;48(4):420-6.

Daoud AS, Batieha A, Ekteish FA, Gharaibeh N, Ajlouni S, and Hijazi S. Iron Status: A Possible Risk Factor for the First Febrile Seizure. J Epilepsia. 2002;43(7):740-3.

Shah SS, Zwerling L, Bell L et al. Low Risk of Bacteremia In Children With Febrile Seizures. Arch Pediatr Adolesc Med J. 2002;156:469-72.

Fallah R, Tirandazi B, Akhavan Karbasi S, Golestan M. Iron Deficiency and Iron Deficiency Anemia in Children with Febrile Seizure. Iranian J Pediatr Hematol Oncol. 2013;3(1):200-4.

Rehmaan N, Biloo AG. Association between Iron Deficiency Anemia and Febrile Convulsions. J College Physicians Surg Pak. 2005;15(6);338-40.

Berg AT, Shinnar S, Hauser A, Alemany M, Shapiro ED, Salomon ME et al. A prospective study of recurrent febrile seizures. The New England J Medic. 1992;327(16):1122-7.

Verity CM, Butler NR, Golding J. Febrile convulsions in a national cohort followed up from birth. incidence, prevalence and recurrence in the first five years of life. BMJ. 1985;290:1307-10.

Mcintosh N. Forfar Et Arneil’s Textbook of Pediatrics. 7th edition. China: Elsevier; 2008:860-1.

Verity CM, Golding J. Risk of epilepsy after febrile convulsion: a national cohort study. BMJ. 1991;303:1373-6.

Dubé CM, Brewster AL, Richichi C, Zha Q, Baram TZ. Fever, febrile seizures and epilepsy. J Trends Neurosci. 2007;30(10):490-6.

Elizabeth KE Nutrition and Child Development. 4th ed. New Delhi: Paras Medical Publisher; 2010.

Auvichayapat P, Auvichayapat N, Jedsrisuparp A, Thinkhamrop B, Sriroj S, Piyakulmala T et al. Incidence of febrile seizures in thalassemic patients. J Med Assoc Thai. 2004;87(8):970-3.

Sherjil A, Saeed Z, Shehzad S, Amjad R. Iron deficiency anaemia-a risk factor for febrile seizures in children. J Ayub Med Coll Abbottabad. 2010;22(3):71-3.

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

Sadeghzadeh M, Khoshnevis P, Mahboubi E. Iron status and febrile seizure- a case control study in children less than 3 years. Iran J Child Neurol Autumn. 2012;6(4):27-31.