Role of iron in breath holding spells and effect of iron therapy in children

Authors

  • Mohmad Saleem Chesti Department of Paediatrics, Government Medical College, Baramulla, Kashmir, India
  • Shilakha Chaman Department of Paediatrics, Government Medical College, Baramulla, Kashmir, India
  • Mudasir Nazir Department of Paediatrics, Government Medical College, Baramulla, Kashmir, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20214160

Keywords:

Breath holding spells, Children and iron deficiency, Anemia and serum ferritin

Abstract

Background: Breath holding spells (BHS) are paroxysmal events resulting from painful stimulus or emotional event resulting in forceful crying, occur in children’s aged between 6 months to 6 years. To assess the role of iron in breath holding spells (BHS) and to assess the efficiency of iron therapy in reducing frequency of BHS.

Methods: This was a prospective, interventional study conducted at GMC baramulla. A total of 70 patients between the ages of 6 months and 5 years with breath holding spells with iron deficiency and iron deficiency anemia were studied. After giving them iron therapy for 6 and 12 weeks, they were assessed for the improvement in their anemia and its impact on the frequency of breath holding spells.

Results: Seventy children with breath holding spells were studied prospectively. Forty (57.15%) cases were males and 30 (42.85%) females. There was a statistically significant rise in the hemoglobin level, serum ferritin, serum iron with 6 and12 weeks of iron therapy (p<0.001). This rise in the hemoglobin level serum ferritin and serum iron was associated with a statistically significant fall in the frequency of breath holding spells with 6 and 12 weeks of iron therapy (p<0.001).

Conclusions: iron supplement is effective in reducing the frequency of breath holding spells and thus iron has role in BHS.

Author Biography

Mohmad Saleem Chesti, Department of Paediatrics, Government Medical College, Baramulla, Kashmir, India

pediatrician

References

DiMario FJ. Breath-holding spells in childhood. AJDC. 1992;146:125-31.

Evans OB. Breath-holding spells. Pediatric Annals. 1997;26:410-4.

Lombroso CT, Lerman P. Breath holding spells. Pediatrics. 1967;39:563-81.

Holowach J, Thurston DL. Breath holding spells and anemia. New Engl J Med. 1963;268:21.

Yılmaz S, Kükner Ş. Anemia in children with breath-holding spells. The J Pediatr. 1996;128:440-1.

Rathore G, Larsen P, Fernandez C, Parakh M. Diverse Presentation of Breath Holding Spells: Two Case Reports with Literature Review. Case Reports in Neurological Medicine. 2013;1-3.

Goldson E, Reynolds A. Child Development & Behavior. In: Hay W, Levin M, Deterding R, Abzug M. Current diagnosis & treatment. 22nd ed. New York: McGraw-Hill Medical. 2014;3:102.

Mittal R. Seizures, Epilepsy and Nonepileptic Events. In: Parthasarathy A, Menon P. IAP Textbook of pediatrics. 5th ed. New Delhi: Jaypee Bros. Medical Publishers. 2013;6:346.

Christensen RD, Ohls RK. Diseases of the blood. Nelson Textbook of Pediatrics. Behrman RE, Kliegman RM,Arvin AM (editors). 2000;XXI:1387-9.

Daoud AS, Batieha A, Al-Sheyyab M, Abuekteish F, Hijazi S. Effectiveness of iron therapy on breath-holding spells. Journal of Pediatrics. 1997;130(4):547-50.

Tonikaboni SH, Alavi S, Mahvelati F, Tabasi Z. Effects of oral iron supplement on breath-holding spells in children, Iran J Child Neurology. 2006;1(1):33-7.

Abbaskhanian A, Ehteshami S, Rezai MS. Effects of Pircetam on Pediatric Breath Holding Spells: A Randomized Double Blind Controlled Trial. Iran J Child Neurol. 2012;6(4):9-15.

Mocan H, Yildiran A, Orhan F, Erduran E. Breath holding spells in 91 children and response to treatment with iron. Arch Dis Child. 1999;81:261-2.

Bhatia MS, Singhal PK, Dhar NK, Nigam VR, Malik SC, Mullick DN. Breath holding spells: an analysis of 50 cases. Indian Pediatr. 1990;27:1073-9.

Zehetner AA, Orr N, Buckmaster A, Williams K, Wheeler DM. Iron supplementation for breath-holding attacks in children. Cochrane Database Syst Rev. 2010;5:CD008132.

Yilmaz U, Doksoz O, Celik T, Akinci G, Mese T, Yilmaz ST. The value of neurologic and cardiologic assessment in breath holding spells. Pak J Med Sci. 2014;30:59-64.

Hamed SA, Gad EF, Sherif TK. Iron deficiency and cyanotic breath-holding spells: The effectiveness of iron therapy. Pediatr Hematol Oncol. 2018;35:186-95.

DiMario FJ. Prospective study of children with cyanotic and pallid breath-holding spells. Pediatrics. 2001;107:265-9.

Kolkiran A, Tutar E, Atalay S, Deda G, Cin S. Autonomic nervous system functions in children with breath-holding spells and effects of iron deficiency. Acta Paediatr. 2005;94:1227-31.

Orii KE, Kato Z, Osamu F. Changes of autonomic nervous system function in patients with breath-holding spells treated with iron. J Child Neurol. 2002;17:337-40.

Calik M, Abuhandan M, Aycicek A, Taskin A, Selek S, Iscan A. Increased oxidant status in children with breath-holding spells. Childs Nerv Syst. 2013;29:1015-9.

Abosdera MM, Sabry MM, and Abdel-Moneim ES. Breath Holding Spells; its relation to iron deficiency anemia, and electroencephalogram findings. American Journal of Research Communication. 2016;4(12):38-9.

Khan I, Muhammad T, Khan MA. Effectiveness of oral iron supplement on breath holding spells in children. J Med Sci. 2012;20(3):138-41.

Couper, Simmer. Iron deficiency in children: food for thought. JMA. 2001;174:162-3.

Oski FA, Honig AS. The effect on the developmental scores of iron deficient infants. J Pediatr. 1978;92:21-5.

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Published

2021-10-25

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Original Research Articles