Assessment of neutrophil-to-lymphocyte ratio and mean platelet volume as inflammatory biomarkers in children with febrile seizures
DOI:
https://doi.org/10.18203/2349-3291.ijcp20262354Keywords:
Febrile seizure, Children, Neutrophil-to-lymphocyte ratio, Mean platelet volume, Inflammatory biomarkerAbstract
Background: Febrile seizures are common neurological events in children aged 6 months to 5 years and are usually associated with acute febrile illnesses. Inflammatory mechanisms may contribute to seizure occurrence during fever. Neutrophil-to-lymphocyte ratio (NLR) and mean platelet volume (MPV) are simple complete blood count-derived markers that may reflect systemic inflammatory activity.
Methods: This descriptive cross-sectional study was conducted in the Department of Pediatrics at a tertiary care centre in Cuddalore district over a period of 12 months. The study included 40 children aged 6 months to 60 months who presented with febrile seizures. Demographic details, clinical profile, etiology of febrile illness and hematological parameters were recorded. NLR and MPV were calculated from complete blood count analysis. Data were summarized using descriptive statistics.
Results: During a study 40 children with febrile seizures includes in the study who fulfilled inclusion and exclusion criteria, in the study toddlers constituted the majority, accounting for 57.5%. Acute gastroenteritis was the most common etiology of febrile illness. The mean hemoglobin level was low 10.10±1.35 g/dl, mean MPV was (8.65±0.88 fL) normal, mean NLR was (4.00±1.52) elevated among the children with Febrile seizure
Conclusions: Children with febrile seizures had a low mean hemoglobin level, elevated mean NLR, and normal MPV. NLR may serve as a simple, inexpensive, and readily available inflammatory marker in children with febrile seizures. Further well-designed case-control studies are needed to determine whether NLR can be used as a reliable predictor of febrile seizures.
References
Yazar A, Akın F, Türe E, Çaksen H, Odabaş D. Mean platelet volume and neutrophil-to-lymphocyte ratio may be used as predictors in febrile seizures. J Pediatr Infect Dis. 2018;13(4):283-6.
Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, editors. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia: Elsevier. 2025.
Aroor AR, Soans ST. The usefulness of neutrophil to lymphocyte ratio in febrile seizure. Int J Contemp Pediatr. 2020;7(5):985.
Söğütlü Y, Altaş U. Predictive value of neutrophil-lymphocyte ratio and other inflammation indices in febrile seizures in children. J Clin Med. 2024;13(17):5330.
Dilber B, Reis GP, Kolayli CC, Cansu A. The role of neutrophil-to-lymphocyte ratio, red blood cell distribution width, and mean platelet volume in predicting febrile seizures and differentiating febrile seizure types. J Pediatr Epilepsy. 2022;11(1):7-14.
Yoldas MA, Hanci F, Dincel GK, Bekdas M. The predictive role of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in children with simple febrile seizures. Exp Biomed Res. 2021;4(3):198-206.
Nada RS, Shatla RH, Hamza MT, Rihan AA. Effect of neutrophil-lymphocyte ratio and mean platelet volume on severity of febrile seizures in Egyptian children. Egypt J Haematol. 2025;50(4):1006-14.
Mosa SA, Atrushi AM, Armishty FS, Abdulrahman MS. The ratio of neutrophils and the mean platelet volume to platelet count ratio as risk factors for febrile convulsions in Zakho. Zanco J Med Sci. 2025;29(2):264-9.
Balikoğlu P, Oflu A, Bükülmez A. Neutrophil-lymphocyte ratio, red cell distribution width and mean platelet volume as practical markers in febrile seizure classification. Rev Paul Pediatr. 2024;42:e2023016.
Tiwari A, Meshram RJ, Singh RK, Singh IV. Febrile seizures in children: a review. Cureus. 2022;14(11):e31422.
Sawires R, Buttery J, Fahey M. A review of febrile seizures: recent advances in understanding of febrile seizure pathophysiology and commonly implicated viral triggers. Front Pediatr. 2022;9:801321.
Kaushik JS, Sondhi V, Yoganathan S, Dubey R, Sharma S, Vinayan KP, et al. Association of Child Neurology consensus statement on the diagnosis and management of febrile seizures. Indian Pediatr. 2022;59(4):300-6.
Corsello A, Marangoni MB, Macchi M, Cozzi L, Agostoni C, Milani GP, et al. Febrile seizures: a systematic review of different guidelines. Pediatr Neurol. 2024;155:141-8.
Eilbert W, Chan C. Febrile seizures: a review. JACEP Open. 2022;3(4):e12769.
Zahorec R. Neutrophil-to-lymphocyte ratio, past, present and future perspectives. Bratisl Lek Listy. 2021;122(7):474-88.
Hosseini S, Gharedaghi H, Hassannezhad S, Sadeghvand S, Maghari A, Dastgiri S, et al. The impact of neutrophil-lymphocyte ratio in febrile seizures: a systematic review and meta-analysis. BioMed Res Int. 2022;2022:8472795.
Moosmann J, Krusemark A, Dittrich S, Ammer T, Rauh M, Woelfle J. Age- and sex-specific pediatric reference intervals for neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and platelet-to-lymphocyte ratio. Int J Lab Hematol. 2022;44(3):296-305.
Zhang X, Song Y, Yin M, Zhang L. Establishment of age-specific reference intervals for peripheral blood SII, NLR, PLR, and LMR in healthy children. BMC Immunol. 2026;27(1):22.
Beyan C, Beyan E. Were the measurements standardized sufficiently in published studies about mean platelet volume? Blood Coagul Fibrinolysis. 2017;28(3):234-6.