Iron Status: A Possible Risk Factor for the First Febrile Seizure

Abstract

Summary:Purpose: We conducted a controlled study to investigate the relation of iron status and first febrile seizure (FFS).Methods: Measures of iron sufficiency including hemoglobin concentration (HB), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and plasma ferritin (PF) were prospectively measured in 75 children with FFS and compared with 75 controls matched for age and sex with febrile illnesses without convulsions.Results: Mean ferritin level was significantly lower in cases with FFS (29.5 ± 21.3 g/L) than in controls (53.3 ± 37.6 g/L) with p ‫ס‬ 0.0001. The proportion of subjects with a PF level Յ30 g/L was significantly higher among children with FFS (49 of 75 vs. 24 of 75) than in controls (p ‫ס‬ 0.000). Mean levels of HB, MCV, and MCH also were lower among FFS cases, but differences failed to attain statistical significance. A higher proportion of cases with FFS had an HB <110 g/L, MCV <72 fL, and MCH <24 pg than did the controls, but the differences were not statistically significant. There were no statistically significant differences between the cases and the controls in the mean peak temperature on admission, types of underlying illness, or family history of epilepsy and of febrile convulsion.Conclusions: PF level was significantly lower in children with FFS than in the reference group, suggesting a possible role for iron insufficiency in FFS. Key Words: Iron status-First febrile seizure.Febrile seizures (FSs) are the most common type of seizures, occurring in 2-5% of all children (1). Because of their association with later epilepsy, recent studies have attempted to identify their risk factors (2,3), including family history of febrile convulsions or epilepsy, perinatal factors, features of the acute underlying illnesses accompanying the FS, and the temperature peak. Pisacane et al. (4) reported that anemia was more common in children younger than 2 years with febrile seizures (FSs), whereas, in contrast, Kobrinsky et al. (5) reported that iron deficiency raises the threshold for seizures. Iron is involved in the metabolism of several neurotransmitters, and monoamine and aldehyde oxidases are reduced in iron-deficiency anemia (6), which is common during the second and third years of life, and has variably been associated with behavioral and developmental disturbances (7). In the present study, we focus on the assessment of the relation, if any, of iron status with FFS. PATIENTS AND METHODS Children with first febrile seizure (FFS) admitted to the Departments of Pediatrics, Princess Rahma and KingHussein Hospitals, between January and December 2000, were considered for inclusion in the study. FS was defined as an event in infancy or childhood, usually occuring between ages 3 months and 6 years, associated with fever but without evidence of intracranial infection or other defined causes of seizures. A single seizure of <15 min duration in the presence of fever without focal features was defined as a simple FS, whereas seizures were defined as complex if they lasted >15 min, had...

Is iron deficiency anaemia a risk factor for febrile seizure? A case control study

“…Respiratory tract infection was the most commonly observed probable illness, as a cause for fever. This was also seen in studies by Piscane et al, Daod et al and Srinivasa et al 13,19,23 Malaria was the common infection found in Idro et al in about 67%. Temperature at time of admission in cases was not found statistically significant in present study though it was significant in Piscane et al (p-value of 0.000) and in Bidabadi et al (p-value of <0.001).…”

“…Daod et al Piscane et al and Fallah et al also found serum ferritin to be statistically correlating with febrile seizures. 13,19,27 Vaswani et al, Kumari et al among Indian studies have reported the same correlation between febrile seizures and serum ferritin levels. 17,20 In studies by Bidabadi et al, Yousefchaijan et al and Idro et al, patients did not show any statistical correlation between ferritin levels and febrile convulsions.…”

Association between iron deficiency anemia and various red cell parameters with febrile convulsions in children of age group 3 to 60 months

“…19 Similar results were observed by Pisacane, et al Daoud, et al showed mean serum ferritin was significantly low in children with first febrile seizure and also proportion of children with low ferritin was significantly higher in febrile seizure group than in controls. 4,20 Some studies done in India also agrees with these findings. 9,21 One finding which stands unique in our study Serum Iron which is less in case group which shows that iron deficiency can have positive association with febrile seizures.…”

Relationship of Iron Deficiency Anemia with Simple Febrile Seizure in Children

“…So, the difference is statistically significant i.e significant number of the cases had low serum ferritin level in comparison to controls. Daoud et al 8 mentioned that mean ferritin level were lower in children who had a seizure with fever, suggesting a possible risk factors in febrile seizures. They have shown that the mean plasma ferritin level was significantly lower (p <0.0001) in the first febrile seizure group compared to the reference group.…”

“…Owing to their association with epilepsy in future in some cases, various studies have attempted to identify the risk factors associated with FS like family history of FS or epilepsy, perinatal factors like maternal smoking & alcohol consumption 3 . Among several other risk factors iron deficiency has been found as a provocating factor of FS in different studies 4,5 .…”