Research Article - Current Pediatric Research (2022) Volume 0, Issue 0
Whats the relation between Iron Deficiency (ID) and Febrile Seizure (FS)? A case control study in Tehran, Iran.
Objective: Febrile Seizures (FS) is the most common form of seizure disorder (3%-4%) in childhood with a good prognosis. Some evidence indicates that Iron Deficiency (ID) might play a role in the initiation of FS. The aim of this case control study was to evaluate the role of ID in the pathogenesis of FS. Methods: In this case-control study, 70 children admitted to the pediatrics department (2014-2016) were studied. Cases included 35 children with FS (mean age: 2.191 ± 0946 years); 62.9% males and 37.1% females. The controls consisted of 35 children with febrile diseases without convulsion (mean age: 1.93 ± 1.433 years) with 65.7% males and 34.3% females. 2 ml of peripheral blood was collected within the first day of admission to the hospital. The blood was tested for CBC, HB, MCV, MCH, and MCHC in 2 groups. The remaining blood in an acid propylene tube was centrifuged, and serum was preserved at -80°C. Serum ferritin was estimated by the EIAS test for the cases and controls. Data were analyzed by SPSS 13. HB, MCV-MCH, MCHC, and serum ferritin levels were compared between 2 groups using appropriate statistical tools. The ferritin level cut-off in serum for differentiating between 2 groups was constructed by ROC (Receiver-Operating-Characteristic) curve. The sensitivity, specifity, PPV, NPV of the test, was calculated. Results: The mean age of cases was 2.191 ± 0946 vs. 1.93 ± 1.433 years in controls. Mean hemoglobin level (11.6 ± 079 vs. 11.86 ± 071; p value=0.2); MCV (75.8 ± 4.3 vs. 77.62 ± 4.1, p value=0.08); serum ferritin levels (54.57 ± 24 vs. 58.31 ± 23, p value=0.64) had no significant difference between 2 groups. The ferritin level (36 ng/ml) had 74.3% sensitivity, 20% specifity, 56% PPV, 52% NPV, with Positive likelihood Ratio being 1.3 and Negative likelihood Ratio: 0.93 to discriminate 2 groups. In our opinion, ID could not lead to FS in all children, but in some cases, with a genetic basis, ID raises the threshold for seizures. Conclusion: The present study to report the ferritin cut-off level, which discriminates the FS cases from non-convulsive febrile children. Ferritin cut-off (36 ng/ml) has an acceptable sensitivity (74.3%) but poor specifity (20%) and just 56% PPV and 52% NPV to differentiate the FS cases from nonconvulsive febrile children. Although the ferritin base level in each child (case/control) before infection was unknown, but in present study both groups was febrile in contrast to previous studies which ferritin level compared with afebrile children. In our opinion, ID could not lead to FS in all children, but in some cases, with a genetic basis; ID raises the threshold for seizures. Due to the high prevalence of ID (26%), especially in the young Iranian population, adding iron to diet might be helpful in decreasing FS in susceptible cases.Author(s): Samileh Noorbakhsh*, Fahimeh Ehsanipour, Azita Tavasooli, Leila Tahernia