Iron deficiency as a risk factor for simple febrile seizures-A case control study

Clinical Epidemiology Resource and Training Centre (CERTC), Medical College, Thiruvananthapuram, Kerala, India.
Indian pediatrics (Impact Factor: 1.04). 05/2011; 49(1):17-9. DOI: 10.1007/s13312-012-0008-6
Source: PubMed


To study the role of iron deficiency as a risk factor for simple febrile seizures.
Case control study.
Pediatric department of a tertiary care teaching hospital.
154 cases and 154 controls were included in the study. Consecutive cases and concurrent controls were selected. Cases were children of age group 6 months to 3 years presenting with simple febrile seizures. Controls were children of same age group presenting with short febrile illness but without any seizures.
After informed consent, detailed history was taken and clinical examination done in both cases and controls and blood investigations were done to diagnose iron-deficiency in both cases and controls. Iron deficiency was diagnosed as per WHO criteria (hemoglobin value <11 g%, red cell distribution width of >15% and serum ferritin value <12 ng/mL). Other explanatory variables, which can be the potential confounders were also included in the study and considered for analysis.
Highly significant association was found between iron deficiency and simple febrile seizures in both univariate and multivariate analysis. Crude odds ratio was 5.34 (CI 3.27- 8.73, P<0.001) and adjusted odds ratio in the logistic regression analysis was 4.5 (CI 2.69- 7.53, P <0.001).
Iron deficiency is a significant risk factor for simple febrile seizures in children of age group 6 months to 3 years.

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    • "Iron serves many functions in the body both systemically, as well as on a tissue specific level. In the central nervous system (CNS), iron is an essential cofactor for many enzymes including those involved in energy metabolism, neurotransmitter synthesis , and the process of myelination (Conrad et al., 2000; Rao et al., 2003; Eden, 2005; Brotanek et al., 2007; Tran et al., 2008; Wu et al., 2008; Collard, 2009; Todorich et al., 2009; Tran et al., 2009; Kumari et al., 2012; Tran et al., 2012; Callahan et al., 2013; Polin et al., 2013; Radlowski and Johnson, 2013; Rao et al., 2013). Therefore, the impact of ID during vulnerable periods of neurodevelopment can be significant, and early gestational ID has been associated with abnormalities in neuronal development in both children and animals (Felt and Lozoff, 1996; Lozoff, 2000; Algarin et al., 2003; Walter, 2003; Lozoff and Georgieff, 2006; Rosato-Siri et al., 2010; Mihaila et al., 2011; Lee et al., 2012; Amin et al., 2013; Pisansky et al., 2013; Greminger et al., 2014; Jougleux et al., 2014) "
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    ABSTRACT: The deleterious effects of anemia on auditory nerve (AN) development have been well investigated; however, we have previously reported that significant functional consequences in the auditory brainstem response (ABR) can also occur as a consequence of marginal iron deficiency (ID). As the ABR has widespread clinical use, we evaluated the ability of this electrophysiological method to characterize the threshold of tissue ID in rats by examining the relationship between markers of tissue ID and severity of ABR latency defects. To generate various levels of ID, female Long-Evans rats were exposed to diets containing sufficient, borderline, or deficient iron (Fe) concentrations throughout gestation and offspring lifetime. We measured hematological indices of whole body iron stores in dams and offspring to assess the degree of ID. Progression of AN ID in the offspring was measured as ferritin protein levels at different times during postnatal development to complement ABR functional measurements. The severity of ABR deficits correlated with the level of Fe restriction in each diet. The sufficient Fe diet did not induce AN ID and consequently did not show an impaired ABR latency response. The borderline Fe diet, which depleted AN Fe stores but did not cause systemic anemia resulted in significantly increased ABR latency isolated to Peak I.The low Fe diet, which induced anemia and growth retardation, significantly increased ABR latencies of Peaks I to IV. Our findings indicate that changes in the ABR could be related to various degrees of ID experienced throughout development.
    Full-text · Article · Jan 2015 · ASN Neuro
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    • "Kumari et al indicated that in India, in FS children, iron deficiency was more frequent than in febrile children without seizure (6). "
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    ABSTRACT: Objective: Seizures are the most common pediatric neurologic problem. Research of the association between iron deficiency and seizures has shown conflicting results. This study evaluates iron status of children with a first seizure attack (febrile seizure (FS) or first unprovoked afebrile seizure (FUS) and healthy control group. Materials & methods: In a cross sectional case control study, iron status of 6-60 month year old admitted children with first seizure to Shahid Sadoughi Hospital from August 2011-December 2012 were evaluated and compared with healthy control children that were referred to primary health care center of Azadshar, Yazd, Iran. Results: 150 children were compared in three equal (FS, afebrile seizure, and control) groups. Hemoglobin levels in FUS (11.39 ± 1.07 g/dl) and FS (11.46 ± 1.18 g/dl) were lower than the control group (11.9 ± 0.89 g/dl) group. Serum iron levels in FS (38.52 ± 11.38 μg/dL) and FUS (42.68 ± 14.76 μg/dL) were lower than the control group (54.32 ± 13.46 μg/dL). Serum ferritin level in FUS (46.21 ± 27.63 ng/mL) and FS (48.91 ± 22.96 ng/ mL) was lower than the control group (75.13 ± 35.57 ng/mL). Iron deficiency (48% in FS, 44% in FUS and 28% in control group) and iron deficiency anemia (26% in FUS, 22% in FS, and 10% in healthy children) was more frequent in children with seizures. Conclusion: Iron status should be evaluated in children with a first attack of febrile or afebrile seizures.
    Full-text · Article · Mar 2014 · Iranian Journal of Child Neurology
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    • "Iron plays an important role in brain energy metabolism (1,7), myelin formation and neurotransmitter metabolism (3, 8-10). Iron deficiency affects the regional monoamine metabolism, such as serotonin, dopamine and norepinephrine, glutamate and gamma-aminobutyric acid (GABA) (11-14).The fetal brain may be at risk even if the infant is not anemic, because when there is not enough iron supply, the first priority of iron is red blood cells instead of other tissues(15). "
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    ABSTRACT: Febrile seizure is one of the most common neurological conditions of childhood. Several theories, such as iron deficiency anemia have been proposed as the pathogenesis of this condition. The aim of this study was to find the association between iron deficiency anemia and febrile seizures in children aged 6 months to 3 years admitted in Valie Asr hospital in Zanjan. Hemoglobin (Hb), mean corpuscular volume (MCV), serum iron (SI), total iron binding capacity (TIBC) and SI/TIBC ratio were assessed in one hundred children with febrile seizures and compared to the values of one hundred healthy children presenting in a heath care center in the same period as the control group. A total of 6% of cases had iron deficiency anemia which was similar to the control group. In the case group SI/TIBC ratio below 12% was seen in 58% of children which was significantly higher than that of the control group (29%). The results of this study suggest that although anemia was not common among febrile seizure patients, iron deficiency was more frequent in these patients.
    Full-text · Article · Feb 2012
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