Association Between Iron Deficiency and Febrile Seizure? A Case Control Study in Tehran, Iran

Abstract Objective: Febrile convulsion (FC) is the most common form of seizures disorder (3-4%) in childhood with good prognosis. Some evidences indicate that iron deficiency (ID) might play a role in initiation of FC. The aim of this case‐control study was to evaluate, the role for ID in pathogenesis of FC (febrile convulsion). We studied 35 FC children and 35 controls (febrile diseases without convulsion) Methods; In this case–control study, 70 chidren admitted in pediatrics department (2014-2016) were studied. Cases included 35 children with FC ( mean age: 2.191 ± 0946 years); 62.9% male,37.1% female .The Controls consisted 35 children with febrile diseases without convulsion (( mean age: 1.93 ± 1.433 years) 65.7% male,34.3% female.Two militter of peripheral blood collected within the first day of admission in hospital. The blood were tested for CBC, HB ,MCV,MCH,MCHC in 2 groups. The remaining blood in an acid‐propylene tube were centrifuged and serum was preserved in‐80°C.Serum ferritin was estimated by EIAS test for the cases and controls .Data were analyzed by SPSS 13.HB ,,MCVMCH,MCHC ,and serum ferritin level were compared between 2 groups using appropriate statistical tools . The Ferritin level cut-off in serum for differentiating between 2 groups was constructed by receiver-operating-characteristic curve(ROC). Sensitivity, specificity, PPV, NPV, of test was calculated.Results: The mean age of cases were 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 not significant difference between 2 groups. The ferritin level 36ng/ml; had 74.3% sensitivity, 20% specifity, 56% PPV, 52% NPV, Positive likelihood Ratio: 1.3; Negative likelihood Ratio: 0.93 to discriminate 2 groups. In our opinion, ID could not lead to FC in all children, but in some cases with genetic basis; ID raises the threshold for seizures. Due to high prevalence of ID (26%) especially in your Iranian population, adding the Iron to diet might be helpful in decreasing FC in susceptible cases.Conclusion: The present study is the first to report the ferritin cut off level which discriminates the FC cases from non convulsive febrile children. Ferritin cut off (36ng/ml has an acceptable sensitivity (74.3% ) but poor specifity (20%) and just 56% PPV, and 52% NPV to differentiate the FC cases from non convulsive febrile children. In our opinion, ID could not lead to FC in all children, but in some cases with genetic basis; ID raises the threshold for seizures. Due to high prevalence of ID (26%) especially in your Iranian population, adding the Iron to diet, might be helpful in decreasing FC in susceptible cases.