Association between iron deficiency and febrile seizures

Abstract

Objective

The relationship between iron status and febrile seizures has been examined in various settings, mainly in the Developing World, with conflicting results. The aim of this study was to investigate any association between iron deficiency and febrile seizures (FS) in European children aged 6–60 months.

Design

Prospective, case–control study.

Setting

Greek population in Thessaloniki.

Patients

50 patients with febrile seizures (cases) and 50 controls (children presenting with fever, without seizures).

Interventions

None.

Main outcome measures

Haematologic parameters (haemoglobin concentration, haematocrit, mean corpuscular volume, red cell distribution width), plasma iron, total iron-binding capacity, plasma ferritin, transferrin saturation and soluble transferrin receptors were compared in cases and controls.

Results

Plasma ferritin was lower (median [range]: 42.8 (3–285.7) vs 58.3 (21.4–195.3 ng/ml; p = 0.02) and Total Iron Binding Capacity (TIBC) higher (mean [Standard Deviation] 267 [58.9] vs 243 [58.45] ?g/dl, p = 0.04) in cases than in controls. Results were similar for 12 complex FS cases (ferritin 30 (3–121 vs 89 (41.8–141.5 ng/lL; TIBC 292.92 [68.0] vs 232.08 [36.27] ?g/dL). Iron deficiency, defined as ferritin <30 ng/ml, was more frequent in cases (24%) than controls (4%; p = 0.004). Ferritin was lower and TIBC higher in 18 with previous seizures than in 32 with a first seizure although haemoglobin and mean cell haemoglobin concentration were higher.

Conclusions

European children with febrile seizures have lower Ferritin than those with fever alone, and iron deficiency, but not anaemia, is associated with recurrence. Iron status screening should be considered as routine for children presenting with or at high risk for febrile seizures.

More information

Identifiers

ORCID for Fenella Kirkham: orcid.org/0000-0002-2443-7958

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