Rahbarimanesh Ali Akbar, Salamati Peyman, Ashrafi Mohammadreza, Sadeghi Manelie, Tavakoli Javad
Department of Paediatric Infectious Diseases , Bahrami Children Hospital, Tehran University of Medical Sciences, Iran.
Acta Med Iran. 2011;49(7):447-50.
Febrile convulsion (FC) is the most common seizure disorder in childhood. white blood cell (WBC) and erythrocyte sedimentation rate (ESR) are commonly measured in FC. Trauma, vomiting and bleeding can also lead to WBC and ESR so the blood tests must carefully be interpreted by the clinician. In this cross sectional study 410 children(163 with FC), aged 6 months to 5 years, admitted to Bahrami Children hospital in the first 48 hours of their febrile disease, either with or without seizure, were evaluated over an 18 months period. Age, sex, temperature; history of vomiting, bleeding or trauma; WBC, ESR and hemoglobin were recorded in all children. There was a significant increase of WBC (P<0.001) in children with FC so we can deduct that leukocytosis encountered in children with FC can be due to convulsion in itself. There was no significant difference regarding ESR (P=0.113) between the two groups. In fact, elevated ESR is a result of underlying pathology. In stable patients who don't have any indication of lumbar puncture, there's no need to assess WBC and ESR as an indicator of underlying infection. If the patient is transferred to pediatric ward and still there's no reason to suspect a bacterial infection, there is no need for WBC test.
热性惊厥（FC）是儿童期最常见的癫痫发作性疾病。在热性惊厥中通常会检测白细胞（WBC）和红细胞沉降率（ESR）。创伤、呕吐和出血也可导致白细胞和红细胞沉降率升高，因此临床医生必须仔细解读血液检查结果。在这项横断面研究中，对410名年龄在6个月至5岁之间、在发热疾病的头48小时内入住巴赫拉米儿童医院的儿童进行了为期18个月的评估，这些儿童无论有无惊厥发作。记录了所有儿童的年龄、性别、体温；呕吐、出血或创伤史；白细胞、红细胞沉降率和血红蛋白。热性惊厥患儿的白细胞显著升高（P<0.001），因此我们可以推断，热性惊厥患儿出现的白细胞增多可能是惊厥本身所致。两组之间的红细胞沉降率无显著差异（P=0.113）。事实上，红细胞沉降率升高是潜在病理状况的结果。在没有任何腰椎穿刺指征的稳定患者中，无需将白细胞和红细胞沉降率作为潜在感染的指标进行评估。如果患者被转到儿科病房，且仍然没有理由怀疑细菌感染，则无需进行白细胞检测。
