Jadhav Renuka, Pande Vineeta, Garud Balakrushna, Mane Shailaja
Paediatrics, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.
Cureus. 2024 Nov 21;16(11):e74129. doi: 10.7759/cureus.74129. eCollection 2024 Nov.
Introduction Febrile seizures are the most common type of seizure in neurologically healthy children under six years of age. Iron deficiency is a prevalent micronutrient deficiency worldwide, though it is medically preventable and treatable. In many developing countries, anaemia remains a significant concern in young children. Iron plays a crucial role in neurodevelopment and overall bodily growth, and low levels of serum ferritin may lower the seizure threshold. Methods The study aimed to determine the correlation of iron profiles between patients with their first episode of febrile seizures and patients with only febrile illnesses. This case-control study enrolled children between 6 and 60 months of age. The case group comprised children who experienced their first episode of febrile seizure, while the control group included children presenting with febrile illness without seizures. The cost of the iron profile was waived for patients enrolled in the study. The study was conducted at a tertiary care centre and charitable hospital. Total blood counts and iron profiles were analyzed to find the association between the risk of febrile seizures and anaemia. Results The study included 150 children, with 50 febrile seizure cases and 100 controls with only febrile illness. The mean age of cases was 2.15 years, while that of the controls was 1.73 years. Males were more prevalent in the febrile seizure group, with 31 (62%) compared to 19 (38%) females. The mean serum transferrin value in cases was 22.46, compared to 28.42 in controls, indicating lower levels in cases (p=0.029). The mean TIBC in cases was 434.84, higher than the control group's 334.46 (p<0.001). The mean serum iron level in cases was 77.64, lower than that of controls at 86.63, though the difference was not significant (p=0.195). RDW >15% was observed in 46 (92%) cases compared to 57 (57%) controls (p<0.001). Conclusion Iron deficiency anaemia is a correctable risk factor for children with febrile seizures between 6 and 60 months of age. Timely diagnosis and correction of anaemia may help prevent febrile seizures in these children. Further research is needed to evaluate effective prevention strategies.
引言
热性惊厥是6岁以下神经系统健康儿童最常见的惊厥类型。缺铁是全球普遍存在的一种微量营养素缺乏症，不过在医学上是可预防和可治疗的。在许多发展中国家，幼儿贫血仍然是一个重大问题。铁在神经发育和身体整体生长中起着至关重要的作用，血清铁蛋白水平低可能会降低惊厥阈值。
方法
本研究旨在确定首次发生热性惊厥的患者与仅患有发热性疾病的患者之间铁指标的相关性。这项病例对照研究纳入了6至60个月大的儿童。病例组包括首次发生热性惊厥的儿童，而对照组包括患有发热性疾病但无惊厥的儿童。参与研究的患者无需支付铁指标检测费用。该研究在一家三级护理中心和慈善医院进行。分析全血细胞计数和铁指标，以找出热性惊厥风险与贫血之间的关联。
结果
该研究共纳入150名儿童，其中50例热性惊厥病例，100例仅患有发热性疾病的对照。病例组的平均年龄为2.15岁，对照组为1.73岁。热性惊厥组中男性更为常见，男性有31例（62%），女性有19例（38%）。病例组的平均血清转铁蛋白值为22.46，对照组为28.42，表明病例组水平较低（p = 0.029）。病例组的平均总铁结合力为434.84，高于对照组的334.46（p < 0.001）。病例组的平均血清铁水平为77.64，低于对照组的86.63，不过差异不显著（p = 0.195）。46例（92%）病例的红细胞分布宽度>15%，而对照组为57例（57%）（p < 0.001）。
结论
缺铁性贫血是6至60个月大患有热性惊厥儿童的一个可纠正的风险因素。及时诊断和纠正贫血可能有助于预防这些儿童发生热性惊厥。需要进一步研究以评估有效的预防策略。
