The association of iron deficiency anaemia with simple febrile seizures in children less than 5 years age: A single centre, prospective, case-control study

Introduction: Febrile seizure (FS) has an incidence of 2-5% in the neurologically healthy child. Among various risk factors, iron deficiency anaemia (IDA) is implicated in the increased risk of FS.

Objectives: To primarily assess the association between IDA and simple FS and secondarily the association of other risk factors with simple FS.

Method: This was a single centre, prospective, case control study involving 120 children, aged between 6 months and 5 years, 60 presenting with simple FS (cases) and 60 presenting with acute febrile episodes without seizures (controls). The study was performed from September 2017 to August 2019. Cases and controls were matched for age, sex, weight, and height. Laboratory investigations such as complete blood count, serum iron (SI), total iron binding capacity (TIBC), and SI/TIBC index were performed and compared between the two groups.

Results: Compared to controls, significantly higher number of cases had a family history of FS and family history of seizure disorder (both p-values<0.05). Moreover, as compared to controls, cases had significantly lower median haemoglobin levels, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration (all p-values<0.05). However, cases had significantly higher median red cell distribution width (p-value = 0.004). Similarly, cases had a significantly lower mean SI levels, and SI/TIBC index, as compared to controls (both p-values<0.05). However, cases had significantly higher mean TIBC (p-values<0.05). Finally, as compared to the controls, cases with IDA had 8.4 fold increased risk of developing the FS. 

Conclusions: The findings of this study suggest that IDA is a risk factor for the development of FS in children aged <5 years.

Sri Lanka Journal of Child Health, 2021; 50(1): 75-82