Serum iron and calcium status in paediatric patients presenting with febrile seizures: A Prospective case-control study.
DOI:
https://doi.org/10.51168/xbbqz465Keywords:
Anemia, Children, Febrile seizures, Hypocalcemia, Iron deficiency, Serum calcium, Serum ferritinAbstract
Background:
Hypocalcemia has been associated with paresthesia, tetany, muscle cramps, convulsions, and seizures. Electrolyte and water balance disturbances are also common during febrile illness. Alterations in serum calcium and iron status can influence seizure vulnerability in young children.
Objectives:
To assess serum iron and calcium status among paediatric patients presenting with febrile seizures and compare these parameters with febrile children without seizures.
Methods:
This prospective case-control study enrolled 400 children aged 6–60 months through consecutive sampling: 200 children with febrile seizures and 200 febrile children without seizures. Demographic and clinical data, complete blood count indices, serum ferritin, and total serum calcium were recorded. Continuous variables were compared using the independent-samples t-test or Mann–Whitney U test, as appropriate; categorical variables were analysed using the Chi-square test or Fisher’s exact test.
Results:
Protein-energy malnutrition was observed in 37.0% of controls and 27.0% of cases. Cases had higher red cell distribution width and lower mean corpuscular haemoglobin, mean corpuscular volume, haemoglobin, and serum ferritin than controls (all p<0.001). Mean serum calcium was comparable between cases and controls (9.11±0.62 versus 9.03±0.91 mg/dL; p=0.305). Iron deficiency anaemia was more frequent among cases (26.0% versus 7.0%; χ²=26.20, p<0.001), whereas hypocalcaemia was comparable (18.0% versus 23.0%; χ²=1.53, p=0.216).
Conclusion:
Iron deficiency was significantly associated with febrile seizures in young children. In contrast, neither mean serum calcium nor the frequency of hypocalcaemia differed significantly between groups.
Recommendations:
Early screening for iron deficiency, prompt nutritional correction, and caregiver counselling should be strengthened in children presenting with febrile illness and febrile seizures.
References
1. Siqueira LF. Febrile seizures: Update on diagnosis and management. Rev Assoc Med Bras (1992). 2010;56:489-492. https://doi.org/10.1590/S0104-42302010000400026
2. Mikati MA, Rahi AC. Febrile seizures. From molecular biology to clinical practice. Neurosciences (Riyadh). 2005;10:14-22. https://doi.org/10.17712/1658-3183.1305
3. Bidabadi E, Mashouf M. Association between iron deficiency anemia and first febrile convulsion: A case-control study. Seizure. 2009;18:347-351. https://doi.org/10.1016/j.seizure.2009.01.008
4. Gupta S, Agarwal N, Maheshwari M. Iron deficiency as a risk factor for febrile seizure: A case control study. People's J Sci Res. 2015;8:37-40.
5. Muneshwar S. A study on nutritional status of children under 6 years of age under the field practice area of UHTC, RIMS, Raichur [doctoral dissertation]. India: Rajiv Gandhi University of Health Sciences.
6. Gupta H, Sharma B, Verma M, Singh VK, Verma R. Association of serum iron and serum calcium levels in children with febrile seizures. Indian J Med Sci. 2024;76:17-21. https://doi.org/10.25259/IJMS_136_2023
7. Sayedzadeh SA, Hemati M. Serum sodium and calcium level in children with simple and recurrent febrile convulsions. J Kermanshah Univ Med Sci. 2007;10:1.
8. Nickavar A, Hasanpour H, Sotoudeh K. Validity of serum sodium and calcium screening in children with febrile convulsion. Acta Med Iran. 2009;47:229-231.
9. Sherjil A, Us Saeed Z, Shehzad S, Amjad R. Iron deficiency anaemia: A risk factor for febrile seizures in children. J Ayub Med Coll Abbottabad. 2010;22:71-73.
10. Vaswani RK, Dharaskar PG, Kulkarni S, Ghosh K. Iron deficiency as a risk factor for first febrile seizure. Indian Pediatr. 2010;47:437-439. https://doi.org/10.1007/s13312-010-0080-8
11. Sultan A, Fayaz M, Khan AN, Fayaz A. Relationship between anaemia and simple febrile convulsions. J Ayub Med Coll Abbottabad. 2013;25:156-158.
12. Aly IA, Kmal HM, Soliman DR, Mohamed MH. Iron profile parameters and serum zinc and copper levels in children with febrile convulsions in Banha. J Am Sci. 2014;10:320-327.
13. Sadeghzadeh M, Asl PK, Mahboubi E. Iron status and febrile seizures: A case control study in children less than 3 years. Iran J Child Neurol. 2012;6:27-31.
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Copyright (c) 2026 Rakesh Balamkar, Dr. Minal Ambade, Dr. Rajesh Kumar Nain (Author)
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