Iron deficiency and febrile seizures: a retrospective analysis

Background: Febrile seizures (FS) are the commonest cause of seizures in children, with 2-5% of neurologically healthy children experiencing at least 1 episode. Iron deficiency is reported to be one of the most prevalent nutritional problems in the world today, especially in developing countries, with an estimated 46%-66% people affected. Our study is an attempt to clarify the relation between iron deficiency and first febrile seizure.Methods: The present study was a case control study carried from December 2016 till June 2018 in a tertiary care hospital at Aurangabad, Maharashtra, India. The study was done after obtaining approval from Institutional ethical Committee.Results: 77 cases and equal number of controls were included. Males were most commonly affected (>50%) as compared to females in both groups. Highest number of cases and controls were in the age group 0.5 to 1 year group, followed by 1-2 and 2-3 years group. Upper respiratory tract infection was most common etiological factor. Anemia (Hb<11 gm/dl) was seen in in 84% of the cases and 65% of the controls. Serum iron and total iron binding capacity (TIBC) was reduced in cases as compared to controls and this difference was highly statistically significant.Conclusions: Iron deficiency is a modifiable risk factor for first episode of febrile seizures in Indian children of age group 6 months to 5 years its early detection and timely correction may be an important determinant for prevention of febrile seizure in children.

To Study the Correlation between Iron Deficiency Anemia and HbA1c Levels in Non Diabetics

Purpose: Iron deficiency anemia is the most occurring formof anemia in India. Hemoglobin A1c (HbA1c) is used in diabeticpatients as an maker to reflect glucose levels of the last 3months. Like blood sugar levelsHbA1c levels are also affectedby presence of variant hemoglobin, hemolytic anemia,nutritional anemias, uremia, pregnancy and acute blood loss.However, reports on the effects of iron deficiency anemia onHbA1clevels are inconsistent. We conducted this study with anaim to analyze the effects of iron deficiency anemia onHbA1clevels among non-diabetics.Methods: 200 patients with Hb<10g/dl underwent peripheralblood film testing. All patients with microcytic hypochromicanemia underwent iron studies .Out of these, 100 non diabeticpatients diagnosed with iron deficiency anemia underwentHbA1c test and data was statically analysed.Results: We found that incidence of iron deficiency anemiawas 54%. Serum iron and ferritin concentrations are inverselyassociated with HbA1c concentration and that HbA1cconcentration tended to be higher in the presence of irondeficiency anemia.Conclusion: This study found a positive correlation betweeniron deficiency anemia and increased HbA1c levels. Hence,Iron deficiency anemia has to be kept in mind before using theHbA1c to diagnose diabetes.

A Comparative Study on Serum Level of Iron, Transferrin during Pregnancy and Post-Partum Period.

Backgrounds and Objectives: Although anaemia has the highest prevalence during Pregnancy, it is common throughout the reproductive cycle. Our study presents a composite picture of haemoglobin (Hb), serum level of iron (SI), total iron binding capacity (TIBC) and percentage iron saturation of transferrin in women during different trimesters of pregnancy and postpartum period. Material and Method: Our study was performed on a total of 100 subjects. 20 from each trimester and 15 post-partal were studied and compared with 25 non-pregnant normal subjects (controls) with age-group between 16-40 years. Results and Interpretation: We observed throughout pregnancy signs of increased iron demand, increased iron turnover and iron deficiency. They were demonstrated by decrease in haemoglobin. serum iron, percentage iron saturation of transferrin and increased TIBC. Conclusion: Thus, serum iron and total iron binding capacity are the good indices for determining the iron status and they provide us an opportunity to replenish iron stores of the pregnant mother at an earlier date thus preventing iron deficiency anaemia.

Serum Ferritin in Preeclampsia and Eclampsia: A Case Control Study.

Preeclampsia is a pregnancy specific, multi-system disorder of unknown etiology characterized by new onset of elevated blood pressure & proteinuria after 20 weeks of gestation. Globally preeclampsia and other hypertensive disorders of pregnancy are a leading cause of maternal and infant illness and death. But the exact pathophysiology is yet to be explored. It was a case control study and was conducted during the period of January 2010 - December 2010 in the department of Obs & Gynae DMCH and dept. of Biochemistry of BSMMU. The main objective of the study was to evaluate the association of serum ferritin and iron in preeclampsia & eclampsia. A total 100 pregnant women were included in this study. Of them 50 preeclamptic or eclamptic, nonanaemic patients not in labour (26-40weeks) were taken as case and 50 normotensive pregnant women were taken as control. Mean Serum ferritin level in case and control group was 100.03 ± 123.52 μgm/L and 31.53 ± 20.86 μgm/L respectively which is highly significant (P< 0.001). Out of 50 cases ferritin level was raised in 10 cases (20%). In 80% cases ferritin level was below the cut-off value that is normal or below normal but in 100% of controls had ferritin level below the cut off value.

Influence of infection on iron profile in severely malnourished children.

Objective. To study the iron profile and find out an accurate diagnostic tool which reflects iron status in different types of infection in severely malnourished children aged 12 months to 71 months. Methods. Hundred and Eight (108) children of whom 72 children were infected and 36 non infected severely malnourished children according to WHO criteria in the age group of 12-71 months were interrogated. 36 healthy control in the same age group were also interrogated. Results. Mean serum iron, total iron binding capacity (TIBC), ferritin concentration in normal children were significantly higher (P<0.001) than non-infected severely malnourished children. On the other hand mean serum ferritin concentration was significantly higher (P<0.001) in infected group than non-infected group but still lower than normal. Mean serum TIBC concentration significantly reduced in severely malnourished children than normal children but no significant difference was observed between non-infected and infected group. Mean serum iron, and transferrin saturation were significantly reduced (P<0.05) in parasitic infestation. Conclusion. Severely malnourished children had reduced mean serum iron profile. Parasitic infestation influenced the marked reduction of mean serum iron concentration and transferrin saturation level. Mean serum iron concentration was reduced in acute respiratory infection(ARI) and parasitic infestation than other infections. Serum ferritin concentration was elevated in all types of infection as acute phase protein but still lower than normal. So Iron, TIBC and Transferin saturation <16% constitute good evidence for iron deficiency in both infected and non-infected severely malnourished children.

The Effects of Iron Supplements and Cereal Intake on the Iron Nutritional Status in Children in Social Welfare Institutions

The study was designed to assess the effect of iron and cereal supplementation on children's iron nutritional status in social welfare institutions. Dietary survey was carried out methods of food weighing and record by interview (n = 74). A nutritional intervention study was carried out through supplementing iron supplements and cereal for 4 weeks in 4 - 12 years old children. Children received daily 40 mg elemental Fe as iron protein succinylate (n = 23) and 3.6 mg elemental Fe as 100 g cereal (n = 24), respectively. Blood samples were drawn before and after supplementation. Nutrients which children's intake was less than two-thirds of the RDA were vitamin A, vitamin B-1, vitamin B-2, calcium and iron. The mean daily intake of iron was 5.1 mg for male and 4.9 mg for female, and 52.3% for male and 45.4% for female of Korean RDA. The proportion of children with iron depletion assessed by TIBC (> 360 microgram/dl) and serum ferritin (< 20 ng/ml) were 56.6% and 58.7%, respectively. The proportion of children with the iron deficient erythropoiesis assessed by serum iron (< 70 microgram/dl), Hb (< 12 g/dl), Hct (< 36%) were 76.0%, 58.7%, 64.0%, respectively. After iron supplements treatment, Hb (p < 0.001), Hct (p < 0.001), serum iron (p < 0.001), transferrin saturation (p < 0.001) and serum ferritin (p < 0.01) increase significantly and only TIBC decreased slightly. After cereal supplementation, in anemic children, Hct (p < 0.001), serum iron (p < 0.001) and transferrin saturation (p < 0.001) were significantly increased. The effect of iron supplements and cereal supplementation in children with iron deficient erythropoiesis were more effective to improve the iron nutritional status than children with iron depletion. It was concluded that cereal supplementation program in anemic children was also effective to improve iron nutritional status.

The Effects of Long-Term Plasmapheresis on the Iron Status of the Donors / 대한수혈학회지

BACKGROUND: We found that intensive and long-term plasmapheresis might be responsible for iron depletion of donors in our previous study. So we examined 88 multi-time and 44 first-time donors to investigate the effects of long-term plasmapheresis on the iron status of the body. METHODS: Eighty eight donors who had never donated whole blood or donated plasma only regularly over a period of 5 years were selected. They were divided into group 1, 2 and 3 by donation interval and group A, B and C by the number of plasmapheresis per year. Fifty eight of them had follow-up data after the donation. Whole blood was taken from the donors before plasmapheresis by the Fenwal Autopheresis-C system. Each sample was assayed for serum ferritin, iron, TIBC and transferrin saturation. RESLUTS: For serum ferritin, iron, TIBC and transferrin saturation, the mean values of multi-time donors were in the normal range but significantly lower than those of first-time donors. Twenty four (27.3%) multi-time donors had either less than 10 ng/mL of serum ferritin or less than 16% of transferrin saturation. Six donors had the lower values of both serum ferritin and transferrin saturation. Among 88 multi-time donors, there were significant differences between groups. Group 1 with the shortest donation interval had significantly lower ferritin value than the other groups. Group C with the highest donation frequency had significantly lower ferritin, TIBC and transferrin saturation values than the other groups. The results for the follow-up data of 58 donors were similar to those for the initial data. CONCLUSION: The donation intervals and the frequency of plasmapheresis influence body iron status of donors. So intensive and long-term plasmapheresis may result in iron depletion in donors. Consequently, a more sophisticated donor screening system to prevent iron depletion in intensive and long-term plasmapheresis donors should be established.