Vol. 7, Issue 2, Part A (2025)

Background: Febrile seizures (FS), affecting 2-5% of children aged 6 months to 5 years, are the most frequent seizures in pediatric practice, occurring with fever but without Central Nervous System (CNS) infection or prior afebrile seizures. FS are classified as simple or complex, based on duration, recurrence, and focality. Iron deficiency anemia (IDA), prevalent among children in low and middle-income countries like Bangladesh, has been implicated as a modifiable risk factor. Given iron’s crucial role in neurodevelopment and neurotransmitter synthesis, its deficiency may lower the seizure threshold. Different studies on the association between IDA (Iron deficiency anemia) and FS yield conflicting results, necessitating further investigation in high-risk populations.
Aim of the study: The study aimed to explore the association between pediatric iron deficiency anemia (IDA) and febrile seizures (FS) by comparing hematological and iron profile among children with and without febrile seizures, in a tertiary care hospital setting in Bangladesh.
Methods: This hospital-based case-control study was conducted in department of pediatrics in Rajshahi Medical College Hospital, Rajshahi, a tertiary care teaching hospital in Bangladesh over a period 1 year from Jan. 2023 to Dec. 2023. A total of 100 children aged 6-60 months were enrolled, 50 children with febrile seizures (cases) and 50 febrile children without seizures (controls). After obtaining informed consent, data were collected via structured interviews, clinical examination, and laboratory investigations. Iron status was assessed using hemoglobin, Mean Corpuscular Volume (MCV), serum ferritin, serum iron, and Total Iron Binding Capacity (TIBC), with IDA defined by WHO criteria. Children with epilepsy, chronic illness, recent iron therapy, CNS infections, or developmental delays were excluded. Data were analyzed using SPSS v26, with p<0.05 considered statistically significant.
Results: The mean age, weight, and sex distribution between cases and controls showed no significant differences. Family history of seizures was significantly higher among cases (22%) than controls (6%, p=0.023). Children with febrile seizures had significantly lower hemoglobin, MCV, serum ferritin, and serum iron levels, and higher TIBC than controls (p< 0.001 for all). Iron deficiency anemia was more prevalent in cases (62%) than controls (28%, p< 0.001). Among seizure types, complex febrile seizures were associated with significantly lower hemoglobin and ferritin levels and a higher rate of IDA (80%) compared to simple seizures (54.3%, p = 0.041).
Conclusion: This study demonstrates a significant association between iron deficiency anemia and febrile seizures in children, especially complex types. Early identification and management of IDA may help reduce seizure risk. Further longitudinal and interventional research is needed to assess the potential protective role of iron supplementation in febrile seizure prevention.