Serum zinc and iron levels in children with febrile seizures

Febrile convulsions are one of the common paediatric emergencies encountered around the world. Febrile seizures occur in 6 months to 5 years of age group. Incidence of febrile convulsions around the world is between 3-4%. It is of similar incidence all over the world.Various risk factors were proposed for development of febrile seizures like developmental delay, >30 days of NICU stay, febrile convulsion history in the family, viral infections, iron and zinc deficiencies. Role of Zinc and iron deficiency in febrile convulsions were studied in western countries. But in India, there are very few studies. In this study we are proposing that low Zinc and Iron levels may predispose to development of febrile seizures. Aim: To estimate serum Zinc and iron levels in children with febrile seizures and compare this values with febrile children without seizures. Materials and Methods: It is a case control study. The study group includes 50 cases (febrile seizures) and 50 controls (fever without seizures) aged 6months to 5 years (6-60 months) attending paediatric out-patient department or admitted in PSG hospital who fulfilled the inclusion criteria. Children who are having atypical febrile seizures, intracranial infections, on Zinc and iron supplementation, electrolyte and metabolic disorders were excluded from the study. Informed and written consent was obtained from cases and controls. Temperature was recorded in Fahrenheit by using digital thermometer. 3-5ml of blood was collected from peripheral line in a red colour container. Serum was separated by centrifugation and stored at -20°C until serum zinc and iron levels were measured. Zinc and Iron levels were estimated by Atomic Absorption Spectroscopy in Stanes laboratory, Coimbatore.Categorization of socioeconomic status was done by modified Kuppuswamy scale, 2012.Nutritional status of all cases and controls were assessed according to IAP classification of malnutrition. Data was analysed using SPSS software. Methods like Chisquare and T-test were used. Results: Mean serum Zinc, Iron, haemoglobin, MCV, MCH, RDW levels were significantly low in cases when compared with controls (p-value 24 months age group. Mean serum Iron and other red cell indices were low in <24 months group when compared with >24 months age group. Odds ratio was 68.3 if patient having both Iron and zinc deficiency. Conclusions: Iron and zinc levels were significantly low in children with febrile seizures when compared to febrile children without seizures.Serum Iron was very much low in children 2years of age.There is no age wise difference in mean Zinc levels. There was 68.3 times increased risk of developing seizures, if they were having both low Iron and Zinc levels