Febril Nöbet Tiplerinde Hemogram Parametrelerinin Karşılaştırılması

Abstract

Amaç: Febril nöbetler (FN) çocukluk çağında en sık görülen nörolojik aciller arasındadır ve klinik olarak basit febril nöbetler (BFN) ve komplike febril nöbetler (KFN) olmak üzere iki tipte sınıflandırılır. FN tiplerinin ayrımı, farklı morbidite ve mortalite riskleriyle ilişkili olması ve her nöbetin klinik özelliklerine dayanması nedeniyle önemlidir, ancak şu anda bu farklılaşmaya yol gösterecek laboratuvar testi bulunmamaktadır. Bu çalışmada FN tipleri ve hemogram parametreleri arasındaki ilişki incelenmiş ve bu parametrelerin ayırıcı tanıda potansiyel kullanımı araştırılmıştır.
Gereç ve Yöntemler: Bu retrospektif çalışmaya, FN kriterlerine uyan, ilk defa FN geçiren ve hemogram sonuçlarına ulaşılabilen toplam 133 hasta dahil edildi. Tanıyı doğrulamak için Amerikan Pediatri Akademisi kriterleri kullanıldı. Hastalar BFN ve KFN olmak üzere iki gruba ayrıldı.
Bulgular: Her iki grup arasında hemoglobin (Hb), hematokrit (HCT), ortalama trombosit hacmi (MPV), nötrofil lenfosit oranı (NLO) ve trombosit lenfosit oranı (TLO) değerleri anlamlı şekilde farklıyken (sırasıyla p<0,001; p=0,002; p=0,033; p<0,001; p<0,001) diğer tam kan sayımı parametrelerinde ise anlamlı bir farklılık yoktu. Ayrıca, KFN grubunda MPV, BFN grubuna göre anlamlı derecede yüksekti.
Sonuç: Bu çalışma çocuklarda hemogram parametreleri ile FN tipleri arasındaki potansiyel ilişkiyi araştıran az sayıdaki çalışmadan biridir. Hemoglobin, MPV, NLO ve TLO’nun kesin bir ayrım sağlamasa da özellikle nöbet hikayesi net olmayan hastalarda klinisyenlere FN tiplerinin ayırt edilmesinde yardımcı olacağını düşünmekteyiz

Keywords

• Febril nöbetler,komplike,basit,hemogram

Comparison of Hemogram Parameters in Febrile Seizures Types

Abstract

Aim: Febrile seizures (FS) are among the most common neurological emergencies during childhood and clinically classified into two types, being simple febrile seizures (SFS) and complicated febrile seizures (CFS). The differentiation between FS types is important, in that they are associated with different morbidity and mortality risks and it is based on the clinical characteristics of each seizure, however there is currently no laboratory test that can guide this differentiation. In this study, the relationship between FS types and hemogram parameters was evaluated and potential use of these parameters in differential diagnosis was investigated.
Material and Methods: This retrospective study included a total of 133 patients whose first FS met the criteria of an FS, and whose hemogram results were available. The American Academy of Pediatrics criteria were used to confirm the diagnosis. The patients were divided into two groups as SFS and CFS.
Results: Hemoglobin (Hb), hematocrit (HCT), mean platelet volume (MPV), neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) differed significantly between two groups (p<0.001, p=0.002, p=0.033, p<0.001, p<0.001, respectively), while no significant difference was identified in total blood count parameters. Moreover, MPV was significantly higher in CFS group than in SFS group.
Conclusion: This is one of the few studies investigating the potential relationship between hemogram parameters and FS types in children. We believe that, although they do not ensure a clear differentiation, Hb, MPV, NLR and PLR may be useful to clinicians in differentiating between FS types, particularly in patients with an unclear seizure history

Keywords

• Febrile seizures,simple,complicated,hemogram

References

1. Subcommittee on Febrile Seizures; American Academy of Pediatrics. Neurodiagnostic evaluation of the child with a simple febrile seizure. Pediatrics. 2011;127(2):389-94.
2. Verity CM, Golding J. Risk of epilepsy after febrile convulsions: a national cohort study. BMJ. 1991;303(6814):1373-6.
3. Dubé CM, Brewster AL, Baram TZ. Febrile seizures: Mechanisms and relationship to epilepsy. Brain Dev. 2009;31(5):366-71.
4. Brugnara C, Oski FA, Nathan DG. Diagnostic approach to the anemic patients. In: Orkin SH, Nathan DG, Ginsburg D, Look AT, Fisher DE, Lux SE, editors. Nathan and Oski’s hematology of infancy and childhood. 7th ed. Philadelphia: Saunders; 2008. p.463-66.
5. Choy M, Dubé CM, Ehrengruber M, Baram TZ. Inflammatory processes, febrile seizures, and subsequent epileptogenesis. Epilepsy Curr. 2014;14(Suppl 1):15-22.
6. Mastrangelo M, Midulla F, Moretti C. Actual insights into the clinical management of febrile seizures. Eur J Pediatr. 2014;173(8):977-82.
7. Sales JW, Bulloch B, Hostetler MA. Practice variability in the management of complex febrile seizures by pediatric emergency physicians and fellows. CJEM. 2011;13(3):145-9.
8. Okumura A, Uemura N, Suzuki M, Itomi K, Watanabe K. Unconsciousness and delirious behavior in children with febrile seizures. Pediatr Neurol. 2004;30(5):316-9.

9. Waruiru C, Appleton R. Febrile seizures: an update. Arch Dis Child. 2004;89(8):751-6.
10. Offringa M, Bossuyt PM, Lubsen J, Ellenberg JH, Nelson KB, Knudsen FU, et al. Risk factors for seizure recurrence in children with febrile seizures: a pooled analysis of individual patient data from five studies. J Pediatr. 1994;124(4):574-84.
11. Akbayram S, Cemek M, Büyükben A, Aymelek F, Karaman S, Yilmaz F, et al. Major and minor bioelement status in children with febrile seizure. Bratisl Lek Listy. 2012;113(7):421-3.
12. Nasehi MM, Abbaskhanian A, Omran MRS. Association between iron deficiency anemia and febrile seizure: A systematic review and meta-analysis. J Pediatr Rev. 2013;1(2):13-8.
13. Bidabadi E, Mashouf M. Association between iron deficiency anemia and first febrile convulsion: A case-control study. Seizure. 2009;18(5):347-51.
14. Ünver O, Sezer RG, Kibar AE, Ünver A, İpek İÖ, Bozaykut A. The association between febrile seizures and iron deficiency anemia in childhood. J Clin Anal Med. 2015;6(1):57-60.
15. Pisacane A, Sansone R, Impagliazzo N, Coppola A, Rolando P, D’Apuzzo A, et al. Iron deficiency anemia and febrile convulsions: case-control study in children under 2 years. BMJ. 1996;313(7053):343.
16. 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(3):71-3.
17. Srinivasa S, Reddy SR. Iron defeiciency anemia in children with simple febrile seizures-A cohort study. Curr Pediatr Res. 2014;18(2):95-8.
18. Heydarian F, Vatankhah H. The role of anemia in first simple febrile seizure in children aged 6 months to 5 years old. Neurosciences (Riyadh). 2012;17(3):226-9.
19. Çelik T. Presentation of patients admitted with febrile seizures. Ege Journal of Medicine. 2011;50(3):175-7.
20. Özaydin E, Arhan E, Çetinkaya B, Özdel S, Değerliyurt A, Güven A, et al. Differences in iron deficiency anemia and mean platelet volume between children with simple and complex febrile seizures. Seizure. 2012;21(3):211-4.
21. Lippi G, Targher G, Montagnana M, Salvagno GL, Zoppini G, Guidi GC. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med. 2009;133(4):628-32.
22. Göksugur SB, Kabakuş N, Bekdaş M, Demircioğlu F. Neutrophil-to-lymphocyte ratio and red blood cell distribution width is a practical predictor for differentiation of febrile seizure types. Eur Rev Med Pharmacol Sci. 2014;18(22):3380-5.
23. Yıldız Y, Cakmak S, Calapoğlu T, Hocaoglu ZI, Karadeniz EG, Ozkasap S. Mean platelet volume can be used as a hospitalization criteria in pediatric patients diagnosed with acute bronchiolitis. Acta Medica Mediterranea, 2018;34(6):1997-2000.
24. Yigit Y, Yılmaz S, Akdoğan A, Halhalli HC, Özbek AE, Gencer EG. The role of neutrophil-lymphocyte ratio and red blood cell distribution width in the classification of febrile seizures. Eur Rev Med Pharmacol Sci. 2017;21(3):554-9.
25. Özkale M, Erol İ, Özkale Y, Sarıtürk Ç. Association between platelet indices and febrile seizures in children. Cukurova Med J. 2016;41(4):695-701.
26. Nikkhah A, Salehiomran MR, Asefi SS. Differences in mean platelet volume and platelet count between children with simple and complex febrile seizures. Iran J Child Neurol. 2017;11(2):44-7.
27. İlhan M, İlhan G, Gök AF, Bademler S, Verit Atmaca F, Ertekin C. Evaluation of neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and red blood cell distribution width-platelet ratio as early predictor of acute pancreatitis in pregnancy. J Matern Fetal Neonatal Med. 2016;29(9):1476-80.
28. Zahorec R. Ratio of neutrophil to lymphocyte counts--rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy. 2001;102(1):5-14.
29. de Jager CP, Wever PC, Gemen EF, Kusters R, van Gageldonk-Lafeber AB, van der Poll T, et al. The neutrophil-lymphocyte count ratio in patients with community-acquired pneumonia. PLoS One. 2012;7(10):e46561.
30. Balta S, Demirkol S, Arslan Z, Demir M, Öztürk C. The neutrophil lymphocyte ratio in patients with ST segment elevation myocardial infarction. Eur Rev Med Pharmacol Sci. 2014;18(1):141.
31. Ulusoy B, Bozdemir K, Akyol M, Mişe HI, Kutluhan A, Korkmaz MH. Investigation of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and mean platelet volume in patients with tinnitus. J Laryngol Otol. 2018;132(2):129-32.
32. Şahbaz A, Çiçekler H, Aynıoğlu Ö, Işık H, Özmen Ü. Comparison of the predictive value of plateletcrit with various other blood parameters in gestational diabetes development. J Obstet Gynaecol. 2016;36(5):589-93.