Febril konvulziyonlu hastalarda hemogram parametrelerinin değerlendirilmesi: Tek merkez deneyimi

Öz

Amaç: Febril konvülziyon patofizyolojisinde artan proinflamatuar (IL-1β, IL-6 ve TNF-α) sitokinlerin etkisiyle kan hücrelerinin oranları ve fonksiyonel özellikleri değişir. Periferik kandaki lökosit sayısı, nötrofil/lenfosit oranı, trombosit sayısı, ortalama trombosit sayısı ve kırmızı kan hücresi dağılım genişliği inflamasyon belirteçleri olarak kullanılabilecek önemli hemogram indeksleridir. Bu çalışmanın amacı febril konvülziyon tanısı ile takip edilen hastalar ile (basit/komplike) aynı zaman dilimindeki sağlıklı kontrol gruplar arasında hemogram parametrelerinin değerlendirilmesi amaçlanmıştır. Yöntem: Ağustos 2019-Mart 2021 tarihlerinde 6 ay-6 yaş arasında basit ve komplike febril konvülziyon tanısı alan ve ilk 24 saat içinde hemogram tetkiki yapılan hastalar, retrospektif olarak gözlemsel analitik vaka kontrol çalışması olarak değerlendirildi. Bulgular: Febril konvülziyon grubu ile kontrol grubu arasında; hemoglobin (Hb) (p=0.048), hematokrit (Hct) (p=0.045), trombosit (plt) (p=0.001), eozinofil (p=0.001) sayılarının, ortalama trombosit hacmi (MPV) (p=0.026), MPV/Plt (p=0.006), Plt/MPV (p=0.001) oranlarının iki grup arasında istatiksel olarak farklı olduğu saptandı. Sonuç: Hemoglobin, hematokrit, trombosit, MPV, MPV/Plt inflamatuar bir süreç olan febril konvülziyon ile ilişkili bulunmuştur. Konu ile ilgili prospektif daha yüksek katılımlı çalışmalara ihtiyaç bulunmaktadır.

Anahtar Kelimeler

• çocuk
• febril konvülziyon
• hemogram alt parametreleri

Evaluation of hemogram parameters in patients with febrile convulsion: a single center experience

Öz

Objective: In the pathophysiology of febrile convulsions, the proportions and functional properties of blood cells change with the effect of increased proinflammatory (IL-1β, IL-6 and TNF-α) cytokines. Peripheral blood leukocyte count, neutrophil/lymphocyte ratio, platelet count, mean platelet count and red blood cell distribution width are important hemogram indices that can be used as inflammation markers. The aim of this study was to evaluate the hemogram parameters between patients followed up with the diagnosis of febrile seizures (simple/complex) and healthy control groups in the same time period. Method: Patients who were diagnosed with simple and complex febrile convulsions between the ages of 6 months and 6 years between August 2019-March 2021 that had hemogram examination within the first 24 hours were evaluated retrospectively as an observational analytical case-control study. Results: Hemoglobin (Hb) (p=0.048), hematocrit (Hct) (p=0.045), platelet (plt) (p=0.001), eosinophil (p=0.001) counts, mean platelet volume (MPV) (p=0.026), MPV/Plt (p=0.006), Plt/MPV (p=0.001), ratios were found to be statistically different between the febrile convulsion group and the control group. Conclusion: Hemoglobin, hematocrit, thrombocyte, MPV, MPV/Plt have been found to be an inflammatory process associated with febrile convulsion. Further prospective studies with larger numbers of participants are now require.

Anahtar Kelimeler

• Child
• febrile convulsion
• hemogram subparameters

Kaynakça

1. 1. Tchapyjnikov MMAD. seizures in childhood-febrile seizures. In: Kliegman SG, Blum, Shah, Tasker, Wilson., editor. Nelson Text Book of Pediatrics: Elsevier 2018. p. 3092-94.
2. 2. Arzimanoglou A GR, Aicardi J. Febrile Convulsions. Aicardi’s epilepsy in children. 3rd ed. Philadelphila: Lippincott Williams and Wilkins; 2004. p. 220-34.
3. 3. Mikati MA HA. Febrile Seizures. In: Kliegman RM SB, Schor NF, St. Geme JW editor. Nelson Textbook of Paediatrics. 20th ed. Philadelphia: Elsevier; 2016. p. 2829.
4. 4. Jones T, Jacobsen SJ. Childhood febrile seizures: overview and implications. Int J Med Sci. 2007;4(2):110-4.
5. 5. Gupta S, Agarwal N, Maheshwari M. Iron deficiency as a risk factor for febrile seizure: A case control study. PJSR. 2015;8(2):37-40.
6. 6. Kumari PL, Nair MK, Nair SM, Kailas L, Geetha S. Iron deficiency as a risk factor for simple febrile seizures--a case control study. Indian Pediatr. 2012;49(1):17-9.
7. 7. Vaswani RK, Dharaskar PG, Kulkarni S, Ghosh K. Iron deficiency as a risk factor for first febrile seizure. Indian pediatrics. 2010;47(5):437-9.
8. 8. Waheed N, Butt MA. Iron status: is there a role in febrile seizures? J Ayub Med Coll Abbottabad. 2012;24(3-4):128-30.

9. 9. 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.
10. 10. Virta M, Hurme M, Helminen M. Increased plasma levels of pro- and anti-inflammatory cytokines in patients with febrile seizures. Epilepsia. 2002;43(8):920-3.
11. 11. Chiba Y, Mizoguchi I, Hasegawa H, Ohashi M, Orii N, Nagai T, et al. Regulation of myelopoiesis by proinflammatory cytokines in infectious diseases. Cell Mol Life Sci. 2018;75(8):1363-76.
12. 12. Lappé JM, Horne BD, Shah SH, May HT, Muhlestein JB, Lappé DL, et al. Red cell distribution width, C-reactive protein, the complete blood count, and mortality in patients with coronary disease and a normal comparison population. Clin Chim Acta. 2011;412(23-24):2094-9.
13. 13. Yildirim Cetin G, Gul O, Kesici-Metin F, Gokalp İ, Sayarlıoglu M. Evaluation of the Mean Platelet Volume and Red Cell Distribution Width in FMF: Are They Related to Subclinical Inflammation or Not? Int J Chronic Dis. 2014;2014:127426.
14. 14. Sharma AK, Sharma R. Evaluating the association between iron deficiency and simple febrile seizure in children aged 6 months to 5 years: a case control study. Int J ContempPediatr. 2018;5:1003-7.
15. 15. Naveed ur R, Billoo AG. Association between iron deficiency anemia and febrile seizures. J Coll Physicians Surg Pak. 2005;15(6):338-40.
16. 16. Sharif MR, Kheirkhah D, Madani M, Kashani HH. The Relationship Between Iron Deficiency and Febrile Convulsion: A Case-Control Study. Glob J Health Sci. 2015;8(2):185-9.
17. 17. Panda SN. The Role of Iron Deficiency as a Risk Factor for Febrile Seizures.
18. 18. Paul SP, Seymour M, Flower D, Rogers E. Febrile convulsions in children. Nurs Child Young People. 2015;27(5):14-5.
19. 19. Goksugur SB, Kabakus N, Bekdas M, Demircioglu 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.
20. 20. Yigit Y, Yilmaz S, Akdogan A, Halhalli HC, Ozbek 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.
21. 21. ÖRNEK Z, KARDEŞ H, PİŞKİN İE, ÇALIK M. Comparison of hemogram parameters in febrile seizures types. Duzce Medical Journal. 2020;22(1):1-6.
22. 22. Daoud AS, Batieha A, Abu‐Ekteish F, Gharaibeh N, Ajlouni S, Hijazi S. Iron status: a possible risk factor for the first febrile seizure. Epilepsia. 2002;43(7):740-3.
23. 23. Modaresi M, Mahmoudian T, Yaghini O, Kelishadi R, Golestani H, Tavasoli A, et al. Is Iron insufficiency associated with Febrile seizure? Experience in an Iranian Hospital. Journal of Comprehensive Pediatrics. 2012;3(1):21-4.
24. 24. Malla T, Malla KK, Sathian B, Chettri P, Singh S, Ghimire A. Simple febrile convulsion and iron deficiency anemia a co-relation in Nepalese children. American Journal of Public Health Research. 2015;3(5A):p11-6.
25. 25. Gencer H, Kafadar İ, Köse G, Yıldırmak Y. Relationship of Febrile Convulsion with Iron Deficiency Anemia and Zinc Deficiency. Journal of Academic Research in Medicine. 2016;6(2).
26. 26. Ozaydin E, Arhan E, Cetinkaya B, Ozdel 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.
27. 27. Yildiz Y, Cakmak S, Calapoglu T, Hocoglu ZI, Karadeniz EG, Ozkasap S. Mean platelet volume can be used as a hospitalization criteria in pediatric patients diagnosed with acute bronchiolitis. 2018.
28. 28. 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.
29. 29. 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.
30. 30. Liu Z, Li X, Zhang M, Huang X, Bai J, Pan Z, et al. The role of Mean Platelet Volume/platelet count Ratio and Neutrophil to Lymphocyte Ratio on the risk of Febrile Seizure. Sci Rep. 2018;8(1):15123.
31. 31. Evans TC, Jehle D. The red blood cell distribution width. J Emerg Med. 1991;9 Suppl 1:71-4.
32. 32. 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.
33. 33. Kartal Ö, Kartal AT. Can we trust RDW for differentiation of febrile seizure types? Eur Rev Med Pharmacol Sci. 2015;19(3):345-6.
34. 34. Sahbaz A, Cicekler H, Aynioglu O, Isik H, Ozmen U. Comparison of the predictive value of plateletcrit with various other blood parameters in gestational diabetes development. J Obstet Gynaecol. 2016;36(5):589-93.