Semra Hız, Uluc Yis, Erhan Bayram, Pakize Karaoglu, Ceren Cirali, Muge Ayanoglu, Ipek Polat

Inflammation and anemia in simple febrile seizures and complex febrile seizures

Aim: This is a unique study that aimed to determine anemia and inflammatory status in simple febrile seizure vs complex febrile seizure patients. Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio are positively correlated with inflammatory markers including TNF alpha and IL-6. They are practical, inexpensive, and valuable tools for evaluating inflammation. Materials and Methods: Patients presenting with first febrile seizures were enrolled retrospectively. We investigated hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration and red blood cell distribution width values and white blood cell count, neutrophil, lymphocyte count, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and mean platelet volume, C - reactive protein. Results: Our study showed that higher neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and lower mean platelet volume values in complex febrile seizure cases than simple febrile seizure cases. We determined cut-off values for neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and mean platelet volume of 2.5, 10523.3, and 7.3 respectively. Conclusion: High neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and low mean platelet volume values can help distinguish simple febrile seizure and complex febrile seizure patients and predict the clinic. The optimal cut-off values that we determined may guide clinicians.

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1. Bidabadi E, Mashouf M. Association between iron deficiency anemia and first febrile convulsion: A case–control study. Seizure 2009;18:347-51.
2. Pavlidou E, Hagel C, Panteliadis C. Febrile seizures: recent developments and unanswered Questions. Childs Nerv Syst 2013;29:2011-17.
3. McClellanda S, Dubéa CM, Yanga J, Baram TZ. Epileptogenesis after prolonged febrile seizures: Mechanisms, biomarkers and therapeutic opportunities. Neuroscience Letters 2011;497:155- 62.
4. Hesdorffer DC, Shinnar S, Lewis DV, , et al. Consequences of Prolonged Febrile Seizures in Childhood (FEBSTAT) Study Team. Risk Factors for Febrile Status Epilepticus: A Case-Control Study. J Pediatr 2013;163(4):1147-51.
5. Sfaihi L, Maaloul I, Kmiha S, et al. Febrile seizures: an epidemiological and outcome study of 482 cases. Childs Nerv Syst 2012;28:1779-84.
6. Johnston MV. Iron Deficiency, Febrile Seizures and Brain Development. Indian Pediatr 2012;49:13-4.
7. Kuang YQ, Kong B, Yang T, Cheng L, Gu JW, Zhou HT, et al. Epileptiform Discharges and Frontal Paroxysmal EEG Abnormality Act as Predictive Marker for Subsequent Epilepsy in Children with Complex Febrile Seizures. Clin EEG Neurosci 2014;45:299-303.
8. Yoong M, Martinos MM, Chin RF, Clark CA, Scott RC. Hippocampal volume loss following childhood convulsive status epilepticus is not limited to prolonged febrile seizures. Epilepsia 2013;54:2108- 15.
9. Chou IC, Lin WD, Wang CH, et al. Interleukin (IL)-1b, IL-1 Receptor Antagonist, IL-6, IL-8, IL-10, and Tumor Necrosis Factor a Gene Polymorphisms in Patients With Febrile Seizures. J Clin Lab Anal 2010;24:154-9.
10. Vezzani A, Maroso M, Balosso S, et al. IL-1 receptor/Toll-like receptor signaling in infection, inflammation, stress and neurodegeneration couples hyperexcitability and seizures. Brain Behav Immun 2011;25:1281-9.
11. Atici Y, Alehan F, Sezer T, T et al. Serum S100B levels in children with simple febrile seizures. Seizure 2012;21:175-7.
12. Teran CG, Medows M, Wong SH, et al. Current Role of the Laboratory Investigation and Source of the Fever in the Diagnostic Approach. Pediatr Emerg Care 2012;28:493-7.
13. Dubé CM, Ravizza T, Hamamura M, Zha Q, Keebaugh A, Fok K, et al. Epileptogenesis provoked by prolonged experimental febrile seizures: mechanisms and biomarkers. J Neurosci 2010;30:7484-94.
14. Nur BG, Kahramaner Z, Duman O, Dundar NO, Sallakcı N, Yavuzer U, et al. Interleukin-6 Gene Polymorphism in Febrile Seizures. Pediatric Neurology 2012;46:36-8.
15. Haspolat S, Baysal Y, Duman O, et al. Interleukin-1a, Interleukin-1b, and Interleukin-1Ra Polymorphisms in Febrile Seizures. J Child Neurol 2005;20:565-8.
16. Feng JF, Huang Y, Liu JS. Combination of neutrophil lymphocyte ratio and platelet lymphocyte ratio is a useful predictor of postoperative survival in patients with esophageal squamous cell carcinoma. Onco Targets Ther 2013;6:1605-12.
17. Ozaydin E, Arhan E, Cetinkaya B, et al. Differences in iron deficiency anemia and mean platelet volume between children with simple and complex febrile seizures. Seizure 2012;21:211-4.
18. Tosun A, Koturoglu G, Serdaroglu G, et al. Ratios of Nine Risk Factors in Children With Recurrent Febrile Seizures. Pediatr Neurol 2010;43:177-82.
19. Bucak A, Ulu S, Oruc S, et al. Neutrophil-toLymphocyte Ratio as a Novel-Potential Marker for Predicting Prognosis of Bell Palsy. Laryngoscope 2014;124:1678-81.
20. Farah R, Khamisy-Farah R. Association of Neutrophil to Lymphocyte Ratio With Presence and Severity of Gastritis Due to Helicobacter pylori Infection. J Clin Lab Anal 2014;28:219-23.
21. Fallah R, Tirandazi B, Akhavan Karbasi S, Golestan M. Iron Deficiency and Iron Deficiency Anemia in Children with Febrile Seizure. Iran J Ped Hematol Oncol 2013;3:200-3.
22. Daoud AS, Batieha A, Abu-Ekteish F, et al. Iron Status: A Possible Risk Factor for the First Febrile Seizure. Epilepsia 2002;43:740-3.
23. Akin F, Solak ES, Kilicaslan C, Boke SB, Arslan S. Iron Deficiency Anemia among Hospitalized Children in Konya, Turkey. Anemia 2013;2013:514801.
24. Reid AY, Riazi K, Campbell Teskey G, Pittman QJ. Increased excitability and molecular changes in adult rats after a febrile seizure. Epilepsia 2013;54:45-8.
25. Pavlidou E, Panteliadis C. Prognostic factors for subsequent epilepsy in children with febrile seizures. Epilepsia 2013;54:2101–7.
26. Yigit Y, Yilmaz S, Akdogan A, et al. The role of neutrophillymphocyte ratio and red blood cell distribution width in the classification of febrile seizures. Eur Rev Med Pharmacol Sci 2017;21:554-9.
27. 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;18:3380-5.
28. Liu Z, Li X, Zhang M, 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;8:15123.
29. Gunluoglu G, Yazar EE, Veske NS, et al. Mean platelet volume as an inflammation marker in active pulmonary tuberculosis. Multidiscip Respir Med 2014;9:11.
30. Oncel MY, Ozdemir R, Yurttutan S, et al. Mean platelet volume in neonatal sepsis. J Clin Lab Anal 2012;26:493-6.
31. Kisacik B, Tufan A, Kalyoncu U, et al. Mean platelet volume (MPV) as an inflammatory marker in ankylosing spondylitis and rheumatoid arthritis. Joint Bone Spine 2008;75:291-4.