Does iron therapy have a place in the management of all breath-holding spells?

Pediatr Int. 2021 Nov;63(11):1344-1350. doi: 10.1111/ped.14685. Epub 2021 Oct 28.

Abstract

Background: Aim of this study was to analyze the effect of iron therapy in children with breath-holding spells, irrespective of their hemoglobin level.

Method: All of the children were evaluated in terms of age, sex, age at onset of the attack, attack frequency, type of breath-holding spell, family pedigree, laboratory values. All enrolled patients were given iron at the dose of 4 mg/kg/day as a single daily dose for 3 months. Patients were called for follow-up appointments 1 and 3 months after the initiation of treatment to record the frequency and severity of spells.

Results: The mean age of the patients was 12.50 ± 9.51 months. Patients were divided into two groups according to the hemoglobin level. The frequency of anemia in children with spells was recorded as 27%. Out of 100 patients treated with iron, 43% showed complete remission at the end of 1 month. At the end of the 3 months, percentage of complete responders increased to 80%. After three-month of iron treatment, 96.2% of the anemic and 73.97% of the non-anemic patients were spell-free. Eight children had mild adverse effects after iron therapy that did not require dose modification.

Conclusions: This study confirmed that iron therapy reduces spell frequency regardless of anemia in all breath-holding spells. A three-month empiric iron therapy should be offered to all children with spells.

Keywords: breath-holding spell; children; empiric iron therapy.

MeSH terms

  • Anemia*
  • Breath Holding*
  • Child
  • Humans
  • Infant
  • Iron
  • Seizures

Substances

  • Iron