Leukocyte count and erythrocyte sedimentation rate as diagnostic factors in febrile convulsion

Area of Science:

• Pediatrics
• Neurology
• Clinical Pathology

Background:

• Febrile convulsion (FC) is a common childhood seizure disorder.
• White blood cell (WBC) and erythrocyte sedimentation rate (ESR) are frequently measured in children with FC.
• External factors like trauma or bleeding can affect WBC and ESR, necessitating careful clinical interpretation.

Purpose of the Study:

• To investigate the relationship between WBC and ESR levels and the occurrence of FC in children.
• To determine if elevated WBC counts in FC are a direct result of the convulsion itself or an underlying infection.

Main Methods:

• A cross-sectional study involving 410 children aged 6 months to 5 years over 18 months.
• Patients were admitted to Bahrami Children hospital within 48 hours of febrile illness, with or without seizure.
• Data collected included age, sex, temperature, history of vomiting, bleeding, trauma, and levels of WBC, ESR, and hemoglobin.

Main Results:

• A significant increase in WBC (P<0.001) was observed in children with FC, suggesting leukocytosis can be caused by the convulsion itself.
• No significant difference in ESR (P=0.113) was found between children with and without FC.
• Elevated ESR is indicative of an underlying pathology, not necessarily the convulsion.

Conclusions:

• Elevated WBC counts in febrile convulsions may be a direct consequence of the seizure activity.
• ESR is not a reliable indicator for differentiating FC from other febrile illnesses in stable patients without signs of bacterial infection.
• WBC and ESR testing may not be necessary in stable febrile patients without indications for lumbar puncture or suspicion of bacterial infection.