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Low iron storage in children with tilt positive neurally mediated syncope

Baris Guven1, Taliha Oner, Vedide Tavli

  • 1Department of Pediatric Cardiology, Izmir Dr Behcet Uz Children's Hospital, Izmir, Turkey. drbarisguven@yahoo.com

World Journal of Pediatrics : WJP
|January 1, 2013
PubMed

Insights

Low iron storage may contribute to neurally mediated syncope (NMS) in children. Evaluating serum ferritin levels is recommended for children experiencing syncope, especially after a positive head-up tilt test.

Area of Science:

  • Pediatric Cardiology
  • Neurology
  • Hematology

Background:

  • Neurally mediated syncope (NMS) mechanisms in children remain unclear.
  • This study investigates the relationship between iron storage and hemodynamic patterns in pediatric syncope.
  • Head-up tilt testing (HUTT) is a diagnostic tool for syncope evaluation.

Purpose of the Study:

  • To assess iron storage levels in children diagnosed with different hemodynamic patterns during HUTT.
  • To explore the potential role of iron deficiency in the pathophysiology of NMS in pediatric patients.

Main Methods:

  • Prospective study of 210 children (11.31±2.49 years) with syncope or pre-syncope.
  • Evaluated medical history, physical examination, hemoglobin (Hb), hematocrit (Hct), and serum ferritin levels.
  • 98 children with NMS underwent a positive head-up tilt test.

Main Results:

  • Significantly lower serum ferritin levels were observed in children with NMS compared to controls (P<0.001).
  • Reduced iron storage (serum ferritin <25 ng/mL) was more prevalent in NMS patients (63% vs. 20%, P<0.001).
  • Iron deficiency prevalence was higher in children with NMS (27% vs. 6%, P=0.003).

Conclusions:

  • Serum ferritin levels should be evaluated in children with NMS and positive HUTT results.
  • Low iron storage is a potential underlying mechanism contributing to neurally mediated syncope in children.
Abstract

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