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Breath Collection from Children for Disease Biomarker Discovery
Published on: February 14, 2019
Paediatric breath-holding spells are associated with autonomic dysfunction and iron deficiency may play a role
H Tomoum1, N Habeeb1, I Elagouza1
1Department of Paediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Insights
Breath-holding spells (BHSs) in young children may be linked to autonomic dysfunction. Lower iron levels and abnormal ECG findings like prolonged QT dispersion were observed in BHS patients, suggesting a potential role for iron deficiency.
Area of Science:
- Pediatric Cardiology
- Autonomic Nervous System Function
Background:
- Breath-holding spells (BHSs) are common in young children, often linked to autonomic nervous system dysregulation.
- Assessing cardiac function and iron status in BHS patients is crucial for understanding underlying mechanisms.
Purpose of the Study:
- To evaluate cardiac performance and iron status in children aged 12-36 months experiencing BHSs.
- To investigate potential correlations between BHS characteristics and observed physiological markers.
Main Methods:
- A case-control study involving 40 children with BHSs and 20 healthy controls.
- Included assessment of serum iron levels and electrocardiograms (ECGs) to analyze cardiac parameters.
Main Results:
- Patients with BHSs exhibited lower serum iron levels and increased QT dispersion and T-wave dispersion compared to controls.
- 4.8% of patients showed dysrhythmia and bradycardia, with longer bradycardia durations during cyanotic spells.
- Prolonged or frequent BHSs were associated with higher occurrences of dysrhythmia.
Conclusions:
- Findings support the hypothesis of autonomic dysfunction in BHSs, particularly in children with prolonged or frequent spells.
- Iron deficiency may contribute to autonomic dysfunction in BHS patients.
- Further research on ECG findings is warranted to assess the risk of life-threatening events.
Aim:
This study assessed cardiac performance and iron in subjects aged 12-36 months with breath-holding spells (BHSs).
Methods:
We consecutively recruited 40 subjects (55% male) experiencing BHSs from the general paediatric outpatients department at the Children's Hospital, Ain Shams University, Egypt, from 2015 to 2016. The 20 matched comparisons were mainly healthy siblings. The workup included iron levels and electrocardiograms.
Results:
The age at the onset of BHSs was 5-24 months with a median monthly frequency of 13. Almost two-thirds of the patients had cyanotic spells, and one-third had pallid spells, lasting 25-90 seconds. Lower serum iron levels and higher QT dispersion and T-wave dispersion were recorded in patients than the comparison group, and 4.8% had dysrhythmia and bradycardia. We observed higher durations of bradycardia during attacks and higher occurrences of dysrhythmia during cyanotic spells, which were more frequent in patients with prolonged or frequent BHSs.
Conclusion:
Our study of patients aged 12-13 months supported the theory of autonomic dysfunction in BHSs. The ECG findings, especially in patients with prolonged or frequent spells, need to be studied further to evaluate the risk of life-threatening events. Iron deficiency may play a role in autonomic dysfunction in patients with BHSs.
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