Comprehensive Evaluation of Inflammatory Biomarkers and Osmolarity to Distinguish Simple and Complex Febrile Seizures
Özlem Erdede1, Erdal Sarı1, Emek Uyur2
1Department of Pediatrics, Zeynep Kamil Maternity and Children's Disease Training and Research Hospital, University of Health Sciences, 34668 Istanbul, Turkey.
Insights
Osmolarity effectively distinguishes between simple and complex febrile seizures (FS) in children, unlike other blood count biomarkers. This finding suggests osmolarity can be a valuable clinical tool for diagnosing FS types.
Area of Science:
- Pediatric Neurology
- Clinical Biochemistry
Background:
- Febrile seizures (FS) classification relies on biomarkers, but existing research has limitations.
- Complete blood count (CBC)-associated biomarkers and osmolarity require further investigation for diagnostic value in FS.
Purpose of the Study:
- To evaluate CBC-associated biomarkers and osmolarity for classifying simple versus complex febrile seizures.
- To determine the diagnostic utility of these markers in pediatric FS.
Main Methods:
- Retrospective analysis of 364 children (5-60 months) with FS, categorized into simple (n=221) and complex (n=143) groups.
- Evaluation of CBC, biochemical tests (sodium, potassium, chloride, glucose, BUN, CRP), and calculated ratios (NLR, MPVLR).
- Osmolarity was calculated and compared between FS types; ROC curve analysis assessed predictive utility.
Main Results:
- Inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), were ineffective in predicting FS types.
- Complex FS cases showed significantly lower osmolarity compared to simple FS cases.
- Osmolarity demonstrated a promising area under the ROC curve (0.754) for distinguishing complex FS, exceeding the 0.700 threshold.
Conclusions:
- Osmolarity shows significant clinical applicability in differentiating between simple and complex febrile seizures.
- Osmolarity can serve as an additional diagnostic tool for physicians managing pediatric FS.
- Further research into osmolarity's role in FS classification is warranted.
Abstract:
With limited sample sizes and varying study outcomes regarding complete blood count (CBC)-associated biomarkers and their febrile seizure (FS) classification, along with limited research on osmolarity, this study aims to evaluate CBC-associated biomarkers, including osmolarity, for a comprehensive view of their diagnostic value. This single-center retrospective study used data from 364 children (aged 5-60 months) diagnosed with FS. The patients were categorized into simple FS (n = 221) and complex FS (n = 143) groups. CBC and biochemical tests, including sodium, potassium, chloride, glucose, blood urea nitrogen, and C-reactive protein levels, were evaluated. The neutrophil-to-lymphocyte ratio (NLR), mean platelet volume-to-lymphocyte ratio, and osmolarity were calculated and compared between FS types and the number of seizures. Receiver operating characteristic (ROC) curve analysis was conducted to assess the predictive utility of these markers. Inflammatory markers, including NLR, were ineffective in predicting FS types. Complex FS cases exhibited a significantly lower osmolarity than simple FS cases. The area under the ROC curve for osmolarity to distinguish complex FS was 0.754, while other markers did not reach the desired threshold of 0.700. Including osmolarity in the classification of FS has clinical applicability. Physicians may consider osmolarity as an additional tool to aid in clinical decision-making.
