Prospective study of severe breath holding spells and role of iron

Abstract

In a prospective longitudinal study, children with severe breath holding spells (BHS) were enrolled to evaluate the effect of oral iron in decreasing the frequency of BHS and to document the natural history of such spells in children not treated and in non-responders to the therapy. The patients who were anemic (hemoglobin more than 2 SD below the mean for that particular age) were treated with oral iron (6 mg/kg/day) for 12 weeks. Other patients served as controls. After 16 weeks from the initiation of treatment, the patients were evaluated for reduction in frequency of BHS. Fifty-nine children constituted the study group. The median frequency of BHS was weekly with 18% of patients having < 1 spell per day. The median age at peak frequency was 8–14 months. Anemia was present in 35/59 patients and these received oral iron therapy for 12 weeks. Twenty-four patients with no anemia constituted the control group. The treated group had a significant reduction in frequency of BHS (77% vs. (29%) compared with the control group (P < 0.01). Among patients in control group and partial and non-responders in the treatment group (39/59), the last spell occurred at mean and median age of 36 months. Iron has a significant role in termination of BHS in anemic patients.

Keywords

Breath holding spells - oral iron therapy