Effect of FeSO4 therapy on children presenting with migraine at a Tertiary Care Hospital, Karachi, Pakistan.

Abstract

Objective: To determine the effect of FeSO₄ therapy on children presenting with migraine at a tertiary care hospital. Study Design: Quasi-experimental study. Setting: Pediatrics Department of National Institute of Child Health, Karachi, Pakistan. Period: January 2025 to September 2025. Methods: A total of 170 children, aged 5–15 years and diagnosed with migraine were included. Iron deficiency anemia (IDA) was labeled using age and gender specific hematologic and biochemical thresholds. Children having IDA received oral FeSO₄ 3–6 mg/kg/day for 3 months, while non-IDA children were given standard care. Data were analyzed using IBM-SPSS v26 applying appropriate statistical tests taking p<0.05 as statistically significant. Results: Among 170 children, 93 (54.7%) were males, and the median age was 10.0 years (IQR 8.0–13.0). IDA was diagnosed in 46 (27.1%) children. After three months of FeSO₄ therapy, median hemoglobin increased from 10.4 (9.9–10.9) to 12.2 g/dL (11.8–12.6), ferritin from 15.3 (12.4–17.8) to 30.8 ng/mL (27.6–33.2), and serum iron from 48.4 (43.0–52.9) to 87.1 µg/dL (80.2–94.6), while TIBC declined from 396.0 (380.7–410.9) to 328.3 µg/dL (312.4–340.8) (all p<0.001). Migraine frequency reduced from 9.0 (7.4–11.5) to 4.0 (3.0–6.5) episodes/month, duration from 6.2 (5.0–7.5) to 3.1 (2.0–4.4) hours, VAS score from 7.2 (6.0–8.5) to 4.3 (3.0–5.5), and school absenteeism from 4.1 (3.0–5.3) to 1.6 (1.0–2.5) (all p<0.001). Conclusion: Among children with migraine, correction of IDA with oral FeSO₄ resulted in significant improvement in hematologic parameters and meaningful reductions in attack frequency, duration, and intensity.