Frequency of hypocalcemia in children aged 6 months to 5 years presenting with febrile convulsions at a Tertiary Care Hospital.

Abstract

Objective: To determine the frequency of hypocalcemia among children presenting with febrile seizures and to identify clinical predictors associated with low serum calcium levels. Study Design: Cross-sectional Observational study. Setting: Department of Pediatric, Pakistan Air Force Hospital, Sargodha. Period: 1^st September 2024 to 31^st August 2025. Methods: A total of 147 children aged 6 months to 5 years presenting with febrile seizures were enrolled using a non-probability consecutive sampling technique. Children with known neurological disorders, metabolic diseases, renal disease, or those receiving calcium/vitamin D supplementation were excluded. The demographic and clinical data including age, gender, weight, height, body temperature, and frequency of seizure episodes were recorded using a structured proforma. Serum calcium levels were measured in laboratory using Atomic Absorption Spectrometry and hypocalcemia was defined as serum calcium <8.5 mg/dL. Data were analyzed using SPSS version 25. Descriptive statistics and binary logistic regression were used to identify predictors of hypocalcemia. Results: Among 147 children 85 (57.8%) were males and 44 (29.9%) were female. Hypocalcemia was observed in 44(29.9%). Children with hypocalcemia were younger (median 2.5 vs. 3.5 years) and had lower median weight and height compared with normocalcemic children. Multiple seizure episodes and younger age were significant predictors of hypocalcemia (p = 0.001 and 0.024, respectively). Conclusion: Hypocalcemia is relatively common among children presenting with febrile seizures particularly in young children and those with recurrent seizure episodes. Early recognition and monitoring are essential to prevent complications. The need of early recognition and correction of hypocalcemia may help reducing seizure recurrence and associated complications.