Does Iron Therapy Affect the Frequency of Breath-Holding Attacks in Children?

Abstract

Clinical scenario: A two-year-old girl presents with repetitive episodes of facial cyanosis with occasional collapse. The episodes last for less than a minute and occur up to three times a day. She makes a rapid recovery after each episode and her mother states that the episodes are worse when Chloe is tired, irritable or does not get her own way. Her physical examination and past medical history is unremarkable. Blood tests are within the normal range with a low normal haemoglobin result 101 g/L. Her elec- trocardiogram and electroencephalogram are normal. Breath- holding attacks (BHAs) are diagnosed. It has been postulated that iron may be beneficial for treatment. Structured clinical question: In children with BHAs (P), does iron therapy (I) compared to placebo (C) affect the frequency of BHAs (O)?