Can the Proinflammatory process affect breath-holding spells?

Abstract

Breath-holding occurs after often pain, anger, crying, trauma, etc. in early childhood. It is defined as episodes of breathlessness and discoloration. Although the pathophysiology of breath-holding is not fully known, it is thought to be due to many factors. Factors such as genetic predisposition, iron deficiency anemia, autonomic nervous system immaturity, vagal-mediated cardiac inhibition, delayed myelination of the brain stem have been blamed in the etiopathogenesis. In our study, we aimed to evaluate the role of lymphocyte/monocyte ratio, neutrophil/lymphocyte ratio, neutrophil/monocyte ratio, MPV/platelet ratio parameters, which are indirect markers of inflammation, in etiopathogenesis. The files of 48 patients who were diagnosed with breath-holding in the pediatric neurology clinic of Balıkesir University Faculty of Medicine between 01.01.2020-01.01.2021 were retrospectively reviewed. The demographic characteristics and laboratory results of 42 healthy children who were admitted to the pediatric clinic in the same period and who were similar to the study group were compared. When the breath-holding was compared with the control group; age, WBC, hemoglobin, hematocrit, MCV, serum iron, serum iron-binding capacity, ferritin, lymphocyte, lymphocyte percentage, neutrophil percentage, neutrophil/lymphocyte ratio was found to be significantly different. Neutrophil percentage, lymphocyte percentage, lymphocyte, neutrophil/lymphocyte ratio which was found to be significantly different are accepted as indicators of subclinical infection or systemic inflammatory response. It is necessary to investigate whether infection, which is one of the most common causes of inflammation in children, is a triggering factor in breath-holding. We think that the presence of infection and/or inflammation should be excluded in the etiopathogenesis of breath-holding. We believe that it would be appropriate to evaluate the lymphocyte/monocyte ratio, neutrophil/lymphocyte ratio, neutrophil/monocyte ratio, MPV / platelet ratio, which is accepted as proinflammation parameters of patients with breath-holding.