SPECIFICS OF CLINICAL MANIFESTATIONS AND NEUROPHYSIOLOGICAL CORRELATES OF AFFECTIVE RESPIRATORY ATTACKS IN CHILDREN WITH IRON DEFICIENCY ANEMIA

Abstract

Objective. To identify specific clinical features and neurophysiological correlates of affective respiratory attacks (ARAs) in young children with concomitant iron deficiency anemia (IDA). Methods. In a comparative study, 120 children aged 1 to 5 years with verified ARAs were examined, divided into two groups: the main group (n=60, ARA with IDA) and the control group (n=60, ARA without iron metabolism disorders). The clinical picture, neurological status, heart rate variability (HRV) indices, and electroencephalography (EEG) data were analyzed. Results. Children with IDA exhibited a specific clinical phenotype of ARA: predominance of the cyanotic type of attacks (70% vs. 50% in controls, p<0.05), higher frequency of paroxysms (3.3±1.5 per week), and pronounced post-attack asthenia. Neurophysiologically, this correlated with the predominance of theta activity on EEG (index 42±8%) and a decrease in the total power of the HRV spectrum (1245±310 ms²), reflecting functional immaturity of brainstem structures and exhaustion of autonomic reserves. Conclusion. The specificity of ARAs against the background of IDA is determined by metabolic disorders in the CNS, manifesting as vagotonia (cyanosis), slowing of cortical rhythms (theta activity), and decreased adaptive potential. The identified neurophysiological markers allow for the differentiation of "iron-dependent" paroxysms from epilepsy and substantiate pathogenetic therapy with iron preparations.