Iron deficiency found to be more prevalent in children with adenotonsillar hypertrophy

Background: To determine the prevalence of iron deficiency in paediatric patients requiring adenotonsillectomy. Methods: Point prevalence cohort study encompassing children 16 years of age or under undergoing adenoidectomy, tonsillectomy or both for either sleep disordered breathing (SDB) or recurrent tonsillitis. A single surgeon performed all the operations across 2 centres in Western Australia, using the same surgical technique. Perioperative blood sampling for iron studies and full blood picture (FBP) were analysed in a multicentre prospective cohort study of children requiring adenotonsillar surgery. The main outcome measure was Iron deficiency defined as a ferritin level of less than 20 µg/L Results: A total of 1,409 participants were included. The prevalence of iron deficiency was 33.9% (95% CI, 31.3–36.7%). An additional 60.8% had a borderline iron level based on ferritin levels and of these, 36.9% had a concurrent low transferrin saturation level indicating iron deficiency; 24.1% of children were deemed anaemic. The difference in iron deficiency prevalence between the recurrent tonsillitis and the SDB group did not reach statistical significance (38.1% vs. 33.3%, P=0.245). Conclusions: The prevalence of iron deficiency in this population is significantly higher than the reported general paediatric population. The role of iron in adenotonsillar hypertrophy is not yet fully understood. The authors recommend testing iron levels in this population and treating with oral iron supplementation as indicated.