Iron status, hepcidin, and CRP in children with endoscopically confirmed adenotonsillar hypertrophy: a controlled cross-sectional study

BACKGROUND: Adenotonsillar hypertrophy (ATH) may influence iron homeostasis through low-grade inflammation and upper airway obstruction, but findings in children remain inconsistent. This study aimed to compare hematologic, iron-related, and inflammatory parameters in school-aged children with and without endoscopically confirmed ATH. METHODS: This controlled cross-sectional study included 300 children aged 6-12 years (150 with ATH and 150 controls). Hemoglobin, serum iron, ferritin, mean corpuscular volume (MCV), C-reactive protein (CRP), and hepcidin were measured. Iron deficiency and anemia were defined according to World Health Organization criteria. Continuous variables were compared using parametric or nonparametric tests as appropriate, and categorical variables were analyzed using Pearson's chi-square test. RESULTS: No statistically significant between-group differences were found in hematologic, iron-related, or inflammatory parameters. Iron deficiency was identified in 30% of children with ATH and 24% of controls (p = 0.24), whereas iron-deficiency anemia was present in 10% and 8%, respectively (p = 0.55). CRP and hepcidin levels were also comparable between groups. CONCLUSION: In this outpatient cohort, ATH was not associated with significant differences in routine iron indices, CRP, or hepcidin. These findings do not support routine iron evaluation solely on the basis of ATH, although targeted assessment may be considered in children with relevant clinical findings.