Iron status in children undergoing tonsillectomy and its short-term modification following surgery

Red cell and iron status parameters were studied in a group of 44 children undergoing tonsillectomy for recurrent throat infections and in a control group of 40 healthy children. In the patient group, before tonsillectomy, 8 children presented a latent iron deficiency and 15 a decrease in serum ferritin levels. This altered iron status can be attributed to a reduced intestinal iron absorption, due to recurrent infections. One and seven days following surgery there was a significant fall in serum iron, serum transferrin and transferrin saturation, in parallel with an increase of serum ferritin and alpha-2 globulins levels. These modifications cannot be attributed to the blood loss, as proven by the constancy of haemoglobin level and of other red cell parameters, but to an unspecific reaction to surgical stress, as observed in fever, traumas and inflammation. They reflect an altered processing of iron, with a temporary block of its release to plasma and an increased storage within the reticuloendothelial cells.