Does Adenoid Hypertrophy Affect Hemoglobin and Erythropoietin Levels in Children?

Year 2024, Volume: 5 Issue: 1, 10 - 19, 06.03.2024

Sercan Çıkrıkcı Ali Can Çelik İbrahim Halil Çelikkıran Secaattin Gülşen

https://doi.org/10.46871/eams.1433494

Abstract

Objective: Adenoid hypertrophy restricts the nasal airflow by obstructing the choanae posteriorly and may lead to chronic hypoxia. The present study mainly aims to compare pre- and postoperative erythropoietin (EPO) and hemoglobin (Hgb) levels in children undergoing adenoidectomy.
Methods: Between 2021 September and 2022 August, 61 children who performed adenoidectomy in the ENT clinic included in this prospective clinical trial. The pre- and postoperative third months EPO and Hgb values of children were compared.
Results: The mean age of the children undergoing adenoidectomy was 5.7±3.4 (range, 3-9 years). Twenty-seven of the subjects were men and 34 were women. The mean EPO values of the adenoid hypertrophy patients preoperatively and at postoperative third months were 13.7±2.4 Mu/mL and 10.8±1.6 Mu/mL, respectively. The decrease in mean EPO value was significant (p = 0.031). The mean Hgb levels of the subjects preoperatively and at postoperative 3rd months were 12.1±2.4 g/dL and 11.9±1.6 g/dL, respectively. When pre- and postoperative 3rd month mean Hgb values compared, the difference was not significant (p = 0.721).
Conclusions: According to these outcomes, grade 4 adenoid hypertrophy is associated with significantly increased EPO values compared to post-operative values in children. To validate these results further prospective studies with larger sample sizes are required.

Keywords

Adenoid hypertrophy, Adenoidectomy, Erythropoietin, Hemoglobin, Hypoxia

References

• 1. Türkoğlu Babakurban S, Aydın E. Adenoidectomy: current approaches and review of the literature. Kulak Burun Bogaz Ihtis Derg 2016;26:181–90.
• 2. Thornval A. Wilhelm Meyer and the adenoids. Arch Otolaryngol 1969;90:383–6.
• 3. Atilla MH, Kaytez SK, Kesici GG, et al. Comparison between curettage adenoidectomy and endoscopic-assisted microdebrider adenoidectomy in terms of Eustachian tube dysfunction. Braz J Otorhinolaryngol 2020;86:38–43.
• 4. Kozcu SH, Demirhan E, Çukurova I. Curettage adenoidectomy versus endoscopic microdebrider adenoidectomy in children: A randomized controlled trial. Int J of Pediatr Otorhinolaryngol 2019;119:63–9.
• 5. Chang WD, Tseng CH, Tsou YA. Mean platelet volume levels in children with sleep-disordered breathing: A meta-analysis. BMC Pediatr 2020;20:1–9.
• 6. Akpinar I, Sayin MR, Gursoy YC, et al. Plateletcrit. A platelet marker associated with saphenous vein graft disease. Herz 2014;39:142–8.
• 7. Clemens J, McMurray JS, Willging JP. Electrocautery versus curette adenoidectomy: comparison of postoperative results. Int J Pediatr Otorhinolaryngol1998;43:115–22.
• 8. Bruni O, Ottaviano S, Guidetti V, et al. The Sleep Disturbance Scale for Children (SDSC). Construction and validation of an instrument to evaluate sleep disturbances in childhood and adolescence. J Sleep Res 1996;5:251-61.
• 9. Ağadayı E, Çelik N, Başer DA. Turkish Validity and Reliability of the Sleep Disturbance Scale for Children. Journal of Turkish Sleep Medicine 2020;2:65-72.
• 10. Abdel-Aziz M. Asymptomatic cardiopulmonary changes caused by adenoid hypertrophy. J Craniofac Surg 2011;22:1401–3.
• 11. Faraut B, Boudjeltia KZ, Vanhamme L, et al. Immune, inflammatory and cardiovascular consequences of sleep restriction and recovery. Sleep Med Rev 2012;16:137–9.
• 12. Korkmaz M, Korkmaz H, Küçüker F, et al. Evaluation of the Association of Sleep Apnea-Related Systemic Inflammation with CRP, ESR, and Neutrophil-to-Lymphocyte Ratio. Med Sci Monit 2015; 21:477-81.
• 13. Panoutsopoulos A, Kallianos A, Kostopoulos K, et al. Effect of CPAP treatment on endothelial function and plasma CRP levels in patients with sleep apnea. Med Sci Monit 2012;18:747-51.
• 14. Mehra R, Redline S. Sleep apnea: a proinflammatory disorder that coaggregates with obesity. J Allergy Clin Immunol 2008;121:1096–102.
• 15. Chami HA, Fontes JD, Vasan RS, et al. Vascular Inflammation and Sleep Disordered Breathing in a Community-Based Cohort Sleep 2013;36:763-8.
• 16. Derin S, Erdogan S, Sahan M, et al. Neutrophil-Lymphocyte Ratio in Patients with Adenoidectomy. J Clin Diagn Res 2016;10:3–5.
• 17. Haase VH. Regulation of erythropoiesis by hypoxia-inducible factors. Blood Rev 2013;27:41-53.
• 18. Sawant AC, Adhikari P, Narra SR, et al. Neutrophil to lymphocyte ratio predicts short- and long-term mortality following revascularization therapy for ST elevation myocardial infarction. Cardiol J 2014;21:500–8.
• 19. Yenigun A. The efficacy of tonsillectomy in chronic tonsillitis patients as demonstrated by the neutrophil-to-lymphocyte ratio. J Laryngol Otol 2015;129:386–91.
• 20. Kanbay A, Tutar N, Kaya E, et al. Mean platelet volume in patients with obstructive sleep apnea syndrome and its relationship with cardiovascular diseases. Blood Coagul 2013;24:532–6.
• 21. Akyol S, Çörtük M, Baykan AO, et al. Mean platelet volume is associated with disease severity in patients with obstructive sleep apnea syndrome. Clinics (Sao Paulo) 2015;70:481–5.
• 22. Varol E, Ozturk O, Gonca T, et al. Mean platelet volume is increased in patients with severe obstructive sleep apnea. Scand J Clin Lab Invest 2010;70:497–502.
• 23. Varol E, Ozturk O, Yucel H, et al. The effects of continuous positive airway pressure therapy on mean platelet volume in patients with obstructive sleep apnea. Platelets 2011;22:552–6.
• 24. Onder S, Caypinar B, Sahin-Yilmaz A, et al. Relation of mean platelet volume with obstructive adenoid hypertrophy in children. Int J Pediatr Otorhinolaryngol 2014;78:1449–51.
• 25. Kucur C, Kulekci S, Zorlu A, et al. Mean platelet volume levels in children with adenoid hypertrophy. J Craniofac Surg 2014;25:29-31.
• 26. Cengiz C, Erhan Y, Murat T, et al. Values of mean platelet volume in patients with chronic tonsillitis and adenoid hypertrophy. Pak J Med Sci 2013;29:569-72.
• 27. Erdim I, Erdur O, Oghan F, et al. Blood count values and ratios for predicting sleep apnea in obese children. Int J Pediatr Otorhinolaryngol 2017;98:85–90.
• 28. Beyan C, Beyan E. Plateletcrit may not provide a distinction between patients with adult -onset Still’s disease and sepsis. Wien Klin Wochenschr. 2021;133:247–8.