الفهرس 
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Abstract
Iron deficiency is the most common nutritional disorder worldwide and affects millions of infants and children. About 27% of children in Egypt have iron deficiency anemia. Several metabolic and functional consequences of iron deficiency have been described. Studies in both animals and humans have shown poor thermoregulation to be one of these deleterious consequences and have implicated impaired thyroid hormone metabolism as a likely cause. Data indicate that iron deficiency impairs thyroid metabolism that has been explained by the iron dependence of Thyroid Peroxidase (TPO), which is a haem containing enzyme, responsible for iodide oxidation into iodine, then its binding to tyrosine residue of thyroglobulin for formation of Mono-Iodotyrosine (MIT) and Di-Iodotyrosine (DIT). Nevertheless, limited studies investigating the interaction and display of ID and thyroid hormones in humans are present. We investigate the association between thyroid dysfunction among children with isolated IDA.
The present study is a prospective cohort study that was carried out at the outpatient clinics of October 6 and Beni-Suef University Hospitals. We included 50 children aged 4-12 years with clinical & laboratory evidence of iron deficiency anemia. The mean age of the included patients was 7.4 ±2.6 years, while the majority of them were males (60%). The mean weight of the included patients was 24.3 ±7.2 kg as well. With regard to laboratory findings, the mean hemoglobin level was 9.4 ± 0.63g/dL, while the mean iron level was 31.06±2.8µg/dL. In addition, the mean ferritin and TIBC levels were 12.7 ±1.9ng/mL and 468.68 ±45.7mg/dL, respectively. The thyroid function tests of the included patients showed that the mean T3 level was 2.9 ±1.15 pg/ml, while the mean T4 was 1.2 ±0.4 ng/dl. In addition, TSH level was 3.8 ±2.3 mU/L. Based on these findings, 14% of the patients had low level of T4 and 26% of the patients had high TSH level. Seven children (14%) were diagnosed with either subclinical or overt hypothyroidism. There was a statistically significant difference between hypothyroidism group and normal patients in laboratory findings. Patients with hypothyroidism had statistically significant lower hemoglobin (p= 0.002) and ferritin (p =0.014) compared to normal patients; while TIBC was significantly higher in hypothyroidism group (p <0.001). Our findings showed a statistical significant negative correlation between hemoglobin level and TSH level (r= -0.477, p< 0.001) and a statistically significant positive correlation hemoglobin and T4 level (r= 0.471, p< 0.001), in addition, there was a significant negative correlation between TIBC level TSH level (r= 0.681, p<0.001) and T4 level (r= -0.57, p< 0.001).
In conclusion, the present study shows that iron deficiency anaemia is significantly related to thyroid function in children. Patients with hypothyroidism had statistically significant lower hemoglobin and ferritin levels compared to other anaemic patients with normal thyroid function; while TIBC was significantly higher in hypothyroidism group. Nevertheless, further large-scale studies are still needed to confirm our findings.