PURPOSE: Thrombocytopenia has been reported in some children with severe iron deficiency anemia, but the validity of the association and the mechanism of the thrombocytopenia are not well established. Six children with severe iron deficiency and thrombocytopenia are described, and the literature is reviewed. PATIENTS AND METHODS: Clinical, hematologic, and morphologic data were collected and analyzed for six patients referred for evaluation of severe microcytic anemia and thrombocytopenia. RESULTS: The children ranged in age from 14 months to 17 years (median age 27 months) and were otherwise healthy. The iron deficiency was nutritional in four patients younger than 3 years of age and resulted from menstrual blood loss in two teenage girls. The mean initial hemoglobin was 2.5 g/dL (range 1.6-4.7) and the mean initial platelet count was 64 x 109/L (range 11-102). Bone marrow examinations were performed in three patients and showed increased numbers of megakaryocytes. After treatment with therapeutic doses of oral iron, all the patients showed rapid increases in their platelet counts. CONCLUSIONS: These observations validate and extend previous reports of an association between severe iron deficiency and thrombocytopenia. The increased numbers of megakaryocytes and the extremely rapid increase in platelet counts after initiation of iron therapy suggest an essential role for iron in a late stage of thrombopoiesis.
PURPOSE:Thrombocytopenia has been reported in some children with severe iron deficiency anemia, but the validity of the association and the mechanism of the thrombocytopenia are not well established. Six children with severe irondeficiency and thrombocytopenia are described, and the literature is reviewed. PATIENTS AND METHODS: Clinical, hematologic, and morphologic data were collected and analyzed for six patients referred for evaluation of severe microcytic anemia and thrombocytopenia. RESULTS: The children ranged in age from 14 months to 17 years (median age 27 months) and were otherwise healthy. The iron deficiency was nutritional in four patients younger than 3 years of age and resulted from menstrual blood loss in two teenage girls. The mean initial hemoglobin was 2.5 g/dL (range 1.6-4.7) and the mean initial platelet count was 64 x 109/L (range 11-102). Bone marrow examinations were performed in three patients and showed increased numbers of megakaryocytes. After treatment with therapeutic doses of oral iron, all the patients showed rapid increases in their platelet counts. CONCLUSIONS: These observations validate and extend previous reports of an association between severe irondeficiency and thrombocytopenia. The increased numbers of megakaryocytes and the extremely rapid increase in platelet counts after initiation of iron therapy suggest an essential role for iron in a late stage of thrombopoiesis.
Authors: Van K Morris; Holly L Spraker; Scott C Howard; Russell E Ware; Ulrike M Reiss Journal: Pediatr Hematol Oncol Date: 2010-08 Impact factor: 1.969
Authors: Ramy Ibrahim; Areej Khan; Shahzad Raza; Muhammad Kafeel; Ridhima Dabas; Elizabeth Haynes; Anjula Gandhi; Omran L Majumder; Mohammad Zaman Journal: Clin Med Insights Case Rep Date: 2012-03-26
Authors: Ramy Ibrahim; Jaffar Ahmad Alhilli; Tyler T Cooper; Irina Dashkova; Judah Guy; Anjula Gandhi; Mohammad Zaman Journal: Clin Med Insights Blood Disord Date: 2013-04-14
Authors: Zhi-Jian Liu; Emoke Deschmann; Haley E Ramsey; Henry A Feldman; Bethan Psaila; Nichola Cooper; Evangelia Vlachodimitropoulou; John Porter; James Bussel; Michael Georgieff; Martha Sola-Visner Journal: Blood Adv Date: 2022-01-11