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Iron deficiency, an unusual cause of thrombocytopenia: results from a multicenter retrospective case-controlled study.

Authors
  • Huscenot, Tessa1
  • Darnige, Luc2
  • Wagner-Ballon, Orianne3
  • Ronchetti, Anne-Marie4
  • Lousteau, Valentine5
  • Limal, Nicolas1
  • Morbieu, Caroline1
  • Gobert, Delphine6
  • Rohmer, Julien7
  • Mathian, Alexis7
  • Le Cann, Marie8
  • Fadlallah, Jehane9
  • Languille, Laetitia1
  • Michel, Marc10
  • 1 Department of Internal Medicine, Hôpital Henri Mondor, National Referral Center for Adult' Immune Cytopenias, Université Paris-Est Créteil, Assistance Publique Hôpitaux de Paris, Créteil, France. , (France)
  • 2 Department of Hematobiology, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France. , (France)
  • 3 Department of Hôpital Henri Mondor, Université Paris-Est Créteil, Assistance Publique Hôpitaux, Créteil, France. , (France)
  • 4 Department of Clinical Hematology, Centre Hospitalier Sud-Francilien, Corbeil-Essonnes, France. , (France)
  • 5 Department of médecine interne, Centre Hospitalier Alpes Leman, Contamine sur Arves, France. , (France)
  • 6 Department of Internal Medicine, Hôpital Saint-Antoine, Assistance Publique Hôpitaux de Paris, Paris, France. , (France)
  • 7 Department of Internal Medicine, Hôpital La Pitié Salpêtrière, Assistance Publique Hôpitaux de Paris, Paris, France. , (France)
  • 8 Department of Hematobiology, Hôpital Saint-Antoine, Assistance Publique Hôpitaux de Paris, Paris, France. , (France)
  • 9 Department of Clinic Immunology, Hôpital Saint-Louis, Assistance Publique Hôpitaux de Paris, Paris, France. , (France)
  • 10 Department of Internal Medicine, Hôpital Henri Mondor, National Referral Center for Adult' Immune Cytopenias, Université Paris-Est Créteil, Assistance Publique Hôpitaux de Paris, Créteil, France. [email protected] , (France)
Type
Published Article
Journal
Annals of Hematology
Publisher
Springer-Verlag
Publication Date
Oct 01, 2019
Volume
98
Issue
10
Pages
2299–2302
Identifiers
DOI: 10.1007/s00277-019-03757-0
PMID: 31444663
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Iron deficiency anemia (IDA) is often associated with mild to moderate thrombocytosis, and iron deficiency-associated thrombocytopenia (IDAT) is much more uncommon and often misdiagnosed as immune thrombocytopenia (ITP). To better describe the features of IDAT, we conducted a retrospective multicenter case-control study. We identified 10 patients (9 women) with a definite diagnosis IDAT, with a median age of 43.5 [range, 16-72] years and a median platelet count of 30.5 × 109/L [range, 21-80], and 7 patients with a possible diagnosis of IDAT. Bleeding manifestations were absent in all patients but one. All the patients recovered (platelet count ≥ 150 × 109/L) upon iron therapy ± red blood cell transfusion after a median time of 6 [4-39] days. When compared with 30 randomly newly diagnosed ITP patients matched on age, the baseline platelet count was significantly lower in ITP (median = 7 × 109/L [4-59], p < 0.001) whereas MPV was higher (10.5 fL [9,4-13,8] vs 8.2 fL, for IDAT p < 0.001). The median platelet count on day 7 was 337 × 109/L [113-1000] for IDAT cases vs 72 × 109/L [13-212] for ITP controls (p < 0.001). IDAT is potentially an under-recognized cause of thrombocytopenia that may be easily managed with iron therapy.

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