Study of iron deficiency anemia with thrombocytosis in association with serum erythropoietin levels
Abstract
Aim: To evaluate the correlation of iron deficiency anemia with thrombocytosis in correlation with serum erythropoietin levels.
Introduction: Thrombocytosis is a common hematologic finding that can present as an incidental finding and can lead to a great diagnostic challenge. Thrombocytosis can be caused due to autonomous or as a reactive overproduction secondary to infections, iron deficiency anemia, malignancies. Erythropoietin (EPO) is the primary regulator of erythrocyte production and also affects thrombopoiesis and platelet function. The mechanism leading to thrombocytosis in cases of iron deficiency anemia (IDA) remains unclear. Hence, this study was undertaken to evaluate correlation between IDA with thrombocytosis and serum EPO levels.
Materials & Methods: A total of 50 patients of all the age groups attending out-patient and inpatient departments of Basaveshwara Medical College Hospital and Research center, Chitradurga suspected of having microcytic hypochromic anemia on initial hematological investigations were included for study over a period from January 2016 to august 2016. Relevant investigations like peripheral smear study, serum iron studies and serum erythropoietin levels were subsequently performed.
Results: Majority 52% (n=26) had anemia between 7-9.9 gm/dl of which 57.69% (n=15) cases had platelet count between 5-7 lakhs/cu.mm, 34.61% (n=9) cases had moderate thrombocytosis and 7.69% (n=2) cases had severe thrombocytosis. Out of 50 cases in the present study 76% (n=38) cases had significant increase in the levels of serum erythropoietin while 24% (n=12) cases had normal serum erythropoietin.
Conclusion: From the present study, it may be concluded that erythropoietin would play a significant role in causing thrombocytosis in patients with iron deficiency anemia.
Downloads
References
2. Buss DH, Cashell AW, O'Connor ML, Richards F 2nd, Case LD. Occurrence, etiology, and clinical significance of extreme thrombocytosis: a study of 280 cases. Am J Med. 1994 Mar;96(3):247-53. [PubMed]
3. Anemias of Disordered Iron Metabolism and Heme Synthesis.In: Mckenzie. Clinical Laboratory Hematology. New Jersey: Pearson Prentice Hall;2004: 189-219.
4. Tania O, Alka B. To Study Hematological Abnormalities of Platelet Count in Children With Iron Deficiency Anemia In India. Intl.J of scientific research. 2016; 5(4): 90-95.
5. Stohlawetz PJ, Dzirlo L, Hergovich N, Lackner E, Mensik C, Eichler HG, Kabrna E, Geissler K, Jilma B. Effects of erythropoietin on platelet reactivity and thrombopoiesis in humans. Blood. 2000 May 1;95(9):2983-9. [PubMed]
6. Dr. Ashok kumar C et al. Incidence of thrombocytosis in iron deficiency anemia in pediatric age group in rural population. Indian Journal of Basic and Applied Medical Research.2013; 3(1): 45-49.
7. Akan H, Güven N, Aydogdu I, Arat M, Beksaç M, Dalva K. Thrombopoietic cytokines in patients with iron deficiency anemia with or without thrombocytosis. Acta Haematol. 2000;103(3):152-6. [PubMed]
8. Red blood cell and bleeding disorders.In:Kumar V, Abbas AK, Fausto N, Aster JC eds. Robbins and Cotran Pathologic Basis of Disease.8th ed. New Delhi: Elsevier ;2010, p.639-76.
9. Goodnough LT, Nemeth E. Iron deficiency and related disorders. In: Greer JP, Arber DA, Glader B, List AF, Means RT(Jr), Paraskevas F, Rodgers GM, eds. Wintrobe’s Clinical Hematology. 13th ed. China:Lippincott Williams&Wilkins;2014,p.617-642.
10. Kadikoylu G, Yavasoglu I, Bolaman Z, Senturk T. Platelet parameters in women with iron deficiency anemia. J Natl Med Assoc. 2006 Mar;98(3):398-402. [PubMed]
11. Choi SI, Simone JV. Platelet production in experimental iron deficiency anemia. Blood. 1973 Aug;42(2):219-28. [PubMed]
12. Beguin Y. Erythropoietin and platelet production. Haematologica. 1999 Jun;84(6):541-7. [PubMed]
13. Kaushansky K. Thrombopoietin and the hematopoietic stem cell. Blood. 1998 Jul 1;92(1):1-3. [PubMed]
14. Alexandrakis MG, Passam FH, Moschandrea IA, Christophoridou AV, Pappa CA, Coulocheri SA, Kyriakou DS. Levels of serum cytokines and acute phase proteins in patients with essential and cancer-related thrombocytosis. Am J Clin Oncol. 2003 Apr;26(2):135-40.
15. Bilic E, Bilic E. Amino acid sequence homology of thrombopoietin and erythropoietin may explain thrombocytosis in children with iron deficiency anemia. J Pediatr Hematol Oncol. 2003 Aug;25(8):675-6.
16. Ishibashi T, Koziol JA, Burstein SA. Human recombinant erythropoietin promotes differentiation of murine megakaryocytes in vitro. J Clin Invest. 1987;79:286-289.
17. Papayannopoulou T, Brice M, Farrer D, Kaushansky K. Insights into the cellular mechanisms of erythropoietin-thrombopoietin synergy. Exp Hematol. 1996; 24:660-669.
OAI - Open Archives Initiative
