Abstract Number: PB0991
Meeting: ISTH 2021 Congress
Background: Iron deficiency is associated with anemia, and somewhat paradoxically, thrombocytosis. Prior studies have demonstrated platelet count reduction in patients treated with oral iron and patients with chronic kidney disease treated with intravenous (IV) iron, but characterization in premenopausal women receiving IV iron replacement (the most prevalent iron deficient population) is lacking.
Aims: To investigate the frequency of thrombocytosis in iron deficient premenopausal women, and whether correction of iron deficiency alters platelet count and other blood indices.
Methods: A multicenter retrospective cohort study was performed for 231 women between 18 and 40 years of age receiving intravenous ferumoxytol or low-molecular weight iron dextran for iron deficiency (ferritin <20µg/L). Only women who achieved a ferritin ≥50µg/L at follow up were included. Pregnant patients and those with platelet disorders, hematologic malignancy, or receiving antineoplastic chemotherapy were excluded. Thrombocytosis was defined as platelet count >400K/mm3. Pre- and post-infusion platelet counts were compared by two-sided paired t-test.
Results: Heavy menstrual bleeding was the most prevalent documented cause of iron deficiency in the cohort (50.2%). The mean ferritin pre and post-infusion was 11.1ng/ml (range: 2-19) and 133.2ng/ml (52-531) respectively. The mean platelet count was 288 (±97) K/mm3 pre-infusion and 261 (±84) K/mm3 post-infusion (Figure 1). Thrombocytosis was present in 18 (7.8%) patients at pre-infusion and 7 (3.0%) patients at post-infusion. The mean change in platelet count from pre-infusion to post-infusion was -26.5K/mm3 (95% CI: -32.1, -20.9, p<0.001). While Hgb, Hct, and red cell count were significantly different post-infusion, no changes in white blood cell count or mean platelet volume were observed.
Conclusions: Thrombocytosis was present but uncommon in premenopausal women with iron deficiency and generally corrected with iron repletion. A small but significant decrease in platelet counts occurred after IV iron in this population, however changes in platelet volume and white cell counts were not observed.
To cite this abstract in AMA style:Elstrott B, Lakshmanan HHS, Aslan J, Shatzel JJ. Iron Repletion Decreases Platelet Count in Iron Deficient Premenopausal Women [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 1). https://abstracts.isth.org/abstract/iron-repletion-decreases-platelet-count-in-iron-deficient-premenopausal-women/. Accessed September 16, 2021.
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