Thrombocytosis in Iron Deficiency Anemia

Abstract Background: Thrombocytosis can be a result of a reactive process such as acute blood loss, infections, iron deficiency anemia (IDA) or a clonal disorder such as Essential Thrombocythemia. The challenge of correctly identifying the etiology of thrombocytosis in an individual patient becomes particularly essential when the clinician is confronted with decisions regarding further workup, follow up as well as preventing future complications such as thrombotic events. Prior data linking iron deficiency anemia and thrombocytosis has been concluded from studies with small sample size, and to a large part, this association is based on anecdotal evidence. Our study examines the association between IDA and platelet counts and to the best of our knowledge is the largest study to do so. Methods: We performed a retrospective chart review of patients seen at our outpatient clinic from 1st January to 31st December 2017. We defined Iron deficiency as serum ferritin <30 mcg/dl, anemia in males as hemoglobin (Hb) <13.1 g/dl, anemia in females as Hb <11.7g/dl and thrombocytosis as platelet count >450,000/ul. Patient demographics, as well as hematological data, were collected and compared between three groups: Iron deficiency anemia, Iron deficiency without anemia, and control. We defined controls as subjects with neither iron deficiency nor anemia. Bivariate analysis using the Chi-square test for categorical variables, and a One-Way ANOVA for continuous variables were used to determine the association between the three groups of interest and the covariates. The relationship between platelet counts and other hematological parameters was evaluated using Pearson's correlation test. Results: Of the 4896 subjects included in our study, 1225 (25.02%) had iron deficiency anemia, 699 (14.28%) had iron deficiency without anemia, and 2972 (60.70%) were controls. The mean age of the cohort was 55.8 (SD = 18.31) years, and 73.9% of the subjects were females. In the IDA group, the mean hemoglobin was 10.21 (SD = 1.39) g/dl, the mean platelet count was 319.24 (SD = 106.92) k/uL, and 127 (10.37%) subjects had thrombocytosis whereas 1098 (89.63%) had normal platelet counts. When compared to the control group, 32 (1.08%) subjects had thrombocytosis, and 2940 ( 98.92%) had normal platelet counts. The difference in numbers of subjects with thrombocytosis between iron deficiency anemia, iron deficiency without anemia and control group was statistically significant as indicated by P<0.001 on the Chi-Square test. Furthermore, we found an inverse relationship between platelet count and ferritin as well as hemoglobin level with a p < 0.0001 across all groups. Conclusions: Our study demonstrated a significant association between iron deficiency anemia and thrombocytosis when compared to the control group however at a lower frequency than seen in the previously published studies. Further studies are needed to study causality and to elucidate the mechanism by which iron deficiency anemia leads to thrombocytosis. Table. Table. Disclosures No relevant conflicts of interest to declare.

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Association between Serum Ferritin and Pre-eclampsia

Bangladesh Medical Journal ◽

10.3329/bmj.v47i3.43494 ◽

2019 ◽

Vol 47 (3) ◽

pp. 18-24

Author(s):

Ratna Paul ◽

Mst Sabrina Moonajilin ◽

Sujit Kumar Sarker ◽

Himel Paul ◽

Swapna Pal ◽

...

Keyword(s):

Blood Pressure ◽

Iron Deficiency ◽

Pregnant Women ◽

Iron Deficiency Anemia ◽

Serum Ferritin ◽

Serum Ferritin Level ◽

Ferritin Level ◽

Deficiency Anemia ◽

Control Group ◽

The Mean

Pre-eclampsia (PE) is a major cause of maternal and prenatal morbidity and mortality in developing countries. PE occurs in about 6% of the general women population. It complicates about 5-15% of pregnancies over 20 weeks and is responsible for 16% of maternal mortality. Pre-delivery serum Ferritin concentration was significantly higher in patients with eclampsia than in healthy pregnant women. The serum ferritin was the best sensitive marker of the iron status parameters reflecting the preeclampsia. The aim of the study is to explore the association between serum ferritin and Preeclampsia and to do a comparison of serum ferritin to assess risk of development preeclampsia between case and control.This is a case-control study with laboratory methods. The study was carried out in Sir Salimullah Medical College and Hospital. Serum Ferritin was tested in the department of biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU). The study was carried out from January 2008 to December 2009 and the sample size was 80. A total of 80 pregnant women, comprising of 40 PE and 40 normotensive primi or multigravida in the third trimester were enrolled in the study. The mean Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) were significantly higher in PE group on both occasions compared to normotensive women with similar chronological age gestational age. Out of the 40 cases 65% patients had severe proteinuria (+++) and 17.5% had moderate proteinuria (++) and 17.5% had mild proteinuria. The difference between case and control with respect to proteinuria was highly significant. More than two third (67.5%) of the cases did not have any iron deficiency anemia, while the rest (32.5%) had mild iron deficiency anemia. In the present study, the mean serum Ferritin level of PE group was almost 10 times higher (167.11 ± 10.43 ngm/ml) than that of controls (17.0 ± 3.03 ngm/ml) than that of control (431.0 ± 10.93 gm/dl). More than one-third of the cases showed serum ferritin >210 ngm/ml, compared to none of the control group. Serum Ferritin level is significantly higher in preeclamptic patients than the control group. Bangladesh Med J. 2018 Jan; 47 (3): 18-24

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The effect of nutrition education based on PRECEDE model on iron deficiency anemia among female students

BMC Women s Health ◽

10.1186/s12905-021-01394-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ali Khani Jeihooni ◽

Sanaz Hoshyar ◽

Pooyan Afzali Harsini ◽

Tayebeh Rakhshani

Keyword(s):

Iron Deficiency ◽

Nutrition Education ◽

Blood Level ◽

Iron Deficiency Anemia ◽

Female Students ◽

Deficiency Anemia ◽

Fars Province ◽

Significant Difference ◽

The Mean ◽

Experimental Group

Abstract Background Iron deficiency anemia disrupts the concentration of adolescent girls; reduces their academic achievement, productivity, and physical strength, and increases the risk of infection. This research aim was to evaluate the effectiveness of the PRECEDE model nutrition education on iron deficiency anemia among female students of Fasa City, Fars Province, Iran. Methods This quasi-experimental study was done on 160 students (80 experimental and 80 control groups) who were selected using a random sampling method in Fasa City, Fars Province, Iran, in 2018–2019. The educational intervention included six sessions based PRECEDE model for 45 or 50 min. A scale of this study consisted of two parts; demographic information, and PRECEDE constructs were used to determine the nutritional behaviors status concluding preventing iron deficiency anemia and hemoglobin, hematocrit, and ferritin blood level in two (before and 4 months after intervention) times. Results In the experimental group of the students the mean age was 13.85 + 1.72 years and in the controlled group was 13.60 + 1.81 years. Moreover, there was no significant difference in the PRECEDE constructs, and nutritional behaviors preventing iron deficiency anemia before the intervention in two groups of study. However, the experimental group showed a significant increase 4 months after the intervention. Also, there was no significant difference in the mean score of hemoglobin, hematocrit, and ferritin blood level between the two groups before the intervention. However, in ferritin level, a significant increase was shown in 4 months after the intervention in the experiential group. Conclusions Based on results, the nutrition intervention education base on PRECEDE model has a positive effect to improve iron deficiency anemia preventive behaviors in female students.

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Facial Profile Shape, Malocclusion and Palatal Morphology in Malay Obstructive Sleep Apnea Patients

The Angle Orthodontist ◽

10.2319/011509-26.1 ◽

2010 ◽

Vol 80 (1) ◽

pp. 37-42 ◽

Cited By ~ 11

Author(s):

S. M. Banabilh ◽

A. R. Samsudin ◽

A. H. Suzina ◽

Sidek Dinsuhaimi

Keyword(s):

Obstructive Sleep Apnea ◽

Null Hypothesis ◽

Control Group ◽

Class Ii Malocclusion ◽

Chi Square ◽

Facial Profile ◽

Obstructive Sleep ◽

Significant Difference ◽

Chi Square Test ◽

The Mean

Abstract Objective: To test the null hypothesis that there is no difference in facial profile shape, malocclusion class, or palatal morphology in Malay adults with and without obstructive sleep apnea (OSA). Materials and Methods: Subjects were 120 adult Malays aged 18 to 65 years (mean ± standard deviation [SD], 33.2 ± 13.31) divided into two groups of 60. Both groups underwent clinical examination and limited channel polysomnography (PSG). The mean OSA and control values were subjected to t-test and the chi square test. Results: Physical examination showed that 61.7% of the OSA patients were obese, and 41.7% of those obese patients had severe OSA. The mean body mass index (BMI) was significantly greater for the OSA group (33.2 kg/m2 ± 6.5) than for the control group (22.7 kg/m2 ± 3.5; P < .001). The mean neck size and systolic blood pressure were greater for the OSA group (43.6 cm ± 6.02; 129.1 mm Hg ± 17.55) than for the control group (35.6 cm ± 3.52; 114.1 mm Hg ± 13.67; P < .001). Clinical examination showed that the most frequent findings among OSA groups when compared with the control group were convex profiles (71.7%), Class II malocclusion (51.7%), and V palatal shape (53.3%), respectively; the chi square test revealed a significant difference in terms of facial profile and malocclusion class (P < .05), but no significant difference in palatal shape was found. Conclusion: The null hypothesis is rejected. A convex facial profile and Class II malocclusion were significantly more common in the OSA group. The V palatal shape was a frequent finding in the OSA group.

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Role of Serum Transferrin Receptor in Diagnosing and Differentiating Iron Deficiency Anemia from Anemia of Chronic Disease in Patients with Chronic Kidney Disease

BIRDEM Medical Journal ◽

10.3329/birdem.v7i2.32451 ◽

2017 ◽

Vol 7 (2) ◽

pp. 132-137

Author(s):

Abdul Latif ◽

Muhammad Rafiqul Alam ◽

Asia Khanam ◽

Farhana Hoque ◽

Muhammad Abdur Rahim ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Chronic Disease ◽

Kidney Disease ◽

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Transferrin Receptor ◽

Deficiency Anemia ◽

Control Group ◽

Anemia Of Chronic Disease ◽

Female Ratio

Background: Anemia is common in patients with chronic kidney disease (CKD) and this is generally anemia of chronic disease, but iron deficiency anemia (IDA) is also common. Soluble transferrin receptor (sTfR) is a useful marker for IDA. Present study was undertaken to assess the utility of sTfR as a marker of IDA in selected group of Bangladeshi patients with CKD.Methods: This cross-sectional study was conducted in the Department of Nephrology, BSMMU, Dhaka, Bangladesh from January 2013 to December 2014. Patients with anemia admitted in nephrology department whether on hemodialysis or not and medicine department of BSMMU were taken for study. The study population was further divided into two groups; Group A, patients who are having IDA and Group B, patients with ACD and a control group was also selected. Data were collected by face to face interview and laboratory investigations with a self-administered questionnaire.Results: The mean age of the patients in two study groups were 38.40±13.23 and 34.85±10.52 years respectively and male-female ratio were 0.5:1 and 1:0.5. Mean sTfR level was higher (4.81± 1.64 ?g/ml) in patients with IDA than (2.89±1.40 ?g/ml) in patients with ACD (p <0.0001). In our study mean ferritin level was 599.59± 449.15?g/L in ACD patients whereas 101.23±119.42 in IDA patients (p<0.0001). Total iron binding capacity (TIBC) was more in ACD patients with sTfRe3?g/ml as compared to ACD patients with sTfR<3?g/ml. Transferrin saturation (TSAT) level was significantly decreased in ACD patients with sTfR ?3?g/ml as compared to ACD patients with sTfR<3?g/ml.Conclusion: sTfR has a comparable ability to S. ferritin in diagnosing IDA and ACD. However, sTfR and serum ferritin alone cannot definitely exclude co-existing iron deficiency in ACD. As sTfR is not affected by infection and/or inflammation, thus providing a non-invasive alternative to bone marrow study.Birdem Med J 2017; 7(2): 132-137

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Iron, Ferritin and Hepcidin Levels in Patients with Iron Deficiency Anemia

International Journal for Research in Applied Sciences and Biotechnology ◽

10.31033/ijrasb.8.5.19 ◽

2021 ◽

Vol 8 (5) ◽

pp. 137-139

Author(s):

Rabaa Khaled Abdel Salam ◽

Saria Naji Mohsin

Keyword(s):

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Iron Transport ◽

Blood Parameters ◽

Deficiency Anemia ◽

Control Group ◽

Blood Picture ◽

Cellular Kinetics ◽

And Storage

This study was conducted to identify the role of some blood parameters, levels of some hormones, proteins, and cellular kinetics that have a role in iron transport and storage, in addition to their relationship with each other and with blood and sex parameters for patients with severe and moderate iron deficiency anemia, and to compare the parameters with healthy people. The study period lasted for the period from (December 2020 until March 2021) The presence of iron deficiency anemia was confirmed by examining the blood picture and the criteria of hepcidin and ferritin. The results showed a significant decrease in the in the concentration of hepcidin, ferritin and iron in patients compared to the control group.

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THE GASTROINTESTINAL EFFECTS OF IRON-DEFICIENCY ANEMIA

PEDIATRICS ◽

10.1542/peds.33.1.83 ◽

1964 ◽

Vol 33 (1) ◽

pp. 83-99

Author(s):

J. L. Naiman ◽

F. A. Oski ◽

L. K. Diamond ◽

G. F. Vawter ◽

H. Shwachman

Keyword(s):

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Deficiency Anemia ◽

Control Group ◽

Poor Correlation ◽

Iron Treatment ◽

High Incidence ◽

Before And After ◽

And Function ◽

Duodenal Biopsies

A group of 14 infants and children with nutritional iron-deficiency anemia were studied with respect to gastrointestinal function and structure both before and after iron treatment. A high incidence of abnormalities was found, consisting of gastric achlorhydria, impaired absorption of xylose and vitamin A, and steatorrhea. Duodenal biopsies revealed varying degrees of chronic duodenitis and mucosal atrophy. There was poor correlation between structure and function. Following treatment with oral iron most of the abnormalities reverted to normal. A control group of 8 children with long-standing anemias not due to iron deficiency were subjected to similar studies, most of which yielded normal results. These observations indicate a diffuse and reversible enteropathy in children as a result of iron deficiency. The pathogenesis and practical implications are discussed.

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The Effect of Iron Deficiency Anemia Early in the Third Trimester on Small for Gestational Age and Birth Weight: A Retrospective Cohort Study on Iron Deficiency Anemia and Fetal Weight

BioMed Research International ◽

10.1155/2019/7613868 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Ilknur Col Madendag ◽

Mefkure Eraslan Sahin ◽

Yusuf Madendag ◽

Erdem Sahin ◽

Mustafa Bertan Demir ◽

...

Keyword(s):

Iron Deficiency ◽

Pregnant Women ◽

Iron Deficiency Anemia ◽

Fetal Weight ◽

Deficiency Anemia ◽

Control Group ◽

Third Trimester ◽

Mild Anemia ◽

Moderate Anemia ◽

Anemia Group

Aim. The aim of the present study was to evaluate the relationship between iron deficiency anemia and small for gestational age (SGA) in early third trimester pregnancies. Methods. A total of 4800 pregnant women who met the inclusion criteria were analyzed retrospectively. We included pregnant women who had iron deficiency anemia between 26+0 and 30+0 weeks of gestation and delivered singletons between 37+0 and 41+6 weeks of gestation. Patients were divided into four groups according to anemia level: (1) hemoglobin (Hb) < 7 mg/dl (n = 80), (2) Hb 7–9.9 mg/dl (n = 320), (3) Hb 10–10.9 mg/dl (n = 1300), and (4) Hb > 11 mg/dl (n = 3100, control group). The primary outcome of this study was the presence of SGA. Results. The demographic and obstetric characteristics were similar among all the groups. Maternal age, BMI <30 kg/m2, nulliparity rates, and previous cesarean delivery rates were similar among groups. Ethnicity was significantly different in the severe and moderate anemia groups (<0.001). Mean fetal weight was 2900 ± 80 g in the severe anemia group, 3050 ± 100 g in the moderate anemia group, 3350 ± 310 g in the mild anemia group, and 3400 ± 310 g in the control group. Fetal weight was significantly lower in the severe and moderate anemia groups compared to the mild anemia and control groups (<0.001). The SGA rate was 18.7% in the severe anemia group, 12.1% in the moderate anemia group, 5.3% in the mild anemia group, and 4.9% in the control group. SGA was significantly higher in the severe and moderate anemia groups compared to the mild anemia and control groups (<0.001). Conclusion. The results of this study indicated that early third trimester severe and moderate iron deficiency anemia was associated with SGA. Iron deficiency anemia in pregnant women may lead to low birth weight.

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Fermented Goat Milk Consumption Enhances Brain Molecular Functions during Iron Deficiency Anemia Recovery

Nutrients ◽

10.3390/nu11102394 ◽

2019 ◽

Vol 11 (10) ◽

pp. 2394 ◽

Cited By ~ 1

Author(s):

Moreno-Fernández ◽

López-Aliaga ◽

García-Burgos ◽

Alférez ◽

Díaz-Castro

Keyword(s):

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Goat Milk ◽

Nervous System Development ◽

Cow Milk ◽

Deficiency Anemia ◽

Control Group ◽

Brain Functions ◽

Mao A ◽

Molecular Functions

Iron deficiency anemia (IDA) is one of the most prevalent nutritional deficiencies worldwide. Iron plays critical roles in nervous system development and cognition. Despite the known detrimental consequences of IDA on cognition, available studies do not provide molecular mechanisms elucidating the role of iron in brain functions during iron deficiency and recovery with dairy components. In this study, 100 male Wistar rats were placed on a pre-experimental period of 40 days and randomly divided in two groups: a control group receiving a normal-Fe diet, (45 mg/kg), and an Fe-deficient group receiving a low-Fe diet (5 mg/kg). At day 40, 10 rats per group were sacrificed to anemia control, and 80 rats were divided into eight experimental groups fed with fermented goat or cow milk-based diets, with normal Fe content or Fe overload (450 mg/kg) for 30 days. IDA decreased most of the parameters related to brain molecular functions, namely dopamine, irisin, MAO-A, oxytocin, β-endorphin, and α-MSH, while it increased synaptophysin. These alterations result in an impairment of brain molecular functions. In general, during anemia recovery, fermented goat milk diet consumption increased dopamine, oxytocin, serotonin, synaptophysin, and α-MSH, and decreased MAO-A and MAO-B, suggesting a potential neuroprotective effect in brain functions, which could enhance brain molecular functions.

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Severe Iron-Deficiency Anemia Still an Issue in Toddlers

Clinical Pediatrics ◽

10.1177/0009922814540990 ◽

2014 ◽

Vol 53 (14) ◽

pp. 1352-1358 ◽

Cited By ~ 16

Author(s):

Gabrielle Paoletti ◽

Debra L. Bogen ◽

A. Kim Ritchey

Keyword(s):

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Motor Development ◽

Retrospective Chart Review ◽

Microcytic Anemia ◽

Deficiency Anemia ◽

Cow’S Milk ◽

Milk Consumption ◽

Cow's Milk ◽

The Mean

Background and Objectives. Chronic, severe iron-deficiency anemia (IDA) in the first years of life increases the risk of irreversibly compromised cognitive, affective, and motor development. While IDA in infants has decreased because of dietary changes (iron-fortified formula and delaying cow’s milk), toddlers (13-36 months) are equally vulnerable to the adverse effects of IDA. We aimed to show that despite public health efforts, severe IDA remains a problem in toddlers and is associated with excess milk consumption. Methods. Retrospective chart review of children 6 to 36 months admitted to or evaluated by hematology at a children’s hospital from January 1, 2005 to December 31, 2010 with a severe microcytic anemia (hemoglobin [Hb] <9 g/dL and mean corpuscular volume (MCV) <75 fL). Results. We identified 68 infants and toddlers with severe IDA; most (84%) were 13 to 36 months old. The mean Hb and MCV were 6.0 g/dL (range = 2.2-8.9 g/dL) and 54.0 fL (range = 45.5-69.8 fL), respectively. Fatigue, poor appetite, and pica were the most common symptoms, found in 43%, 29%, and 22% of patients, respectively. Only 41% of parents reported pale skin while 77% of physicians recorded it on physical exam. Daily cow’s milk consumption surpassed 24 ounces for 47 of 48 children with reported intake; 11 consumed more than 64 ounces per day. Conclusions. Despite current screening recommendations, severe IDA continues to be a problem in toddlers and strongly correlates with excess cow’s milk consumption. This reiterates the importance of screening for IDA into routine toddler care.

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Pengaruh Aplikasi Android Aneminfo terhadap Pengetahuan dan Sikap Remaja Putri terkait Anemia Defisiensi Besi

JURNAL PROMOSI KESEHATAN INDONESIA ◽

10.14710/jpki.15.2.65-69 ◽

2020 ◽

Vol 15 (2) ◽

pp. 65-69

Author(s):

Rizki Septia Saraswati ◽

Apoina Kartini ◽

Farid Agushybana

Keyword(s):

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Young Women ◽

Intervention Group ◽

Deficiency Anemia ◽

Control Group ◽

Android Application ◽

Educational Media ◽

Knowledge And Attitudes ◽

Validated Questionnaire

Background: Iron deficiency anemia is one of the nutritional problems that still occur in Indonesia which is common in young women. Early nutrition education is needed to prevent these problems. The purpose of this study was to analyze the effect of the android-based educational media "Aneminfo" on the knowledge and attitudes of young women regarding iron deficiency anemia. Method: This research was conducted with a quasi-experimental design with a pre-post control group design with a sample of 37 people for each group taken from 2 vocational schools in the city of Semarang. The intervention was carried out using educational media in the form of the “Aneminfo” android application. Changes in knowledge and attitudes between before and after the intervention were measured using a validated questionnaire and tested using the Wilcoxon and Mann-Whitney tests. Results: The results showed a significant increase in knowledge in the intervention group (p = 0.001), and there was a significant increase in attitude in the intervention group (p = 0.011) compared to the control group. The conclusion of this study is the Aneminfo android application can be an alternative media for the government and health workers in providing education about iron deficiency anemia to increase adolescent knowledge and prevent anemia from an early age.

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