Iron Deficiency Anemia, Thrombocytosis, and Cerebrovascular Accident

Thrombocytosis in Iron Deficiency Anemia

“…Extreme thrombocytosis is not so common but in one report of 100 consecutive patients with iron deficiency anemia, platelet counts were above 1,000×10 9 /l in 7% of the patients (4). Alteration of the bone marrow megakaryocyte count in iron deficiency anemia is not mentioned usually except for two reports (4,5). In these reports, the authors mentioned that the bone marrow megakaryocyte counts were increased and the plausible explanation of the thrombocytosis might be an increased production of platelets.…”

“…Although thrombotic and bleeding events are much less likely to occur in association with reactive thrombocytosis than autonomous thrombocytosis (2), thrombotic complications were occasionally reported in iron deficiency anemia (5,7).…”

Thrombocytosis Secondary to Iron Deficiency and Recurrent Cerebral Ischemia Possibly Improved by Plateletpheresis

“…Most occurred during an acute relapse, but 1 patient was in the recovery phase (as in the patients reported here) [3], 1 was in remis sion [4], and 1 had undergone panproctoco lectomy a decade earlier [5]. In such cases, the persistent abnormalities of fibrinolysis of inactive UC [6] may be more relevant than the well-known effects of active UC on clot ting factors and platelet function.…”

“…Many believe that reactive throm bocytosis is less frequently associated with such manifestations. Thrombotic complica tions do however occur, for example three patients have been reported with cerebral infarcts and thrombocytosis that was sec ondary to iron deficiency [1][2][3]. Standard teaching is that minor thrombotic manifes tations may be managed with aspirin, and more serious manifestations may require plateletpheresis.…”

Environmental Toxins and the Heart

“…396À400 The relationship between iron body stores and cerebral vascular accident levels may be U-shaped because both deficiency and excess have been associated with increased risk. 374,400 Iron deficiency anemia may lead to a hypercoagulable state directly related to iron deficiency and/or anemia; thrombocytosis secondary to iron deficiency anemia; and anemic hypoxia, whereby a mismatch between oxygen supply and end-organ demand leads to ischemia and infarction 396,397,399,401 …”