Severe iron deficiency anaemia and stroke

Swann, I. L.; Kendra, J. R.

doi:10.1046/j.1365-2257.2000.00097.x

Cited by 25 publications

(14 citation statements)

References 9 publications

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“…5–7 In contrast, several other studies have documented a link between iron deficiency and increased stroke incidence. 3–5,25–29 The concept of both a reduced and increased iron status being associated with an increased stroke risk has been supported by the results of the National Health And Nutrition Examination Survey cohort. 5 This study followed subjects for 12 years and included 652 cases of stroke, finding a significantly increased risk of stroke in white women at a transferrin saturation <30% and transferrin saturation >44% relative to those with a transferrin saturation of 30% to 36%.…”

Section: Discussionmentioning

confidence: 99%

Iron Status and Risk of Stroke

Gill

Monori

Tzoulaki

et al. 2018

Stroke

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Background and Purpose— Both iron deficiency and excess have been associated with stroke risk in observational studies. However, such associations may be attributable to confounding from environmental factors. This study uses the Mendelian randomization technique to overcome these limitations by investigating the association between genetic variants related to iron status and stroke risk. Methods— A study of 48 972 subjects performed by the Genetics of Iron Status consortium identified genetic variants with concordant relations to 4 biomarkers of iron status (serum iron, transferrin saturation, ferritin, and transferrin) that supported their use as instruments for overall iron status. Genetic estimates from the MEGASTROKE consortium were used to investigate the association between the same genetic variants and stroke risk. The 2-sample ratio method Mendelian randomization approach was used for the main analysis, with the MR-Egger and weighted median techniques used in sensitivity analyses. Results— The main results, reported as odds ratio (OR) of stroke per SD unit increase in genetically determined iron status biomarker, showed a detrimental effect of increased iron status on stroke risk (serum iron OR, 1.07; 95% CI, 1.01–1.14; [log-transformed] ferritin OR, 1.18; 95% CI, 1.02–1.36; and transferrin saturation OR, 1.06; 95% CI, 1.01–1.11). A higher transferrin, indicative of lower iron status, was also associated with decreased stroke risk (OR, 0.92; 95% CI, 0.86–0.99). Examining ischemic stroke subtypes, we found the detrimental effect of iron status to be driven by cardioembolic stroke. These results were supported in statistical sensitivity analyses more robust to the inclusion of pleiotropic variants. Conclusions— This study provides Mendelian randomization evidence that higher iron status is associated with increased stroke risk and, in particular, cardioembolic stroke. Further work is required to investigate the underlying mechanism and whether this can be targeted in preventative strategies.

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Section: Discussionmentioning

confidence: 99%

Iron Status and Risk of Stroke

Gill

Monori

Tzoulaki

et al. 2018

Stroke

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“…Iron deficiency anemia has been suggested to be associated with stroke, although it is still difficult to provide direct evidence. [4][5][6][7][8] There are 3 possible mechanisms by which iron deficiency anemia could cause thrombosis. First, thrombocytosis secondary to iron deficiency anemia causes thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Venous Thrombosis Associated With Iron Deficiency Anemia

Ogata

Kamouchi

Kitazono

et al. 2008

Journal of Stroke and Cerebrovascular Diseases

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“…The putative mechanisms underlying anemia and stroke syndromes are not completely understood [4], and it is believed that iron deficiency, may cause ischemic stroke by several potential mechanisms. Thrombocytosis is often associated with iron deficiency and microcytosis produces a reduction in the red cell deformability and could produce a hypercoagulable state [10]. The platelet count and function observed in iron-deficiency anemia could act synergistically to promote thrombus formation, especially in the setting of an underlying atherosclerotic disease [11].…”

Section: Discussionmentioning

confidence: 99%

Iron-Deficiency Anemia Leading to Transient Ischemic Attacks due to Intraluminal Carotid Artery Thrombus

Çağlayan

Nazlıel

İrkeç

et al. 2013

Case Reports in Neurological Medicine

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Reactive thrombocytosis secondary to iron-deficiency anemia (IDA) is a rare but recognized cause of stroke. We report the case of a patient with iron-deficiency anemia presenting with multiple transient ischemic attacks (TIA) due to intraluminal thrombus of an internal carotid artery. The putative mechanisms underlying anemia and stroke syndromes are not completely understood, and it is believed that iron deficiency may cause ischemic stroke by several potential mechanisms. Thrombocytosis is often associated with iron deficiency, and microcytosis produces a reduction in the red cell deformability and could produce a hypercoagulable state. The platelet count and function observed in iron-deficiency anemia could act synergistically to promote thrombus formation, especially in the setting of an underlying atherosclerotic disease. The presence of floating thrombus in a patient with clinical and MRI evidence of stroke represents a significant therapeutic dilemma and requires immediate decision about treatment.

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Severe iron deficiency anaemia and stroke

Abstract: Neurological complications of severe anaemia in childhood are rare. We report a case of severe iron deficiency in a child of 23 months, presenting as an acute hemiparesis.

Cited by 25 publications

References 9 publications

Iron Status and Risk of Stroke

Iron Status and Risk of Stroke

Cerebral Venous Thrombosis Associated With Iron Deficiency Anemia

Iron-Deficiency Anemia Leading to Transient Ischemic Attacks due to Intraluminal Carotid Artery Thrombus

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