Significance of platelet parameters in cases of iron deficiency anemia with reference to thromboembolic complications - A study in central India

Background: Iron deficiency anemia (IDA) is one of the most common and potentially treatable health problems. The platelet behavior is often unpredictable and complicated in IDA. The present study was aimed to evaluate significance of platelet parameters in IDA, effect of iron therapy on them, and complications related to platelet parameters in such cases. Patients and Methods: It was a prospective observational study. A total of 85 outdoor and indoor consecutive patients of pure IDA with low ferritin levels were enrolled as cases. Platelet parameters - mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (Pct) obtained by automated blood cell counter were studied at the time of presentation and after 1 month of oral iron therapy. Results: IDA was diagnosed more in females (65, 76.5%). All the basic hematological parameters were significantly altered in cases (P < 0.005) except WBC and Pct. Red blood cell parameters have a linear relationship with MPV and inverse with platelet count and PDW. 35 out of 85 IDA cases (41%) showed reactive thrombocytosis (RT). Mild RT was significantly associated with mild anemia (8.1-10 gm%; n = 11) as compared to moderate RT. Six thromboembolic complications were encountered which presented mostly with mild RT, less MPV, high PDW and Pct linearly increasing with platelet count. On follow-up, cases with RT after 1 month of oral iron therapy, platelets showed significant reduction (P = 0.00015) and rise in Hb levels (P = 0.025). Conclusions: RT is common finding in IDA. Thromboembolic central nervous system complications should always be kept in mind because they may deteriorate the clinical picture in otherwise benign course of IDA.