Effect of Iron Therapy on Platelet Counts in Patients with Inflammatory Bowel Disease-Associated AnemiaReportar como inadecuado




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Background and Aims

Secondary thrombocytosis is a clinical feature of unknown significance. In inflammatory bowel disease IBD, thrombocytosis is considered a marker of active disease; however, iron deficiency itself may trigger platelet generation. In this study we tested the effect of iron therapy on platelet counts in patients with IBD-associated anemia.

Methods

Platelet counts were analyzed before and after iron therapy from four prospective clinical trials. Further, changes in hemoglobin, transferrin saturation, ferritin, C-reactive protein, and leukocyte counts, before and after iron therapy were compared. In a subgroup the effect of erythropoietin treatment was tested. The results were confirmed in a large independent cohort FERGIcor.

Results

A total of 308 patient records were available for the initial analysis. A dose-depended drop in platelet counts mean 425 G-L to 320 G-L; p<0.001 was found regardless of the type of iron preparation iron sulphate, iron sucrose, or ferric carboxymaltose. Concomitant erythropoietin therapy as well as parameters of inflammation leukocyte counts, C-reactive protein had no effect on the change in platelet counts. This effect of iron therapy on platelets was confirmed in the FERGIcor study cohort n=448, mean platelet counts before iron therapy: 383 G-L, after: 310 G-L, p<0.001.

Conclusion

Iron therapy normalizes elevated platelet counts in patients with IBD-associated anemia. Thus, iron deficiency is an important pathogenetic mechanism of secondary thrombocytosis in IBD.



Autor: Stefanie Kulnigg-Dabsch, Rayko Evstatiev, Clemens Dejaco, Christoph Gasche

Fuente: http://plos.srce.hr/



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