Clinico-hematological study of abnormalities of platelet count in children with iron deficiency anemia

Abstract

Background: Iron deficiency anemia is a major cause of morbidity in developing countries like India. The aim of the study was to assess abnormalities of platelet count in iron deficiency anemia and to relate the severity of thrombocytosis with severity of anemia and its association with erythropoietin (EPO) level.Methods: A prospective observational study comprising of 200 children below 18 years confirmed to have IDA. Erythropoietin (EPO) level was done in patients who had thrombocytosis. Degree of thrombocytosis was correlated with EPO and also with ferritin, haematological indices like hemoglobin and MCV (mean corpuscular volume) and blood counts were followed up while on iron therapy for one month.Results: Thrombocytosis was noted in 24.5%. In 75.5% thrombocytosis was mild. Platelet had negative correlation with Hb (hemoglobin). EPO was elevated in 67.35% of thrombocytosis. EPO showed negative correlation with Hb and Ferritin and positive correlation with platelet however, these were non-significant. All patients were treated with standard preparation of ferrous fumarate (33mg elemental iron every 5 ml) in a dose of 3mg/kg/day of elemental iron along with appropriate dietary advice.  On one month follow up 92% of the study population showed normalization of platelet count.Conclusions: Nearly One-fourth of children had thrombocytosis. Platelet count was inversely related to Hb and ferritin level. EPO was increased in two-third cases of thrombocytosis and showed positive correlation with platelet count. As authors excluded patients with severe IDA requiring blood transfusion, authors did not get any thrombocytopenia in present study.