title: Effect of iron therapy on platelet counts in patients with inflammatory bowel disease-associated anemia.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Medicine 3, Medical University of Vienna, Vienna, Austria.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Kulnigg-Dabsch
authors.forename: Rayko
authors.initials: R
authors.lastname: Evstatiev
authors.forename: Clemens
authors.initials: C
authors.lastname: Dejaco
authors.forename: Christoph
authors.initials: C
authors.lastname: Gasche
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000097:blood* / Q000188:drug therapy* / Q000378:metabolism; D001792:Blood Platelets / Q000166:cytology / Q000187:drug effects* / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D015331:Cohort Studies; D004921:Erythropoietin / Q000627:therapeutic use; D005293:Ferritins / Q000378:metabolism; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000097:blood* / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D007501:Iron / Q000627:therapeutic use*; D058085:Iron Compounds / Q000627:therapeutic use*; D000090463:Iron Deficiencies; D007958:Leukocyte Count; D010976:Platelet Count / Q000379:methods; D011446:Prospective Studies; D013922:Thrombocytosis / Q000097:blood / Q000188:drug therapy / Q000378:metabolism; D014168:Transferrin / Q000378:metabolism
chemical_list: D006454:Hemoglobins; D058085:Iron Compounds; D014168:Transferrin; D004921:Erythropoietin; D002097:C-Reactive Protein; D005293:Ferritins; D007501:Iron