Effect of Iron Therapy on Platelet Counts in Patients with Inflammatory Bowel Disease-Associated Anemia

被引:46
作者
Kulnigg-Dabsch, Stefanie [1 ]
Evstatiev, Rayko [1 ,2 ]
Dejaco, Clemens [1 ]
Gasche, Christoph [1 ,2 ]
机构
[1] Med Univ Vienna, Dept Med 3, Vienna, Austria
[2] Med Univ Vienna, Christian Doppler Lab Mol Carcinoma Chemoprevent, Vienna, Austria
来源
PLOS ONE | 2012年 / 7卷 / 04期
基金
奥地利科学基金会;
关键词
RANDOMIZED CONTROLLED-TRIAL; PORTAL-VEIN THROMBOSIS; ULCERATIVE-COLITIS; DEFICIENCY ANEMIA; INTRAVENOUS IRON; FERRIC CARBOXYMALTOSE; THROMBOEMBOLIC EVENTS; CROHNS-DISEASE; THROMBOCYTOSIS; ERYTHROPOIETIN;
D O I
10.1371/journal.pone.0034520
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
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.
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页数:6
相关论文
共 49 条
[1]  
Basak R, 2008, Mymensingh Med J, V17, P74
[2]  
Beguin Y, 1999, HAEMATOLOGICA, V84, P541
[3]   Cerebral sinovenous thrombosis in children: Another reason to treat iron deficiency anemia [J].
Benedict, SL ;
Bonkowsky, JL ;
Thompson, JA ;
Van Orman, CB ;
Boyer, RS ;
Bale, JF ;
Filloux, FM .
JOURNAL OF CHILD NEUROLOGY, 2004, 19 (07) :526-531
[4]   GASTRO-INTESTINAL BLEEDING DUE TO CHRONIC PORTAL-VEIN THROMBOSIS IN ULCERATIVE-COLITIS [J].
CAPRON, JP ;
REMOND, A ;
LEBREC, D ;
DELAMARRE, J ;
DUPAS, JL ;
LORRIAUX, A .
DIGESTIVE DISEASES AND SCIENCES, 1979, 24 (03) :232-235
[5]   Thrombopoietin is not uniquely responsible for thrombocytosis in inflammatory disorders [J].
Ceresa, Iride F. ;
Noris, Patrizia ;
Ambaglio, Chiara ;
Pecci, Alessandro ;
Balduini, Carlo L. .
PLATELETS, 2007, 18 (08) :579-582
[6]   Predictors of corticosteroid-dependent and corticosteroid-refractory inflammatory bowel disease: analysis of a Chinese cohort study [J].
Chow, D. K. L. ;
Sung, J. J. Y. ;
Tsoi, K. K. F. ;
Wong, V. W. S. ;
Wu, J. C. Y. ;
Leong, R. W. L. ;
Chan, F. K. L. .
ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 2009, 29 (08) :843-854
[7]   The CD40/CD40L costimulatory pathway in inflammatory bowel disease [J].
Danese, S ;
Sans, M ;
Fiocchi, C .
GUT, 2004, 53 (07) :1035-1043
[8]   Platelets in inflammatory bowel disease: Clinical, pathogenic, and therapeutic implications [J].
Danese, S ;
de la Motte, C ;
Fiocchi, C .
AMERICAN JOURNAL OF GASTROENTEROLOGY, 2004, 99 (05) :938-945
[9]  
Elalamy I., 2008, EUR REV MED PHARMACO, V121, P843
[10]   FERGIcor, a Randomized Controlled Trial on Ferric Carboxymaltose for Iron Deficiency Anemia in Inflammatory Bowel Disease [J].
Evstatiev, Rayko ;
Marteau, Philippe ;
Iqbal, Tariq ;
Khalif, Igor L. ;
Stein, Juergen ;
Bokemeyer, Bernd ;
Chopey, Ivan V. ;
Gutzwiller, Florian S. ;
Riopel, Lise ;
Gasche, Christoph .
GASTROENTEROLOGY, 2011, 141 (03) :846-U558