Iron Deficiency Anemia-Induced Lymphocytopenia in a Young Female

Abstract

Iron deficiency anemia is the most common type of anemia, and it occurs when the human body does not have enough of the mineral iron (https://www.healthline.com/health/irondeficiency-anemia#diagnosis). Iron deficiency anemia is caused by blood loss, insufficient dietary intake, or poor absorption of iron from food. Sources of blood loss can include heavy periods, childbirth, uterine fibroids, stomach ulcers, colon cancer, and urinary tract bleeding (https://www.nhlbi.nih.gov/health-topics/iron-deficiency-anemia). Poor absorption of iron from food may occur as a result of an intestinal disorder such as inflammatory bowel disease or celiac disease, or surgery such as a gastric bypass (https://www.who.int/nutrition/topics/ ida/en/). Little is known about the association between iron deficiency anemia and lymphocytopenia. Here, we report on a 17-year-old female who presented with iron deficiency anemia and was found to have lymphopenia. She recovered after having received intravenous iron therapy.

Intravenous ferric carboxymaltose for the management of iron deficiency and iron deficiency anaemia in children and adolescents: a review

“…Of these, 33 were related to the use of FCM in children or adolescents < 18 years and were included in this narrative review (Table 1). The 33 publications evaluated in this analysis consisted of 19 retrospective studies [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39], two prospective studies [40,41], eight case reports [42][43][44][45][46][47][48][49], one case series (included three case reports [50]), one audit [51], one pharmacokinetic/pharmacodynamic modelling study [52] and one letter to the editor [53].…”

“…Other patient groups included in the studies were restless legs syndrome (one study [25]), restless sleep disorder (one study [26]), heart failure (one study [38]) and intestinal failure (one study in children under 2 years of age [21]). Furthermore, there were case reports of adolescents with IBD (three cases [50]), children unable to receive blood transfusions (one case of a 5-year-old undergoing cardiac surgery [48] and one case of a 17-year-old with posttraumatic anaemia following a road accident [46]), extreme IDA (one case in a 13-year-old [43]), Crohn's disease (one case of a 17-year-old [45]), anaemic retinopathy (one case of a 16-year-old [49]), lymphocytopenia (one case of a 17-yearold [42]), Burkitt's lymphoma (one case of a 16-year-old [44]) and iron-refractory iron deficiency anaemia (IRIDA) with prior anaphylaxis to IV iron (one case of an adolescent whose age was not reported [47]).…”

Complex Interactions in Regulation of Haematopoiesis—An Unexplored Iron Mine

“…Contradictory reports have indicated occurrences of neutropenia in some patients affected with severe IDA. A recent case of a middle aged woman with severe IDA exhibiting neutropenia, which recovered following intravenous iron therapy presents yet another example of the significance of iron deficiency in affecting neutrophil biology [99]. Observation of neutropenia in some severe IDA patients may also explain the increased risk of infections reported in them [100].…”

“…While CD4+ T cells were significantly reduced in the IDA group, CD8+ T-cell counts were higher indicating the importance of early diagnosis and treatment of asymptomatic cases of IDA before cellular immunity is further compromised [113]. Restoration of normal lymphocyte counts upon intravenous iron therapy in an IDA patient, signifies the effect of iron deficiency on white blood cells which has not yet been investigated in detail [99]. Excess iron levels also affect lymphocyte counts.…”