Iron deficiency anemia presenting as pancytopenia in an adolescent girl

Jhamb, Rajat; Kumar, Ashok

doi:10.1515/ijamh.2011.012

Cited by 13 publications

(19 citation statements)

References 8 publications

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“…Pallor (49%) was the most common physical finding observed followed by splenomegaly (27%) in present study. These findings were comparable to other studies reported from the Indian subcontinent [3,5,6,11,12].…”

Section: Discussionsupporting

confidence: 93%

“…The commonest cause of pancytopenia, reported from various studies throughout the world has been aplastic anaemia. On the contrary most studies conducted in the Indian subcontinent observed megaloblastic anaemia to be the major cause of pancytopenia.However, occasional studies reported from India observed aplastic anaemia as the most common underlying etiology of pancytopenia with megaloblastic anaemia [6,9,11,13,14,15].…”

Section: Discussionmentioning

confidence: 99%

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Pancytopenia associated megaloblastic anemia: a clinico-hematological study in a tertiary care hospital

Rohira

Sawke

2019

Trop J Pathol Microbiol

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Background: Pancytopenia is a common and important clinical and haematological problem. It is a striking feature of many serious and life-threatening illnesses, ranging from simple drug-induced bone marrow hypoplasia, megaloblastic anemia to fatal bone marrow aplasias and leukemias. Thus, identification of the correct cause will help in implementing appropriate therapy and determine the better management and prognosis. Objectives: To study the clinical presentations and evaluate the hematological parameters including bone marrow aspiration in pancytopenia associated megaloblastic anemia cases. Materials and Methods: It was a prospective study, in which 75 cases of megaloblastic anemia associated with pancytopenia were evaluated clinically, along with hematological parameters and bone marrow aspiration in Department of Pathology, CMCH, Bhopal, over a period of one and half year. Results: Among 150 cases of pancytopenia studied, the commonest cause for pancytopenia was megaloblastic anemia (50%), followed by hperslenism (18%), and aplastic anemia (11%). Most of the patients presented with generalized weakness and fever. The commonest physical finding was pallor, followed by splenomegaly. Macrocytic normochromic red cells morphology was observed in 44(59%) patients of megaloblastic anaemia, followed by dimorphic blood picture in 20(27%) cases. The commonest marrow finding was hypercellularity with megaloblastic erythropoiesis. Conclusion: The present study concludes that in pancytopenia cases megaloblastic anaemia is a common and important clinical and haematological problem. Detailed primary hematological investigations along with bone marrow aspiration in pancytopenic patients are helpful for understanding of disease process and to diagnose or to rule out other causes of pancytopenia. These are also helpful in planning further investigations and management because many of them are completely curable while others are manageable.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Pancytopenia associated megaloblastic anemia: a clinico-hematological study in a tertiary care hospital

Rohira

Sawke

2019

Trop J Pathol Microbiol

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“…Thrombocytopenia may occur in patients with severe IDA who receive iron therapy; however, it is very uncommon [3]. Its pathogenesis remains undetermined but is thought to be related to the alteration in the activity of iron-dependent enzymes involved in thrombopoiesis [14,20].…”

Section: Discussionmentioning

confidence: 99%

Iron-Induced Thrombocytopenia: A Mini-Review of the Literature and Suggested Mechanisms

Babikir¹,

Raza²,

Soliman³

et al. 2020

Cureus

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Anemia constitutes a major global health burden, and iron deficiency is the most common cause of it. Iron deficiency and replacement affect not only hemoglobin (Hb) levels but also other hematological parameters such as platelet count. In this mini-review, we explore thrombocytopenia as a side effect of iron replacement therapy. We searched for relevant articles published in English, and all case reports/series of iron-induced thrombocytopenia were collected and analyzed. A total of 11 case reports and one case series were found relating to very low Hb at a baseline level of 5.25 +/-2.2 g/dl and variable platelet count at baseline that dropped in 9 +/-3 days to an average of 121 +/-112 x 10 9 /L, which in most of the cases was self-corrected. The parenteral route was more commonly reported to be associated with thrombocytopenia, and discontinuation of therapy was needed in two patients. The mechanisms, prevalence, and clinical significance of thrombocytopenia associated with iron replacement are unknown; several effects of iron on the primary hematopoietic cells and stromal cell lines have been proposed, such as influence on common progenitors, effects on cytokines, and thrombopoietic effect of erythropoietin, which is directly affected by iron levels. Iron replacement can lead to significant thrombocytopenia. Further research is needed to describe the exact incidence, mechanism, and clinical significance of thrombocytopenia associated with iron supplementation.

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“…A single patient with pancytopenia and severe iron deficiency anaemia (Hb-5.5%) showed a micronormoblastic picture on aspiration with erythroid hyperplasia on biopsy and decreased bone marrow iron stores. It has been shown in various studies that iron deficiency presenting with pancytopenia is rare and can be made worse with iron replacement therapy due to decline in leucopoiesis and thromboboiesis [16].…”

Section: Discussionmentioning

confidence: 99%

To Evaluate the Role of Bone Marrow Aspiration and Bone Marrow Biopsy in Pancytopenia

Desalphine

Bagga

Gupta

et al. 2014

JCDR

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Iron deficiency anemia presenting as pancytopenia in an adolescent girl

Cited by 13 publications

References 8 publications

Pancytopenia associated megaloblastic anemia: a clinico-hematological study in a tertiary care hospital

Pancytopenia associated megaloblastic anemia: a clinico-hematological study in a tertiary care hospital

Iron-Induced Thrombocytopenia: A Mini-Review of the Literature and Suggested Mechanisms

To Evaluate the Role of Bone Marrow Aspiration and Bone Marrow Biopsy in Pancytopenia

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