Platelet function alterations and their relation to P-selectin (CD62P) expression in children with iron deficiency anemia

Abstract

Iron deficiency anemia (IDA) may cause platelet aggregation dysfunction and this can be reversed by iron therapy. On the other hand, it has been reported that the platelet fractions carrying the platelet activation markers, CD62P and CD63, are increased in thalassemic patients and there is a significant correlation between the increased levels of soluble P-selectin and free iron in sickle cell disease. This study was performed to investigate the alterations of platelet functions and whether iron deficiency results in diminished expression of activation marker (P-selectin; CD62P) leading to platelet aggregation dysfunction in children with IDA. Hemoglobin, erythrocyte indices (mean erythrocyte volume and red blood cell distribution width), serum levels of iron, transferrin and ferritin, platelet aggregation tests (with ADP, collagen, and ristocetin), PFA-100 closure time, and CD62P expression were evaluated in fasting blood samples of 22 children with IDA and 20 children without anemia. CD62P expression was detected by flow cytometry in normal and 5 μmol/l ADP-activated platelets. Mean closure times were longer in the patient group than control. In platelet aggregation tests, mean values of maximum aggregation times by ristocetin, ADP, and collagen were also more prolonged in patient group. Ristocetin-induced maximum aggregation rates (amplitude) were significantly higher in patients. However, ADP and collagen induction did not produce the same effect. CD62P expressions were significantly higher on activated platelets of the patient group, although they were similar in both groups before activation by ADP. These findings suggest that platelet aggregation and adhesion have been delayed in children with IDA; however, platelet function abnormalities are not associated with CD62P expression on platelet surface.

Iron deficiency-induced thrombocytosis increases thrombotic tendency in rats

“…Our group has previously shown that baseline and ADP-stimulated platelet P-selectin expression was higher in IBD patients with ID as compared to after iron replacement therapy 19 . In another study on children with IDA, P-selectin was likewise elevated on agonist stimulation 34 . Apart from platelet P-selectin, we also found in the current study that plasma soluble P-selectin was increased in ID and diminished upon iron replacement therapy.…”

“…We did not find a significant difference in platelet aggregability to ADP or collagen in ID, although our previous study showed increased aggregability to ADP in platelets from rats after 2 weeks on ID, which then diminished by 3 weeks 16 . Several patient studies have actually reported impaired aggregability to ADP or collagen in IDA 34 , which increases with iron replacement therapy [38][39][40] . This occurred despite an increased PLT in ID in some studies 38,39 .…”

Effect of Severe Maternal Iron Deficiency Anemia on Neonatal Platelet Indices

“…The effect of severe maternal IDA on neonatal platelet indices has not been studied so far. Several authors have demonstrated platelet aggregation and adhesion dysfunction and its reversal after iron therapy in children with IDA [9,10]. Perlman et al have demonstrated an association between severe IDA and thrombocytopenia in children of age 14 mo to 17 y.…”

“…However, there is paucity of literature regarding the effect of maternal iron deficiency and low fetal iron store on fetal thrombopoiesis. Several studies in children or older age group have found a relationship between iron metabolism and thrombopoiesis with iron deficiency anemia (IDA), either in the form of abnormal platelet counts [7,8], or abnormal platelet function [9,10].…”

An Overlooked Side Effect of Iron Treatment: Changes in Menstruation

“…Additionally, the relationships between with iron and platelet function were shown in many studies [20,21] . Yıldırım et al [20] reported that platelet aggregation and adhesion have been delayed in children with iron deficiency anemia. Pratićo et al [21] found that iron (Fe 2+ )…”