Increased Levels of Thrombopoietin and IPF in Patients with Iron Deficiency Anemia

Background

Thrombocytosis has been reported in about 50% of patients with iron deficiency anemia (IDA). However, the mechanism of the increase in the number of platelets is unknown. To investigate the relationship of endogenous thrombopoietin (TPO) and circulating platelet counts, we measured the plasma levels of TPO, immature platelet fraction (IPF) and erythropoietin ( EPO ) in 25 patients with IDA.

Patients and methods

Patients with IDA (newly diagnosed) were recruited from February 2013 through March 2014 in Teikyo University School of Medicine. TPO (Immuno-Biological Laboratory, Japan), was determined by an EILSA. IPF was measured on the Sysmex XE2100. EPO (Roch Diagnostic Japan) was determined by an EILSA.

Results and Conclusions

The number of platelets was increasing in the half patients with IDA in this study. Peripheral blood samples for measuring IPF were obtained from 300 healthy adult controls (160 women and 140 men) and 20 patients with IDA, consisting of 19 women and 6 men with age ranging from 16 to 75 years. The etiology of iron deficiency was gastrointestinal (GI) blood loss, menometrorrhagia, previous GI surgery, and low dietary iron intake. The mean absolute-IPF was significantly higher for IDA patients than for healthy control (8193±571 vs. 4254±193 p＜0.05). The endogenous levels of TPO were significantly elevated in patients with IDA (216.4±41 pg/ ml) as compared with normal controls (116.5±23 pg/ml). Also, The endogenous levels of EPO were significantly elevated in patients with IDA as compared with normal controls. There was a significant inverse correlation between serum Fe levels and platelet counts (r=0.551, p＜0.05). Also, a positive correlation (r=0.311, p＜0.05) between platelet counts and endogenous level of TPO was found. Moreover, there was a significant inverse correlation (r=-0.458, p＜0.05) between Hb and TPO. These results suggest that TPO is active regulator, in thrombopoiesis and megakaryocytopoiesis in patients with IDA. Also, it appears there is relationship between erythropoiesis and TPO.