Blandinières Adeline, Arlet Jean-Benoît, Gaussem Pascale, Pouchot Jacques, Darnige Luc
Université de Paris, Hôpital européen Georges Pompidou, AP-HP, Service d'hématologie biologique, Paris, France, Université de Paris, Innovative Therapies in Haemostasis, Inserm 1140, Paris, France.
Université de Paris, Hôpital européen Georges Pompidou, AP-HP, Service de médecine interne, Paris, France.
Ann Biol Clin (Paris). 2020 Aug 1;78(4):433-437. doi: 10.1684/abc.2020.1564.
Iron deficiency anemia is frequently associated with thrombocytosis. However, in some rare cases of very severe iron deficiency, a thrombocytopenia may occur. This condition may lead to a misdiagnosis of immune thrombocytopenic purpura and thus to unnecessary tests in this context. Here we report two patients who presented with iron deficiency associated thrombocytopenia rapidly corrected after martial supplementation. We then discuss the value of measuring immature platelet fraction (IPF), which represents the population of newly formed platelets containing a greater amount of residual RNA. For both cases, low IPF values at admission indicated a central origin of thrombocytopenia with decreased platelet production, which is the pathophysiological mechanism of iron deficiency associated thrombocytopenia.
缺铁性贫血常与血小板增多症相关。然而，在一些极重度缺铁的罕见病例中，可能会出现血小板减少。这种情况可能导致免疫性血小板减少性紫癜的误诊，进而在此情况下进行不必要的检查。在此，我们报告两名患者，他们表现为缺铁相关性血小板减少，在补充铁剂后迅速得到纠正。然后我们讨论了测量未成熟血小板比率（IPF）的价值，该比率代表了含有大量残余RNA的新形成血小板群体。对于这两个病例，入院时低IPF值表明血小板减少源于中心性血小板生成减少，这是缺铁相关性血小板减少的病理生理机制。
