Kalff Hannah, Cario Holger, Holzhauer Susanne
Department of Pediatric Hematology and Oncology, Charité University Medicine, Berlin, Germany.
Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany.
Front Pediatr. 2022 Aug 1;10:926925. doi: 10.3389/fped.2022.926925. eCollection 2022.
Iron deficiency anemia has a high prevalence in children and has repeatedly been implicated as a risk factor for arterial and venous thrombosis. As an effective therapy for iron deficiency anemia is available, understanding the association between this form of anemia and the potentially severe thrombosis phenotype is of major clinical interest. Recent findings shed light on pathophysiology of hypercoagulability resulting from iron-restricted erythropoiesis. Specifically, an animal model of induced iron deficiency allowed identifying multiple mechanisms, by which iron deficiency anemia results in increased thrombus formation and thrombus progression both in arterial and venous thrombosis. These findings complement and support conclusions derived from clinical data. The purpose of this mini review is to summarize current evidence on the association of iron deficiency anemia and thrombosis. We want to increase the awareness of iron deficiency as a risk factor for thrombosis in the pediatric population. We discuss how novel pathophysiological concepts can be translated into the clinical settings and suggest clinical studies on prevention and treatment strategies in high-risk patient groups.
缺铁性贫血在儿童中患病率很高，并且一再被认为是动脉和静脉血栓形成的危险因素。由于有针对缺铁性贫血的有效治疗方法，了解这种贫血形式与潜在的严重血栓形成表型之间的关联具有重大临床意义。最近的研究结果揭示了铁限制红细胞生成导致高凝状态的病理生理学机制。具体而言，诱导缺铁的动物模型有助于确定多种机制，缺铁性贫血通过这些机制导致动脉和静脉血栓形成中的血栓形成增加和血栓进展。这些发现补充并支持了从临床数据得出的结论。本综述的目的是总结目前关于缺铁性贫血与血栓形成关联的证据。我们希望提高对缺铁作为儿科人群血栓形成危险因素的认识。我们讨论了如何将新的病理生理学概念转化为临床实践，并建议针对高危患者群体进行预防和治疗策略的临床研究。
