IRON deficiency anaemia with thrombocytosis was frequently associated with elevated erythropoietin levels, but researchers found no significant relationship between erythropoietin concentration and platelet count, suggesting the hormone alone may not explain the development of reactive thrombocytosis.
Iron deficiency anaemia is the most common nutritional anaemia worldwide and is often accompanied by reactive thrombocytosis. Although erythropoietin production increases in response to anaemia, its contribution to elevated platelet counts has remained uncertain. To investigate this relationship, researchers conducted a hospital based cross sectional study at a tertiary care centre over a 20-month period.
The study included 48 newly diagnosed patients with iron deficiency anaemia and thrombocytosis. Investigators assessed complete blood count, peripheral blood smear findings, iron profile, serum ferritin, and serum erythropoietin concentrations. Anaemia and thrombocytosis severity were classified using World Health Organization and Dame–Sutor criteria, respectively, before correlations between laboratory parameters were analysed.
Women accounted for 77.09% of the study population. More than half of patients, representing 52.09%, had severe anaemia, while mild thrombocytosis was the most common platelet abnormality, affecting 91.6% of participants.
Serum erythropoietin concentrations were elevated in 83.3% of patients. However, statistical analysis demonstrated no significant association between haemoglobin concentration and serum erythropoietin levels (r=0.01; p=0.35). Likewise, no significant relationship was identified between platelet count and serum erythropoietin concentration (r=−0.06; p=0.37).
These findings indicated that although erythropoietin production increased in most patients with iron deficiency anaemia and thrombocytosis, higher hormone levels did not correspond to either worsening anaemia or increasing platelet counts within this cohort.
The authors concluded that erythropoietin alone was unlikely to play a decisive role in the development of thrombocytosis associated with iron deficiency anaemia. While elevated serum erythropoietin was common, its lack of correlation with platelet count suggested that additional biological mechanisms are likely to contribute to reactive thrombocytosis in these patients.
The findings provide further insight into the pathophysiology of iron deficiency anaemia with thrombocytosis and may help inform future research investigating the factors responsible for platelet elevation in this common clinical setting.
Reference
Kulandaivel Al et al. Serum erythropoietin level in cases of iron deficiency anemia with thrombocytosis: a cross-sectional study. Ir J Med Sci. 2026;DOI: 10.1007/s11845-026-04564-z.
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