The Indian Journal of Pediatrics

, Volume 52, Issue 2, pp 139–145 | Cite as

Platelet aggregation in iron deficiency anemia

  • R. K. Malhotra
  • A. K. Saraya
  • R. Kumar
  • V. P. Choudhry
  • O. P. Ghai
Original Articles


In-vitro platelet aggregation with ADP, adrenaline and collagen was studied in pediatric patients with iron deficiency before and after iron therapy, and in normal controls. Hyporeactivity of platelets to all agonists was seen in the untreated patients. This returned to normal following correction of anemia by iron therapy. There was a significant correlation between hemoglobin or serum iron and transferrin saturation on the one hand, and parameters of platelet aggregation on the other (P<0.001). Results of zero order correlation coefficient however, showed that platelet reactivity was actually dependent on the hemoglobin levels rather than the iron parameters per se. This may explain the prolonged bleeding time in patients with iron deficiency, particularly those associated with thrombocytopenia. Anemic individuals may be protected against thrombotic disorders due to this reduced platelet reactivity.

Key words

Platelet, Anemia bleeding time 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Lopas H, Rabiner SP: Thrombocytopenia associated with iron deficiency anemia.Clin Pediatr 5: 609, 1966Google Scholar
  2. 2.
    Sahud MA, Olsen H, Pedemont L: (Letter) Thrombocytopenia and iron deficiency.Ann Intern Med 81: 132, 1974PubMedGoogle Scholar
  3. 3.
    Gross S, Keefer V, Newman AJ: Platelets in iron deficiency anemia. I. The response to oral and parenteral iron.Pediatrics 34: 315, 1964PubMedGoogle Scholar
  4. 4.
    Sonneborn D: Thrombocytopenia and iron deficiency (Letter).Ann Intern Med 80: 111, 1974PubMedGoogle Scholar
  5. 5.
    Choi SI, Simone JV, Jackson CW: Megakaryopoiesis in experimental iron deficiency anemia.Blood 43: 110, 1974Google Scholar
  6. 6.
    Cohen JB, Gibar V: Anemia and menstrual blood loss.Obstet Gynecol Surv 35: 597, 1980PubMedGoogle Scholar
  7. 7.
    Lee GR, Wintrobe MM, Bunn HF: Iron deficiency anemia and the sideroblastic anemias: Isselbacher KJ, Adams RD, Braunwald E, Petersdorf RG, Wilson JD, (eds);Principles of internal medicine, 9th edition, McGraw Hill International Book Company, Tokyo, 1980 p 1514Google Scholar
  8. 8.
    Kannel WB, Gordon T, Wolf PA, McNamara P: Hemoglobin and the risk of cerebral infarction, the Framingham study.Stroke 3: 409, 1972PubMedGoogle Scholar
  9. 9.
    Editorial: The bleeding time and the hematocrit.Lancet i: 997, 1984Google Scholar
  10. 10.
    Dacie JV, Lewis SM:Practical hematology 5th ed; Churchill Livingstone, Edinburgh, 1975Google Scholar
  11. 11.
    Ramsay WNM: Plasma iron: The determination of iron in serum or plasma.Adv Clin Chem 1: 1, 1958PubMedCrossRefGoogle Scholar
  12. 12.
    Ressler N, Zak B: Serum unsaturated iron binding capacity.Am J Clin Pathol 30: 87, 1958Google Scholar
  13. 13.
    Anderson BB: Investigation into the Euglena methods for the assay of vitamin B12 in serum.J Clin Pathol 17: 14, 1964PubMedCrossRefGoogle Scholar
  14. 14.
    Herbert V: Aseptic addition method for lactobacillius casei assay of folate activity in human serum.J Clin Pathol 19: 12, 1966PubMedCrossRefGoogle Scholar
  15. 15.
    Wasi P, Disthasongchan P, Na-Nakorn S: The effect of iron deficiency on the levels of hemoglobin A2 and E.J Lab Clin Med 71: 85, 1968PubMedGoogle Scholar
  16. 16.
    Huisman THJ, Dozy AM: Quantitative determination of the minor hemoglobin component HbA2 by DEAE-Cellulose Chromatography.Anal Biochem 2: 400, 1961PubMedCrossRefGoogle Scholar
  17. 17.
    Born GVR: Aggregation of blood platelets by adenosine and its reversal.Nature (Lond) 194: 927, 1962CrossRefGoogle Scholar
  18. 18.
    Barbui T, Battista R: Studio quantitativo dell'aggregazione piastrinica da ADP e da adrenaline mediante I'aggregometro di mustard.La Ricerca in Clinica e in laboratorio 2: 299, 1972Google Scholar
  19. 19.
    Duke WW: The relation of blood platelets to hemorrhagic disease.JAMA 60: 185, 1960Google Scholar
  20. 20.
    Hellem AJ, Borchgrevink CE, Ames SB: The role of red cells in hemostasis: the relation between hematocrit, bleeding time and platelet adhesiveness.Br J Haematol 7: 42, 1961PubMedGoogle Scholar
  21. 21.
    Livio M, Gotti E, Marchesi D, Mecca G, Remuzzi G, de Gaetoma G: Uraemic bleeding: role of anemia and beneficial effect of red cell transfusions.Lancet ii: 1013, 1982CrossRefGoogle Scholar
  22. 22.
    Goldsmith HI: Red cell motions and wall interaction in tube flow.Fed Proc 30: 1578, 1971PubMedGoogle Scholar
  23. 23.
    Turitto VT, Baumgartner HR: Platelet interaction with subendothelium in a perfusion system: physical role of red blood cells.Microvasc Res 9: 335, 1975PubMedCrossRefGoogle Scholar
  24. 24.
    Turitto VT, Weiss HJ: Red blood cells; their dual role in thrombus formation.Science 541, 1980Google Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 1985

Authors and Affiliations

  • R. K. Malhotra
    • 1
  • A. K. Saraya
    • 2
  • R. Kumar
    • 2
  • V. P. Choudhry
    • 1
  • O. P. Ghai
    • 1
  1. 1.Department of PediatricsAll India Institute of Medical SciencesNew Delhi
  2. 2.Haematology Unit, Department of PathologyAll India Institute of Medical SciencesNew Delhi

Personalised recommendations