• S Chaker, S Very, D Helley, P Gaussem, J Pouchot, L Darnige, A-M Fischer, L Capron, and J-B Arlet.
• Service d'hématologie biologique, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, université Paris Descartes, 75908 Paris cedex 15, France.
• Rev Med Interne. 2010 Sep 1; 31 (9): 631-6.

IntroductionIron deficiency is typically associated with microcytic anemia and thrombocytosis. It is a very uncommon cause of thrombocytopenia.Case ReportA 17-year-old female presented with marked fatigue and dyspnea on exertion. Review of systems was only remarkable for abundant menstruations during the past two years. The hemogram revealed a profound microcytic anemia (4.4 g/dL, mean corpuscular volume [MCV] 49 fL) and a thrombocytopenia (33 G/L). Marked iron deficiency was also present: ferritinemia <3 μg/L. Investigations did not find any cause of iron deficiency anemia other than excessive menstrual loss. Bone marrow examination showed an increase number of megakaryocytes, compatible with an immune thrombocytopenia purpura. Iron supplementation completely normalized the platelet count within 48 hours.ConclusionIron affects thrombopoiesis. Because the number of megakaryocytes may then increase in the bone marrow, "iron deficiency thrombocytopenia" may be falsely diagnosed as immune thrombocytopenic purpura, leading to inappropriate corticosteroid therapy. Iron supplementation is the appropriate treatment of iron deficiency thrombocytopenia and allowed a rapid correction of the platelet count in all the 24 cases that have been previously reported with sufficient detail to be analyzed in the literature.Copyright © 2010 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

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