Ronald S. Go, MD; Luis F. Porrata, MD; Timothy G. Call, MD
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Go RS, Porrata LF, Call TG. Thrombocytopenia after Iron Dextran Administration in a Patient with Severe Iron Deficiency Anemia. Ann Intern Med. 2000;132:925. doi: 10.7326/0003-4819-132-11-200006060-00025
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Published: Ann Intern Med. 2000;132(11):925.
TO THE EDITOR:
A 30-year-old woman was hospitalized because of progressive fatigue. The physical examination was significant for pallor and a flow murmur. Eight years before presentation, she had undergone gastroplasty for obesity. Iron deficiency anemia secondary to malabsorption was diagnosed 1 year before presentation, when her hemoglobin level was 8 mg/dL. The patient was prescribed iron tablets but discontinued using them because of gastric intolerance. She was then lost to follow-up until the hospitalization described here.
Laboratory tests revealed a hemoglobin level of 3.1 g/dL, a mean cell volume of 77 fL, a reticulocyte count of 2.13%, a platelet count of 426 × 109/L, an iron level of 5 µg/dL, a transferrin saturation of 1%, and a ferritin level of 8 µg/L. The patient's religious faith prohibited blood transfusion. Iron dextran, 100 mg/d, was given intramuscularly until day 8, when the patient developed asymptomatic thrombocytopenia with a platelet count nadir of 20 × 109/L (Figure). Iron dextran was discontinued, and therapy with oral ferrous fumarate, 200 mg, plus ascorbic acid, 120 mg, was started. Within 2 days, the patients' platelet count improved.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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