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Case report
An unusual case of extreme thrombocytosis caused by iron deficiency
  1. Kristin Bergmann1 and
  2. Olav J Bergmann1,2
  1. 1Department of Haematology, Vejle Hospital, Vejle, Denmark
  2. 2Faculty of Health, Aarhus University, Aarhus, Denmark
  1. Correspondence to Dr Olav J Bergmann; OJB{at}


Iron deficiency is a common cause of reactive thrombocytosis resulting in usually mild to moderately increased but sometimes even in extreme thrombocytosis (ie, >1000×109/L). We report a case of a 34-year-old woman who developed an increased platelet count of 1953×109/L. Upon admission, cytoreductive therapy was initiated until an underlying chronic myeloproliferative neoplasia was ruled out. The patient had undergone bariatric surgery 5 years previously, and surprisingly, a diagnosis of reactive thrombocytosis due to iron deficiency secondary to iron malabsorption was made. It is concluded that the degree of extreme thrombocytosis may be even fourfold to fivefold increased in patients with severe iron deficiency. Our finding emphasises the importance of regular control of possible need for iron supplementation following bariatric surgery.

  • haematology (incl blood transfusion)
  • nutritional support
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  • Contributors KB is the primary author and was responsible for data acquisition, analysis, interpretation and manuscript preparation. OJB participated in data interpretation and manuscript evaluation. Both authors read and approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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