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Thrombin generation assay in platelet-poor plasma in children with iron deficiency anemia
Umur Özdöl1, Zeynep Canan Özdemir2, Ersin Töret2
1Department of Pediatrics, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkıye.
Insights
Children with iron deficiency anemia (IDA) show increased thrombin generation, indicating a hypercoagulable state. Oral iron replacement therapy effectively reverses these changes within one month.
Area of Science:
- Pediatric Hematology
- Hemostasis and Thrombosis Research
- Anemia Pathophysiology
Background:
- Iron deficiency anemia (IDA) is the most prevalent anemia in childhood.
- IDA is associated with an increased risk of hypercoagulability.
- Endogenous thrombin generation is a key marker of hypercoagulability.
Purpose of the Study:
- To investigate endogenous thrombin production in children with IDA.
- To assess the impact of oral iron replacement on thrombin generation in pediatric IDA.
- To evaluate changes in thrombin generation assay (TGA) parameters before and after iron therapy.
Main Methods:
- Study included 72 children with IDA and 60 healthy controls.
- Thrombin generation assay (TGA) performed on platelet-poor plasma.
- TGA parameters (lag time, time to peak, peak height, ETP) measured before and 1 month after oral iron treatment.
Main Results:
- Children with IDA exhibited significantly increased thrombin generation (higher peak height and ETP, shorter lag time and time to peak) compared to controls.
- One month of oral iron replacement normalized TGA parameters in the IDA group.
- Post-treatment values for lag time, time to peak, peak height, and ETP became similar to those of healthy children.
Conclusions:
- Pediatric IDA is characterized by heightened endogenous thrombin production and a hypercoagulable state.
- Oral iron therapy effectively reverses the prothrombotic changes associated with IDA.
- These findings highlight the importance of addressing iron deficiency to mitigate thrombotic risks in children.
Objectives:
Iron deficiency anemia (IDA) is the most common type of anemia in childhood and it leads to a hypercoagulable state. We investigated endogenous thrombin production in platelet-poor plasma before and after oral iron replacement in children with IDA using the thrombin generation assay (TGA).
Methods:
A total of 72 children diagnosed with IDA (IDA group) and 60 healthy children (control group) were included in the study. Blood samples were collected from the patients before and 1 month after oral iron replacement. TGA parameters [lag time, time to peak, peak height, endogenous thrombin potential (ETP)] were studied.
Results:
In the IDA group, the lag time and time to peak decreased by 8.3% and 10.6%, respectively, and the endogenous thrombin potential (ETP) and peak height both increased by 30% compared to those of the control group. Compared to the values before iron replacement, 1 month after iron replacement, the lag time and time to peak increased by 8.7% and 5%, respectively, and the ETP and peak height decreased by 31% and 31.3%, respectively, and became similar to those of the control group.
Conclusion:
Children with IDA have increased endogenous thrombin production in platelet-poor plasma and a tendency for hypercoagulability. These changes are reversible, and the ETP values become similar to those of healthy children 1 month after iron replacement.
