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P333. Thrombocytosis and iron deficiency in inflammatory bowel disease patients: a mutual relationship

E. Voudoukis1, K. Karmiris1, P. Oustamanolakis2, A. Theodoropoulou1, A. Charitakis3, Z. Archontakis3, K. Giannakopoulou3, A. Sfiridaki4, G. Paspatis1, I. Koutroubakis2, 1Venizelion General Hospital, Department of Gastroenterology, Heraklion-Crete, Greece, 2University Hospital, Department of Gastroenterology, Heraklion-Crete, Greece, 3Venizelion General Hospital, Laboratory of Haematology, Heraklion-Crete, Greece, 4Venizelion General Hospital, Blood Bank, Heraklion-Crete, Greece

Background

Thrombocytosis and iron deficiency anemia (IDA) are frequent complications of inflammatory bowel disease (IBD). The aim of this study was to investigate the correlation between IDA and thrombocytosis in IBD patients.

Methods

198 consecutive IBD patients and 102 healthy controls (HC) participated in the study. The parameters investigated were: PLT, MPV, PDW, PCT, HCT, Hb, MCV, RDW, ferritin, soluble transferrin receptor (sTfR), sTfR-F index (sTfR-F = sTfR/log10 ferritin), vitamin B12, folic acid. Thrombocytosis was defined as an absolute number of PLT >4×105/µL. Disease activity indices (CDAI for CD and SCCAI for UC) as well as CRP were also correlated with the study parameters.

Results

The patients demonstrated decreased HCT, Hb, MCV, MPV and ferritin and increased absolute PLT count, RDW, PDW, PCT, sTfR and sTfR-F index compared to HC (p < 0.0001). Twenty-seven patients exhibited thrombocytosis (13.6%). These patients presented with more severe anemia, significantly altered markers of IDA (RDW, sTfR, sTfR-F index increase and MCV, ferritin decrease) and increased inflammatory indices (CRP, CDAI, SCCAI) compared to those without thrombocytosis (p < 0.05). The absolute PLT count of the IBD patients correlated with HCT, Hb, MCV, RDW, Fe, ferritin, sTfR, sTfR-F, CRP, SCCAI and CDAI. All the other PLT-associated parameters (MPV, PDW and PCT) correlated only with Hb and sTfR (Spearman's rho correlation). In the multivariate analysis only Hb, RDW, CRP, ferritin and sTfR-F continued to correlate with the absolute PLT count (p < 0.05). None of the aforementioned was observed in the HC. Moreover, the absolute PLT count was associated with patients' age (r = −0.23, p = 0.001) and body weight (r = −0.23, p = 0.02) as well as with the use of azathioprine (p = 0.02) and 5-aminosalicylic acid (5-ASA, p = 0.04). Both drugs were associated with a decreased absolute PLT count.

Conclusion

Absolute PLT count seems to correlate with IDA parameters as well as with disease activity in our cohort of IBD patients. Hemoglobin, RDW, CRP, ferritin and sTFR-F were the strongest predictors of thrombocytosis in these patients. Controlling the inflammation and managing IDA could lead to reversing thrombocytosis in IBD patients.