A 30-year-old woman with long-standing iron deficiency anemia (Hb 7.2 g/dL, MCV 64 fL, serum ferritin 4 ng/mL) has a platelet count of 580 × 10⁹/L. Which statement best explains this finding?
- A She likely has a myeloproliferative neoplasm and needs JAK2 mutation testing
- B Reactive thrombocytosis is common in iron deficiency anemia and usually resolves with iron replacement ✓
- C Thrombocytosis indicates she has combined B12 and iron deficiency
- D Essential thrombocythemia should be considered given the degree of thrombocytosis
Correct answer: B. Reactive thrombocytosis is common in iron deficiency anemia and usually resolves with iron replacement
Explanation
Reactive thrombocytosis occurs in up to 10-15% of patients with iron deficiency anemia and normalizes with iron therapy. It is a benign secondary phenomenon, not requiring myeloproliferative workup. The degree rarely exceeds 1000 × 10⁹/L. This distinguishes iron deficiency from anemia of chronic disease, where thrombocytosis is not typical.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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