PB0275 - Patients with mild-to-moderate bleeding disorders and bleeding disorder of unknown cause are at an increased risk for iron deficiency

Sunday, June 23, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Presenting Author(s)

Tim Dreier, MD

PhD-Student
Clinical Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna
Vienna, Wien, Austria

Co-Author(s)

Dino Mehic

PhD Student/MD
Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna
Vienna, Wien, Austria
Jasmin Rast

PhD Student/MD
Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna
Vienna, Wien, Austria
HH

Helmuth Haslacher

Senior Consultant for Laboratory Medicine
Department of Laboratory Medicine
Vienna, Wien, Austria
AK

Alexandra Kaider

Statistician
Center for Medical Data Science
Vienna, Wien, Austria
Cihan Ay, MD

Professor
Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna
Vienna, Wien, Austria
Ingrid Pabinger

Professor
Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna
Vienna, Wien, Austria
Johanna Gebhart

Assoc. Professor
Department of Internal Medicine I, Clinical Division of Hematology and Haemostaseology, Medical University of Vienna
Vienna, Wien, Austria

Background: Iron deficiency (ID) and resultant iron deficiency anemia (IDA) are common comorbidities of bleeding disorders. Patients with mild-to-moderate bleeding disorders (MBD) present with lifelong bleeding tendencies (e.g. mucocutaneous bleeding, hypermenorrhagia) or life-threatening bleeding complications after hemostatic challenges (surgery, delivery).

Aims: We aimed to investigate the prevalence of ID and IDA in MBD patients compared to healthy controls (HC), and according to the diagnoses bleeding disorder of unknown cause (BDUC), von Willebrand disease (VWD), platelet function disorders (PFD) and coagulation factor deficiencies (CFD).

Methods: Patients from the Vienna Bleeding Biobank (EC Nr: 603-2009), a prospective cohort study on adult patients with MBD and a group of age- and sex-matched HC were investigated. ID was defined as serum-ferritin of < 30 ng/ml and/or a transferrin-saturation of ≤15%, in accordance with the guidelines of the American Society of Hematology. IDA was defined as ID with anemia (Hemoglobin < 12g/dl for women and < 13g/dl for men).

Results: 646 patients and 202 HC were analysed. Detailed characteristics are shown in table 1. In MBD patients, the overall prevalence of ID was significantly higher with 37% than in HC with 28%. Furthermore, 38% of patients with BDUC and 48% of VWD patients had ID, which was significantly more prevalent than in HC (Table1). The prevalence of IDA was not increased in any of the patient subgroups.
Additionally, female sex was significantly associated with ID, while higher age was associated with physiological iron-status parameter levels. (Figure1)

Conclusion(s): Women with MBD, and especially VWD or BDUC, are at increased risk for ID compared to the general population. These results highlight the importance of thorough testing of iron-status in these patients, regardless of their individual clinical presentation. Due to the comparatively low prevalence of IDA, cell counts alone do not seem sufficient for the detection of an iron deficient state.