June 1974

Iron Deficiency and Thrombocytosis

Author Affiliations

Istanbul, Turkey

Arch Intern Med. 1974;133(6):1070. doi:10.1001/archinte.1974.00320180188017

To the Editor.  —Several points made by Drs. Knizley and Noyes in their article titled "Iron Deficiency Anemia, Papilledema, Thrombocytosis and Transient Hemiparesis" (Arch Intern Med 129:483-486, 1972) need explanations. On carefully examining the case report, we came to two conclusions:1. The case presented must have had long-standing active blood loss, possibly due to internal hemorrhoids—if not from any other cause like intestinal telangiectasia—otherwise, such low levels of hemoglobin, hematocrit, and serum iron would not have developed as a result of only one bleeding episode, which took place one week prior to admission. The papilledema also is suggestive of a long-standing iron deficiency. Findings like thrombocytosis, reticulocytosis, and leukocytosis show that this chronic blood loss had not ceased completely during the patient's stay in the hospital and continued, at least intermittently, perhaps in decreased quantities, only to stop long after his admission.2. The stool tests for blood, we

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