Iron Deficiency Anemia in Glanzmann Thrombasthenia: What a Recent Study Found

People with Glanzmann Thrombasthenia (GT) can experience repeated bleeding throughout their lives. Over time, that blood loss can contribute to iron deficiency and iron deficiency anemia (IDA).

A study published in Hemophilia examined how often iron deficiency anemia occurred and how clinicians managed bleeding in children and young people with GT and Bernard-Soulier syndrome (BSS). Researchers reviewed records from one treatment center between 2007 and 2019.

What Did the Study Find?

The study included 14 patients, 12 with Glanzmann Thrombasthenia and two with BSS.

The most striking finding was how common iron deficiency anemia was:

• 79% (11 of 14) developed iron deficiency anemia.
• 57% received oral iron.
• 21% received both oral and IV iron.
• 50% required a red blood cell transfusion because of severe anemia associated with an acute or recent severe bleeding event.

Because this was a very small study that also included two patients with BSS, these percentages do not mean that 79% of everyone with GT will develop iron deficiency anemia.

Why Can GT Cause Iron Deficiency?

Repeated bleeding causes the body to lose iron along with blood.

In this study, nosebleeds were the most common bleeding symptom, affecting 79% of patients. Oral and gastrointestinal bleeding were also reported. All three girls who had reached menarche experienced heavy menstrual bleeding.

This matters because even when individual bleeding episodes are controlled, repeated blood loss can gradually reduce the body’s iron stores.

Can You Have Iron Deficiency Without Anemia?

Yes. Iron deficiency can develop before hemoglobin falls enough for someone to be considered anemic.

The researchers noted that ferritin is commonly used to evaluate stored iron. However, debate continues over the best ferritin level for defining iron deficiency, particularly in people with rare inherited bleeding disorders.

The study’s authors concluded that routine monitoring for iron deficiency, with or without anemia, may help improve health and bleeding management.

What About Preventing Bleeding?

Three patients with recurrent severe bleeding and persistent iron deficiency anemia received long-term preventive recombinant activated factor VII (rFVIIa).

Their annual bleeding rates decreased by 78%, 55%, and 7%. Median hemoglobin increased by 1.3 g/dL, while median ferritin increased by 14.6 ng/mL after prophylaxis began. Iron Deficiency Anemia Glanzman…

However, this involved only three patients, including one with BSS. The researchers stated that larger studies are needed to determine the effectiveness, appropriate dosing, and long-term risks of this approach. Iron Deficiency Anemia Glanzman…

The findings should therefore not be interpreted as showing that preventive rFVIIa is appropriate for everyone with GT.

What Does This Mean for People With Glanzmann Thrombasthenia?

The main takeaway is simple: managing GT may involve paying attention not only to bleeding, but also to the iron lost because of that bleeding.

People who experience frequent nosebleeds, heavy menstrual bleeding, gastrointestinal bleeding, or other recurring blood loss may want to discuss hemoglobin, ferritin, and iron testing with their hematologist.

The study does not establish how often everyone with GT should be tested or what their ideal iron level should be. Those decisions should be individualized based on bleeding history, bloodwork, and medical guidance.

Study Limitations

This was a small retrospective study from a single treatment center. Only 14 patients were included, 12 had GT, and the research focused on pediatric patients. Iron testing also varied considerably between patients.

The findings therefore highlight a potentially important issue in GT care, but larger studies are needed before broader conclusions can be made.

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