The Prevalence of Iron Deficiency Anemia in Primary Antiphospholipid Syndrome

Karin KLACK, 1 Vanessa MONMA, 1 Karina PELIÇARI, 2 Simone APPENZELLER, 2 Jozélio Freire de CARVALHO3

1Nutritional Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo-SP, Brazil
2Rheumatology Division, Department of Medicine, Faculty of Medical Science, State University of Campinas (UNICAMP), Campinas, Brazil
3Rheumatology Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo-SP, Brazil

Keywords: Antiphospholipid syndrome; iron deficiency anemia; iron deficiency; nutrition

Abstract

Objectives: The aim of this study was to evaluate the prevalence of subclinical and clinical iron deficiency with iron deficiency anemia in primary antiphospholipid syndrome (PAPS).

Patients and methods: The study was comprised of 29 PAPS patients and 29 healthy controls matched for age, gender, and socioeconomic status. Participants received iron, folic acid, vitamin B12, and vitamin C. A battery of tests was performed to determine the iron storage. The mean disease duration was 70±51.3 months in the patient group.

Results: Iron storage depletion was observed in 10.3% of the individuals in both groups (p=0.5). Iron deficient erythropoiesis (IDE) was observed in only three PAPS patients (10.3%) (p<0.001). Iron deficiency anemia (IDA) was more common in the PAPS patients compared to controls (48.2% vs. 10.3%, respectively; p=0.009). The mean iron levels were significantly lower in the PAPS group than the controls (75.5 vs. 95.8, respectively; p=0.03). Red cell distribution width-coefficient of variation (RDW-CV) (14.9 vs. 13.2; p=0.02) and red cell distribution widthstandard deviation (RDW-SD) (46.7 vs. 40.5; p=0.009) were significantly increased in the patient group. The folic acid and vitamin C levels were lower in the PAPS group than the control group (p<0.05).

Conclusion: This study showed for the first time that PAPS patients have a higher incidence of IDA and IDE compared to healthy controls. This can be attributed to inadequate ingestion of folic acid and vitamin C.