Iron Deficiency and Vitamin B12 Deficiency Effects on Mean Platelet Volume (MPV)
Iron deficiency can cause elevated MPV, while vitamin B12 deficiency does not consistently affect MPV values. 1
Iron Deficiency and MPV
- Iron deficiency anemia is associated with increased mean platelet volume (MPV), particularly in patients with more severe and hypochromic anemia 1
- Studies have demonstrated an inverse correlation between iron parameters (serum iron and transferrin saturation) and platelet count in patients with iron deficiency anemia 1
- Patients with more severe iron deficiency anemia tend to have higher MPV values compared to those with milder forms of anemia 1
- The relationship between iron deficiency and elevated MPV is particularly notable in women with iron deficiency anemia and thrombocytosis 1
Vitamin B12 Deficiency and MPV
- Vitamin B12 deficiency is not consistently associated with changes in MPV values 2
- Only 41.1% of patients with vitamin B12 deficiency demonstrate high mean corpuscular volume (MCV ≥100 fl), and MPV changes are not a characteristic feature 2
- Even in patients who develop pernicious anemia from vitamin B12 deficiency, MPV alterations are not a primary hematological finding 2
- When vitamin B12 deficiency co-exists with iron deficiency (which occurs in 22.2% of vitamin B12 deficient patients), the iron deficiency may be the primary driver of any MPV changes 3
Diagnostic Implications
- MPV can serve as an additional diagnostic parameter when evaluating platelet disorders and anemias 4
- High MPV appears correlated with several conditions including iron deficiency, myeloproliferative disorders, and thalassemia 4
- Adding MPV assessment to platelet count evaluation allows for more nuanced detection of hematological disorders, even when platelet counts remain within normal ranges 4
- In patients with normal platelet counts but iron deficiency anemia, MPV may be elevated despite treatment that improves other hematological parameters 5
Clinical Management Considerations
- When elevated MPV is detected, iron studies (serum iron, ferritin, TIBC, transferrin saturation) should be performed to evaluate for iron deficiency 6
- In patients with macrocytosis (elevated MCV) but normal or elevated MPV, both vitamin B12/folate deficiency and iron deficiency should be considered in the differential diagnosis 7
- Treatment of iron deficiency may not immediately normalize MPV, even when other hematological parameters improve 5
- In patients with both iron and vitamin B12 deficiencies, addressing both nutritional deficiencies is important, as mixed deficiency states can present with complex hematological pictures 3
Monitoring Response to Treatment
- When treating iron deficiency, there may be a decrease in platelet count and plateletcrit, but MPV often remains unchanged despite improvement in other parameters 5
- Monitoring both iron parameters and platelet indices can provide insights into treatment response in patients with iron deficiency anemia 1
- In patients with combined deficiencies, intravenous iron supplementation may be more effective than oral supplementation for normalizing iron status 3