Unveiling the link between iron–zinc deficiencies and thrombocytosis at pediatric age

Aim: Reactive thrombocytosis can result from various mechanisms, including increased megakaryocyte activity and reduced platelet clearance. Iron deficiency, often linked to elevated platelet production, is a common cause. However, the role of zinc deficiency in platelet count changes remains unclear. This study retrospectively investigated the effects of iron and zinc deficiencies on platelet parameters in children. Material and Methods: 73 pediatric patients (36 females, 37 males) were analyzed for platelet count and mean platelet volume (MPV) in relation to ferritin and zinc levels. Patients were grouped as follows: Group 1- normal ferritin and zinc; Group 2- low ferritin, high zinc; Group 3- normal ferritin, low zinc; Group 4- low ferritin and zinc. Statistical analysis included assessment of normality using the Shapiro-Wilk and Kolmogorov-Smirnov tests, followed by one-way ANOVA and post-hoc pairwise t-tests with Bonferroni correction for multiple comparisons, and Pearson correlation analysis for MPV and platelet count relationships. Results: Platelet counts and MPV were similar across all groups, indicating no direct effect of zinc deficiency on thrombocytosis. Zinc-deficient patients had significantly lower ferritin levels (p < 0.05). A moderate inverse correlation was observed between MPV and platelet count (r = -0.548), which became stronger with MPV stratification (r = -0.841). Conclusion: Zinc deficiency was not associated with elevated platelet counts in this cohort. However, its association with reduced ferritin and the observed MPV-platelet relationship highlight the potential influence of trace elements on hematopoiesis. Clinicians should consider nutritional status in the evaluation of pediatric platelet disorders, and further research is warranted to clarify these interactions.