From famine to feast: a seesawing platelet count in severe iron deficiency anemia

A 22-month-old previously healthy girl presented with profound microcytic anemia and severe thrombocytopenia due to iron deficiency. Following transfusions and iron supplementation, her platelet count rose dramatically, peaking at 3.5 million/µL before gradually normalizing over several months. This case highlights the rare presentation of iron deficiency with severe thrombocytopenia, which can mimic bone marrow disorders. It also illustrates the phenomenon of rebound thrombocytosis after iron repletion, emphasizing the need for close platelet monitoring to mitigate potential thrombotic risk.