Mechanisms of Thrombocytosis in Iron-Deficiency Anemia.

Iron-deficiency anemia is frequently accompanied by reactive thrombocytosis, yet the mechanisms underlying this association remain incompletely understood. Beyond impaired erythropoiesis, iron availability has emerged as an active regulator of hematopoietic lineage decisions. This review synthesizes current evidence on how iron deficiency influences megakaryocytic-erythroid balance, with emphasis on progenitor-level regulation, iron sensing pathways and downstream megakaryocyte maturation. We discuss experimental and clinical studies supporting compensatory hematopoietic responses under iron-deficient conditions and propose an integrated framework linking systemic iron status to altered platelet and erythroid output.