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El cáncer broncogénico tiene una base genética, que se expresa por factores externos relacionados a la exposición medioambiental y laboral, en los últimos años ha cambiado el perfil epidemiológico con incidencia creciente en mujeres sin hábito tabáquico en rangos de 50-70 años. Paciente femenino de 50 años con el antecedente de exposición a humo de leña y uso de pesticidas, con síndrome de atelectasia pulmonar masiva izquierda. Se realizó estudios fibrobroncoscopicos con toma de biopsia de masa tumoral endobronquial izquierda y se realizó la primera criobiopsia por fibrobroncoscopía en Bolivia, posteriormente paciente fue sometida a neumonectomia izquierda con estudio histopatológico concluyente de carcinoma indiferenciado de células pequeñas con primario pulmonar. Existe una fuerte asociación entre la exposición medio-ambiental y laboral y el cáncer broncogénico en pacientes no fumadores, incluso en variantes histopatológicas infrecuentes en este subgrupo como el cáncer de células pequeñas o microcítico.
Bronchogenic cancer has a genetic basis, which is expressed by external factors related to environmental and occupational exposure. In recent years, the epidemiological profile has changed with increasing incidence in women without tobacco habit in ranges of 50-70 years. A 50-year-old female patient with a history of exposure to wood smoke and pesticide use, with massive left lung atelectasis syndrome. Fibrobronchoscopy studies were performed with a biopsy of the left endobronchial tumor mass and the first cryobiopsy was performed by fibrobronchoscopy in Bolivia, later the patient underwent left pneumonectomy with a conclusive histopathological study of undifferentiated small cell carcinoma with a pulmonary primary. There is a strong association between environmental and occupational exposure and bronchogenic cancer in non-smokers, even in infrequent histopathological variants in this subgroup such as small cell or microcytic cancer.
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Objective:The study was planned to evaluate the clinical utility of microcytic anemia factor (MAF) and low hemoglobin density (LHD%) in the screening of iron deficiency in blood donors.Methods:A total of 400 blood donors, 200 male and 200 female, were randomly admitted to Fujian Blood Center from January1, 2022 to February 28, 2022 by the way of stratified sampling. According to the fourth edition of Diagnostic and therapeutic criteria for hematological diseases, the patients were divided into three groups: normal group (N=299), iron depletion group (ID, n=54) and iron deficient erythropoiesis group (IDE, n=47), Blood routine indexes including hemoglobin (HGB), mean corpuscular volume hemoglobin (MCV), mean corpuscular hemoglobin content (MCH), mean corpuscular hemoglobin concentration (MCHC) and iron metabolism indexes including serum ferritin (SF), serum iron (SI), total iron binding capacity (TIBC), transferrin saturation (TS) and unsaturated iron binding capacity (UIBC) were measured, MAF and LHD% were calculated by formula.One-way ANOVA or Kruskal-Wallis H tests were used to analyze the differences among three groups. Spearman correlation analysis was used to analyze the correlation between MAF and LHD% and iron metabolism indexes.The Receiver Operating Characteristic (ROC) curve was used to evaluated the diagnostic value of MCH, MCHC, MAF and LHD% for iron deficiency in blood donors. Results:MAF in ID group which was 11.81±0.81 were higher than the IDE group which was 10.69±0.95 and lower than the healthy group which was 13.17±1.24, the total difference among the three groups was statistically significant ( F=110.784, P<0.001), the difference between two groups was statistically significant ( P<0.01); LHD% in ID group which was 2.61 (1.87, 3.91)% were lower than the IDE group which was5.60(2.99, 8.02)% and higher than the healthy group which was1.74 (1.22, 2.73)%, the total difference among the three groups was statistically significant ( H=62.166, P<0.001), the difference between two groups was statistically significant ( P<0.01).In 101 iron deficiency blood donors, Spearman correlation analysis showed that MAF was positively correlated with SF, SI and TS ( r=0.426, P<0.01; r=0.547, P<0.01; r=0.566, P<0.01);contrarily, LHD% was negatively correlated with SF, SI and TS ( r=-0.397, P<0.01; r=-0.400, P<0.01; r=-0.479, P<0.01).The areas under the ROC curve of MCH, MCHC, MAF and LHD% diagnostic ID were 0.745, 0.646, 0.819 and 0.646, respectively;the cut-off value of MAF was 12.56, with a sensitivity of 67.90% and a specificity of 83.30%.While the areas under the ROC curve of MCH, MCHC, MAF and LHD% diagnostic IDE were 0.901, 0.834, 0.941 and 0.834, respectively; the cut-off value of MAF was 11.73, with a sensitivity of 87.60% and a specificity of 87.20%. Conclusions:MAF performed a high diagnostic value of iron deficiency, especially IDE, and can be used as a marker in the diagnosis of iron deficiency in blood donors.
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Background: Anemia is widespread public health problem with 1.62 billion people affected globally. In India, Anemia is considered a major health problem. Children, women of child bearing age and pregnant women are more prone to develop anemia. Anemia affects the physical and mental growth of children, associated with increase maternal and fetal mortality, leads to reduced work productivity in adults. The present study was undertaken to determine prevalence and severity of anemia among patients who attended the outpatient clinics of a Unani research hospital in Telangana. Methods: This hospital based retrospective observational study wasconducted from January 2020 to December 2020 to investigate the prevalence, type, and determinants of anemia. The complete haemogram values of all the patients who underwent haemogram investigation were noted, information was compiled, tabulated, and analysed. Descriptive statistics were computed with percentages, mean, standard deviation, and student抯 t-test was used find the significance of study parameters.Results: Prevalence of anemia was 26.2% (872/3326), high prevalence of anemia was observed in females (44.04%) compared to males (5.72%) (p<0.0001). The prevalence was more in reproductive age group (58.6%). Moderate anemia (58.6%) was more prevalent followed by mild anemia (36.6%). Microcytic hypochromic blood picture predominates with the incidence of 53.6% followed by normocytic blood picture 42.2%.Conclusions: Results confirmed high prevalence of anemia in females and moderate anemia being more prevalent followed by mild anemia and majority of anemia cases were microcytic, suggesting iron deficiency as the main cause of anemia.
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The advent of automation has made diagnosis of Anemia and to some extent its underlying cause easy. The objective of our study is to correlate RBC indices and RBC Histogram findings with peripheral smear to provide a better approach in accurate diagnosis of Anemia and to analyze their limitations. All cases of Anemia as per WHO reference range of Hemoglobin levels were included in our study. Patients who have received medical treatment for Anemia in past three months, patients having recent history of blood transfusion, patients having Leukemia or Leukemoid reactions were excluded from the study. Venous blood samples collected from these patients were run in SYSMEX automated hematology analyzer and complete blood count, Red Blood Cell (RBC) indices ie, Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin (MCH), Mean Corpuscular Hemoglobin Concentration (MCHC), Red Cell Distribution Width (RDW) and RBC Histogram were obtained and peripheral smears were examined. Anemia typing was done based on RBC indices and position, shape and skewing of RBC histograms, followed by peripheral smear examination for morphological typing of Anemia. The diagnoses made by peripheral smear versus RBC histogram and indices were compared and analysed
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Introducción: El cáncer de pulmón constituye una de las principales causas de muerte en Cuba. La mayoría de los enfermos acuden al servicio de salud en etapa avanzada de la enfermedad, la poliquimioterapia es uno de los tratamientos utilizados. Objetivos: Evaluar la respuesta al tratamiento con cisplatino-etopósido vs cisplatino-paclitaxel, en pacientes con carcinoma no microcítico en estadios avanzado de la enfermedad. Métodos: Se realizó un estudio descriptivo, prospectivo, en 40 pacientes diagnosticados con carcinoma no microcítico en estado avanzado de la enfermedad, que fueron asignados de forma aleatoria a uno de los dos grupos de tratamiento de cisplatino + etopósido (n=20) y cisplatino + paclitaxel (n=20) en el Hospital Neumológico Benéfico Jurídico en el período comprendido desde enero de 2017 a septiembre de 2018. Resultados: Predominaron pacientes del sexo masculino entre 50 a 69 años de edad, 37,5 por ciento en estadio IV. En 72,5 por ciento de los pacientes se encontró una respuesta clínica al tratamiento, en la modalidad de cisplatino + etopósido 70 por ciento y en cisplatino + paclitaxel 75 por ciento respectivamente. Se observó un porcentaje similar de respuesta objetiva antitumoral, 32,5 por ciento de los pacientes tuvieron una reducción parcial de la lesión tumoral, mientras que en otro 32,5 por ciento se observó estabilidad de la enfermedad. Por el contrario, en 35 por ciento restante hubo progresión de la enfermedad. Conclusiones: Se concluye que ambas modalidades tienen una efectividad similar en la evolución clínico-radiológica de los enfermos de carcinoma no microcítico en etapa avanzada(AU)
Introduction: Lung cancer constitutes one of the main causes of death in Cuba. Most of the patients come to the health service at an advanced stage of the disease. Polychemotherapy is one of the treatments used. Objectives: To assess the response to treatment with cisplatin-etoposide vs. cisplatin-paclitaxel, in patients with advanced non-small cell carcinoma. Methods: A descriptive, prospective study was conducted in 40 patients diagnosed with advanced non-small cell carcinoma. They were randomly assigned to one of the two treatment groups: cisplatin + etoposide (n = 20) and cisplatin. + paclitaxel (n = 20) at the Pneumologic Hospital from January 2017 to September 2018. Results: Male patients predominated, ages ranged between 50 and 69 years, 37.5 percent were in stage IV. Clinical response to treatment was found in 72.5 percent of patients, that is, 70 percent in the modality of cisplatin + etoposide and 75 percent in cisplatin + paclitaxel. Similar percentage of objective antitumor response was observed, that is, 32.5 percent of the patients had partial reduction of the tumor lesion, while disease stability was observed in 32.5 percent . In contrast, in the remaining 35.0 percent , disease progression was observed. Conclusions: Both modalities are concluded to have similar effectiveness in the clinical-radiological evolution of persons suffering from non-microcytic carcinoma in advanced stage(AU)
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Humans , Male , Female , Carcinoma, Non-Small-Cell Lung/drug therapy , Drug Therapy, Combination/methods , Epidemiology, Descriptive , Prospective Studies , Carcinoma, Non-Small-Cell Lung/mortality , Cuba , Dose-Response Relationship, DrugABSTRACT
Background: Anemia is a most common health issue in Indian population mainly due to nutritional deficiencies. A number of factors contribute in anemia which is further categorized based on various parameters in hematological indices and microscopic examination.Methods: A retrospective study has been carried out on the patients (n = 1332) in a retrospective study on the patients (n = 1332) in Raebareli district to determine prevalence of anemia and subsequent categorization into normocytic, microcytic and macrocytic based on complete blood count (CBC) profile and blood smear.Results: This study demonstrates 15.54% patients were diagnosed for anemia and more than half of the total anemic patients (55.07%) were found to be suffered from macrocytosis which was found significantly more prevalent among male (65.17%) compare to female (38.38%) patients.Conclusions: Several factors may contribute to macrocytosis among male population including alcoholism in Raebareli region. However, female patients were found almost equally susceptible to all three forms of anemia: normocytic, microcytic and macrocytic. This study provides a key insight into prevalence and possible causes of different types of anemia in this region which may be useful for implementation of government health programs to counter this problem and provide better treatment plans.
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@#Introduction: Differentiating between thalassaemia and iron deficiency anaemia (IDA) in hypochromic anaemia is a challenge to pathologists as it influences the choice of subsequent specialized confirmatory tests. In this study, we aimed to evaluate the performance of microcytic to hypochromic ratio (MicroR/ Hypo-He, M/H ratio) as a discriminant index in hypochromic anaemia. Materials and Methods: A retrospective study was carried out on 318 subjects with hypochromic anaemia, which comprised 162 IDA and 156 thalassaemia trait subjects with α-thalassemia, β-thalassemia and HbE trait. Optimal cut-off value, sensitivity and specificity of M/H ratio for thalassaemia trait discrimination was determined using Receiver Operating Characteristic (ROC) analysis. Results: Subjects with thalassaemia trait showed higher MicroR compared to IDA ( p< 0.001) while subjects with IDA demonstrated higher Hypo-He than thalassaemia trait (p < 0.001). M/H ratio was significantly higher in thalassaemia trait compared to IDA, with medians of 3.77 (interquartile range: 2.57 – 6.52) and 1.73 (interquartile range: 1.27 – 2.38), respectively (p < 0.001). M/H ratio > 2.25 was the optimal cut-off value for discriminating thalassaemia trait from IDA in hypochromic anaemia, with the area under ROC curve (AUC) of 0.83, sensitivity of 80.8% and specificity of 71.6%. Conclusions: M/H ratio is a useful discriminant index to distinguish thalassaemia trait from IDA in hypochromic anaemia prior to diagnostic analysis for thalassaemia confirmation. High M/H ratio is suggestive of thalassaemia trait than of IDA. However, more studies are required to establish the role of M/H ratio as a screening tool for thalassaemia discrimination in hypochromic anaemia.
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Introduction: Red blood cell (RBC) indices and histogramobtained from automated analyzer give an idea aboutmorphological changes in anaemia. Along with the peripheralsmear, they can be used to interpret the cause of anaemia.The aim of the present study was to correlate typing ofanaemia based on RBC indices and histograms obtained fromautomated analyzer with peripheral smear examination and togive a better approach in the diagnosis of anaemia and analysetheir limitations.Material and methods: Blood samples collected from1575 anaemic patients, over a period of one year, in theHematology laboratory, were typed for anaemia, first byparameters obtained by haematology analyzer (RBC indiceswith red cell distribution width) and then by peripheral bloodsmear findings. The correlation between the diagnosis madeby peripheral smear versus RBC indices and histogram wereanalysed to find out the significance of the mean difference invarious parameters.Results: Microcytic hypochromic anaemia (50.86%) wasthe most common followed by normocytic normochromic(25.14%), macrocytic (2.29%), dimorphic (15.43%) andhaemolytic anaemia (6.29%) as diagnosed on peripheralsmear examination. Analysis by RBC indices showed 59.43%,32%, 3.43%, 2.86% and 2.29% of microcytic hypochromic,normocytic normochromic, macrocytic, dimorphic andhaemolytic anaemia respectively. Out of 801 (50.86%) casesof microcytic hypochromic anaemia on smear, 513(32.5%)revealed left shift while 288 (18.3%) showed broad-basedcurve on the histogram. In normocytic normochromic anaemia,anormal bell-shaped curve was seen in 378 cases (25%)while 18 cases (1.1%) showed the broad curve. Histogramsin macrocytic anaemia show a right shift in 27 cases (1.7%)while 9 cases (0.6%) showed left shift. In dimorphic anaemia,the histogram was bimodal only in 2.9% of cases whereas amajority (11.4%) showed broad-base histogram.Conclusion: Histogram and RBC indices give valuableinformation, but peripheral smear examination remains theimportant diagnostic tool in haematological disorders.
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ABSTRACT Background: Refractory or unexplained iron deficiency anemia accounts for about 15% of all cases. The endoscopic gastrointestinal workup sometimes fails to establish the cause of iron deficiency anemia and a considerable proportion of patients regardless of risk category fail to respond to oral iron supplementation. The aim of the present study was to assess the etiological role of Helicobacter pylori infection in adult Egyptian patients with unexplained or refractory iron deficiency anemia. Methods: A case controlled study was composed of 104 iron deficiency anemia cases and 70 age- and gender-matched healthy controls. Patients were diagnosed with iron deficiency anemia according to hemoglobin, mean corpuscular volume, serum ferritin, and transferrin saturation. Upper and lower endoscopies were performed and active H. pylori infection was investigated by testing for the H. pylori antigen in stool specimens. Hematological response to H. pylori treatment with triple therapy together with iron therapy (n = 32) or only iron therapy (n = 32) were assessed in patients with H. pylori infection. Results: H. pylori infection was more prevalent in patients with unexplained or refractory iron deficiency anemia (61.5%). Of the different hematological parameters investigated, there was a significant correlation only between H. pylori infection and mean corpuscular volume (p-value 0.046). Moreover, there was a significant correlation between receiving triple therapy together with iron supplementation and improvements in the hematological parameters [hemoglobin (p-value < 0.001), mean corpuscular volume (p-value < 0.001), iron (p-value < 0.001) and serum ferritin (p-value < 0.001)] compared to receiving iron supplementation alone. Conclusions: Failing to test for H. pylori infection could lead to a failure to identify a treatable cause of anemia and could lead to additional and potentially unnecessary investigations. Furthermore, treatment of H. pylori infection together with iron supplementation gives a more rapid and satisfactory response.
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Humans , Male , Female , Adult , Middle Aged , Aged , Anemia, Refractory , Helicobacter pylori , Anemia, Iron-Deficiency , Medically Unexplained SymptomsABSTRACT
ABSTRACT Background: Anemia during childhood is one of the biggest public health problems worldwide, including Brazil. Insufficient or abnormal production of hemoglobin, loss of iron and excessive destruction of red blood cells are the most common causes of anemia. Among the reasons of anemia, iron deficiency accounts for 50% of anemia cases in developing countries. Affected individuals present a wide range of clinical problems, including delayed neuropsychomotor progression, impaired cellular immunity and reduction of intellectual capacity. This study aimed to evaluate the prevalence of anemia in children attending public schools in the metropolitan region of Curitiba, Paraná, Brazil. Method: A retrospective study was conducted of 409 children aged 8-12 years old included in an extension project of the Universidade Federal do Paraná. The results of complete blood count and hemoglobin electrophoresis of all children were evaluated. Anemia was considered when the hemoglobin levels were <11.5 g/dL. Results: The prevalence of anemia was found to be 2.2% of the population studied, with hypochromic microcytic anemia being the most common type. Seven children had sickle cell trait and one had β-thalassemia. Conclusion: The prevalence of anemia in this study was considered normal according the World Health Organization classification, which is different from the data found in other Brazilian regions.
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Humans , Male , Female , Child , Blood Cell Count , Cross-Sectional Studies , Anemia, Iron-Deficiency , Anemia , Anemia, HypochromicABSTRACT
El objetivo de este trabajo fue determinar la evolución del desempeño analítico en la determinación de hierro sérico, de los laboratorios participantes del Sub- Programa PEEC-Hematología (PEEC-H) del Programa de Evaluación Externa de Calidad Prof. Dr. Daniel Mazziotta de la Fundación Bioquímica Argentina, mediante el análisis de los resultados de ferremia en 6 encuestas (E) realizadas en los meses de julio entre los años 2010 y 2015 (E 77, 81, 85, 89, 93 y 97). Hasta el 2011 se utilizaban métodos con y sin desproteinización, siendo estos últimos los más utilizados (94%). En 2015 en la red de laboratorios se emplearon solamente métodos directos sin desproteinización, siendo los colorimétricos los más utilizados (aproximadamente 95%). El Desvío Relativo Porcentual aceptable (DRPa) fue de ±10% en todas las encuestas analizadas. El 56% de los laboratorios tuvieron un desempeño promedio aceptable en las E 77, 81 y 85, evolucionando 3 años después, a 70% en las E 89, 93 y 97. Según estas consideraciones, al presente no es necesario ajustar el DRPa para el analito hierro, ya que con este valor los laboratorios aún deben trabajar para lograr una mejoría en su desempeño.
The aim of this work was to evaluate the evolution of the analytical performance of serum iron determination by the laboratories participating in the Sub- Program PEEC-Hematology (PEEC-H) EQAS Program Prof. Dr. Daniel Mazziotta of the Argentine Biochemical Foundation. To this end, results of serum iron determinations from July 2010 to July 2015 (surveys #77, 81, 85, 89, 93 and 97) were used. Up to 2011, there were methods both with and without deproteinization, the latter being the most used (94%). In 2015, only one commercial method without deproteinization was used, with colorimetric methods employed in 95% of the cases. In all the surveys analyzed, the acceptable DRP was ±10%. In surveys 77, 81 and 85, 56% of the laboratories had an acceptable performance percentage, and it evolved to a 70% in the surveys 89, 93 and 97, three years later. According to these considerations, there is no need to adjust the acceptable DRP for the iron analyte. In this way, laboratories will continue to work in order to improve their performance.
O objetivo deste estudo foi determinar a evolução do desempenho analítico na determinação de ferro sérico, dos laboratórios participantes no Sub-Programa PEEC-Hematologia (PEEC-H) do Programa de Avaliação Externa de Qualidade Prof. Dr. Daniel Mazziotta da Fundación Bioquímica Argentina, através da análise dos resultados de ferremia em 6 pesquisas de opinião (E) realizadas nos meses de julho entre os anos 2010 a 2015 (Pesquisa No. 77, 81, 85, 89, 93 e 97). Até 2011 eram empregados métodos com e sem desproteinização, sendo os colorimétricos os mais utilizados (aproximadamente 95%). O Desvio Relativo Percentual aceitável (DRPa) foi de ±10% em todas as pesquisas analisadas. 56% dos laboratórios tiveram desempenho médio aceitável nas pesquisas 77, 81 e 85, progredindo para 70% nas pesquisas de 89,93 e 97, 3 anos mais tarde. De acordo com estas considerações, hoje não é necessário ajustar o DRPa para o analito ferro, visto que com esse valor os laboratórios ainda devem trabalhar para alcançar uma melhoria no seu desempenho.
Subject(s)
Humans , Quality Control , Clinical Laboratory Techniques/methods , Iron/analysis , Clinical Laboratory Techniques , Total Quality Management , LaboratoriesABSTRACT
In Korea, recent epidemiologic studies show that the incidence of β-thalassemia is increasing as the influx of South-East Asian population increases and molecular technologies develop. However, many patients are still misdiagnosed as iron deficiency anemia (IDA). All patients with microcytic anemia need to perform evaluation including reticulocyte index, Mentzer index, and iron studies. Considering the increasing incidence of β-thalassemia, hemoglobin beta globulin (HBB) gene sequencing should be performed if suspicious. In our cases, patients whose parents were both Koreans were confirmed to have β-thalassemia with a substitution in c1, ATG>GTG, and deletion of the HBB gene. In Korea, initiation condon ATG>AGG (20.9%) is most common mutation, followed by codon 17 (A>T) (17.6%), codon 121 (G>T) (12.1%), and so on. We report two cases of β-thalassemia diagnosed by genetic testing for microcytic anemia.
Subject(s)
Humans , Anemia , Anemia, Iron-Deficiency , Asian People , Beta-Globulins , beta-Thalassemia , Codon , Epidemiologic Studies , Genetic Testing , Incidence , Iron , Korea , Parents , ReticulocytesABSTRACT
In Korea, recent epidemiologic studies show that the incidence of β-thalassemia is increasing as the influx of South-East Asian population increases and molecular technologies develop. However, many patients are still misdiagnosed as iron deficiency anemia (IDA). All patients with microcytic anemia need to perform evaluation including reticulocyte index, Mentzer index, and iron studies. Considering the increasing incidence of β-thalassemia, hemoglobin beta globulin (HBB) gene sequencing should be performed if suspicious. In our cases, patients whose parents were both Koreans were confirmed to have β-thalassemia with a substitution in c1, ATG>GTG, and deletion of the HBB gene. In Korea, initiation condon ATG>AGG (20.9%) is most common mutation, followed by codon 17 (A>T) (17.6%), codon 121 (G>T) (12.1%), and so on. We report two cases of β-thalassemia diagnosed by genetic testing for microcytic anemia.
Subject(s)
Humans , Anemia , Anemia, Iron-Deficiency , Asian People , Beta-Globulins , beta-Thalassemia , Codon , Epidemiologic Studies , Genetic Testing , Incidence , Iron , Korea , Parents , ReticulocytesABSTRACT
Background: Sickle cell disease (SCD) patients have mechanisms that are thought to protect them more than apparently normal individuals from iron deficiency. However, evidence exists that in SCD, hypoferritinaemia may be more prevalent than hyperferitinaemia, especially in developing countries. Methods: Serum ferritin (SF) levels were measured - using an ELISA based kit (Biocheck, USA), and disease severity calculated in fifty- two asymptomatic steady state (ASS) SCD patients; who were iron chelation naive and both parameters correlated. Erythrocyte morphology and malaria parasitaemia were assessed, patients with parasitaemia were excluded. 64 apparently normal individuals in the same environment and socioeconomic group were also assessed as above and served as controls. Statistical analysis was done using SPSS version 20. Results were expressed as means and standard error of mean. Level of significance was set at p= 0.05. Results: 30.7% and 7.6% of the test subjects had hypoferritinaemia and hyperferritinaemia respectively compared to controls, where 56% had hypoferritinaemia and none had hyperferritinaemia. Erythrocyte morphology showed hypochromia and microcytosis to different degrees in all test subjects assessed: 1+ (10.5%), 2+ (63.2%) and 3+ (26.3%), while only 5% of controls had hypochromia and microcytosis. Blood transfusion and age did not seem to significantly affect SF levels (p= 0.65 and 0.93) respectively. SF levels increased progressively with disease severity but didn’t reach statistical significance (p=0.29). Conclusion: The results suggest that hypoferritinaemia is more prevalent than hyperferitinaemia, and that SF levels may be a useful index for computing an objective severity score in SCD management. Anaemia of chronic inflammation may cause a significant part of the anaemia in SCD.
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Iron-deficiency anemia (IDA) is the most frequent hematologic and nutritional disorder in children. The risk factors associated with IDA in children are rapid growth with inadequate dietary iron, low birth weight, premature birth, perinatal bleeding, early cow's milk intake, and breastfeeding beyond 6 months without iron supplementation. Blood loss is also an important cause of IDA. Most children with IDA are asymptomatic and may go undiagnosed. The diagnosis of IDA is confirmed by microcytic hypochromic anemia and a low level of serum ferritin. Monitoring the response to iron supplementation is a reasonable intervention for a clinically stable child with mild anemia and inadequate iron intake. IDA must be differentiated from the anemia that arises from chronic disease and thalassemia. Oral iron is usually recommended as first-line therapy. Parenteral iron is indicated in cases of poor compliance or failure of oral iron, intestinal malabsorption, or chronic bleeding.
Subject(s)
Child , Humans , Infant, Newborn , Anemia , Anemia, Hypochromic , Anemia, Iron-Deficiency , Breast Feeding , Chronic Disease , Compliance , Diagnosis , Ferritins , Hemorrhage , Infant, Low Birth Weight , Iron , Iron, Dietary , Milk , Nutrition Disorders , Premature Birth , Risk Factors , ThalassemiaABSTRACT
Background: Hemoglobinopathies are the most common inherited red cell disorders worldwide. Identification of these disorders is immensely important epidemiologically and for improved management protocols. Aim and Objectives: Our aim was to determine the prevalence of hemoglobinopathies in patients with microcytic hypochromic anemia and to assess the suitability of using high performance liquid chromatography (HPLC) routinely for screening antenatal cases and patients with anemia. Materials and Methods: A total of 4335 cases received from Mar 2007 to Nov 2011 were studied for various hemoglobinopathies and variants on BIO RAD ‘VARIANT’ analyzer. Results: Of the 4335 cases studied, 2119 were antenatal cases, 1710 patients with other disorders and 506 family studies. Of these, 688 cases displayed abnormal hemoglobin fractions on HPLC of which 140 were antenatal women. There were 455 cases of thalassemia trait, 24 thalassemia major, 20 thalassemia inter-media, 54 sickle cell trait, fi vesickle cell disease, 21 double heterozygous thalassemia–sickle cell trait, nineand 4 Hb D- Punjab heterozygous and homozygous respectively, three Hb D Thalassemia trait, 20 and 37 Hb E homozygous and heterozygous respectively, three Hb E Thalassemia trait and four cases of Hb Q India. Twenty nine adults had isolated HbF elevation. Conclusion: Our study found a high prevalence (15.8%) of hemoglobinopathies amongst microcytic hypochromic anemia and antenatal cases. An accurate diagnosis helps in preventing unnecessary iron loading. Screening all antenatal cases with anemia helps in timely antenatal counseling, thus preventing the psychological trauma of bearing a transfusion dependent child for life.
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The present cross-sectional study involving 240 women of reproductive age as the study population was carried out in the beneficiary slum area, the field practice area of Community Medicine department to find out the burden of nutritional anemia and study its epidemiological correlates. The prevalence of anemia was found to be 60.8%, of which 39.6, 20.0 and 1.2% women had mild, moderate and severe anemia, respectively. Almost 63, 21.2 and 15.7% of the study subjects had microcytic hypochromic picture, indicative of iron deficiency anemia, normocytic hypochromic picture suggestive of early stage of iron deficiency anemia and dimorphic/ macrocytic hypochromic anemia implying iron deficiency anemia and or folate/vitamin B12 deficiency respectively. Statistical analyses have shown that epidemiological factors like age, education of respondents, socioeconomic status, history of excessive menstrual bleeding and inadequate intake of green leafy vegetables and pulses were found to be significantly associated with anemia.
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BACKGROUND: Iron deficiency anemia (IDA) is the most common anemia followed by anemia of chronic disease (ACD). Reticulocyte indices have been shown to be helpful indicators for detecting IDA. We investigated whether RBC and reticulocyte indices can be used to differentiate ACD from IDA. METHODS: A total of 85 women showing microcytic hypochromic anemia (38 IDA and 47 ACD cases) were enrolled. IDA was defined as those with ferritin level of 450 microg/dL. ACD was defined as ferritin level of > or =6 microg/dL, TIBC of or =24.6 pg could be used to differentiate ACD from IDA with 85.1% sensitivity and 81.6% specificity. CONCLUSIONS: The reticulocyte indices, especially CHr, are useful for the differential diagnosis of microcytic hypochromic anemias, ACD and IDA.
Subject(s)
Adult , Female , Humans , Anemia , Anemia, Hypochromic , Anemia, Iron-Deficiency , Blood Cell Count , Chronic Disease , Diagnosis, Differential , Erythrocyte Indices , Ferritins , Hemoglobins , Iron , Reticulocytes , ROC Curve , Sensitivity and SpecificityABSTRACT
Hemoglobine (Hb) Q-India is an innocuous αglobin variant: α64 Asp → His. DNA sequencing studies have shown that the Hb Q India mutation is GAC → CAC in codon 64 of the α1 gene. Hb Q-India is a well-known hemoglobin variant in South-East Asia but only isolated case reports exist in literature to describe this rare entity in the rest of de world. The variant has been found with various forms of αand ß thalassemia. This hemoglobin has the same electrophoretic mobility as Hb S. We report, for the first time, the identification of Hb Q-India in an Argentinian woman (her parents came from Gibraltar), referred to our laboratory bearing a mild microcytic hypocromic anemia; a co-inherited α+ thalassemia (-α3.7 th) was also found.
La hemoglobina (Hb) Q India es una hemoglobina anormal e inocua que afecta la cadena α de esta. Los análisis de secuencia han demostrado que la mutación se encuentra en el codon 64 GAC → CAC del gen α1. Si bien es una variante muy conocida en el sudeste asiático, solo se han reportado pocos casos en el resto del mundo. Esta hemoglobina anormal se ha encontrado asociada con diversas formas de α y ß talasemia y su posición electroforética es idéntica a la de la Hb S. Reportamos, por primera vez, la identificación de la Hb Q India en una mujer Argentina (cuyos padres procedían del Peñón de Gibraltar), enviada a nuestro laboratorio por padecer de anemia microcítica hipocrómica, en la que se encontró también la coexistencia de α+ talasemia (-α3,7 th).
ABSTRACT
El cáncer de pulmón no microcítico constituye la principal causa de muerte por cáncer en la mayoría de los países del mundo. Por este motivo realizamos esta revisión que tiene como objetivo ofrecer una panorámica de la integración de las líneas de tratamiento que se deben llevar en esta enfermedad. Las opciones fundamentales de tratamiento son: cirugía, quimioterapia, radioterapia, tratamiento con monoclonales y vacunas. La integración entre ellas hace posible una mejor respuesta al tratamiento
The non-microcytic lung cancer is the leading cause of death from cancer in most of world countries. That is the objective of present review is to offer a panorama of the integration of these lines of treatment inherent in the disease. The main options of treatment are: surgery, chemotherapy, radiotherapy, treatment with monoclonal antibiotic therapy and vaccines. Its integration makes possible a better response to treatment