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Introduction: Megaloblastic anemias secondary to Vitamin B12 deficiency are a group of pathologies produced by defective nuclear DNA synthesis. Objective: To describe the maturation alterations found in hematopoietic precursors of the bone marrow in a series of patients with megaloblastic anemia. Methods: Were included patients attended at the Regional Hospital of Concepción with bone marrow samples sent for the study of cytopenia by flow cytometry whose final diagnosis was megaloblastic anemia. The immunophenotype was performed with CD45, CD34, CD117, HLA-DR, markers of neutrophil (CD13, CD11b, CD10, CD16) and/or erythroblast (CD105, CD71, CD36) maturation. Results: From the flow cytometry laboratory database, 8 patients with megaloblastic anemia were identified, and myelodysplastic syndromes (n=9) and normal or reactive bone marrow (n=10) were used as controls. 44% were men, with a median age of 58 years. Megaloblastic anemia was associated with a higher proportion of size and complexity of erythroid and myeloid progenitors compared to lymphocytes compared to controls. The total percentage of erythroblasts and the proportion of CD34+ myeloid cells associated with erythroid lineage was higher in megaloblastic anemia, associated with a maturation arrest in the CD105+ precursor stage (69% vs 19% and 23%, p<0.001). The heterogeneity of CD36 and CD71 in megaloblastic anemia was similar to myelodysplastic syndromes. Conclusions: Megaloblastic anemia produces a heterogeneous involvement of hematopoiesis, characterized by a greater size and cellular complexity of precursors of the neutrophil and erythroid series and a maturation arrest of the erythroblasts.
Introducción: Anemias megaloblásticas secundarias a la deficiencia de vitamina B12 son patologías producidas por una síntesis defectuosa del ADN nuclear. Objetivo: Describir las alteraciones madurativas encontradas en precursores hematopoyéticos de la médula ósea de una serie de pacientes con anemia megaloblástica. Métodos: Se incluyeron pacientes atendidos en el Hospital Regional de Concepción con muestras de médula ósea enviadas para estudio de citopenias por citometría de flujo cuyo diagnóstico fue anemia megaloblástica. El inmunofenotipo se realizó con CD45, CD34, CD117, HLA-DR, marcadores de maduración de serie de neutrófilo (CD13, CD11b, CD10, CD16) y/o eritroblasto (CD105, CD71, CD36). Resultados: Se identificaron 8 pacientes con anemia megaloblástica y como controles se utilizaron síndromes mielodisplásicos (n=9) y médula ósea normal o reactiva (n=10). El 44% eran hombres, con una mediana de edad de 58 años. La anemia megaloblástica se asoció con una mayor proporción de tamaño y complejidad de progenitores eritroides y mieloides con respecto de los linfocitos en comparación a los controles. El porcentaje total de eritroblastos y la proporción de células mieloides CD34+ comprometidas con el linaje eritroide fue mayor en anemia megaloblástica, asociado a una parada madurativa en la etapa de precursor CD105+ (69% vs 19% y 23%, p <0.001). La heterogeneidad de CD36 y CD71 en anemia megaloblástica fue similar a los síndromes mielodisplásicos. Conclusiones: la anemia megaloblástica produce una afectación heterogénea de la hematopoyesis, caracterizada por un mayor tamaño y complejidad celulares de precursores de la serie neutrófilo y eritroide y una detención madurativa de los eritroblastos.
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Introducción: la anemia es un problema de salud pública en países desarrollados y no desarrollados; esta entidad tiene repercusiones en el desarrollo socioeconómico de las comunidades y, especialmente, en la salud de embarazadas, niños y jóvenes. Objetivo: describir los aspectos generales del síndrome anémico, sus presentaciones más frecuentes y el estado del arte de dicha problemática en el suroccidente colombiano. Método: se realizó una búsqueda bibliográfica con un lapso de 30 años (1990-2020) en Medline, Google Scholar, Lilacs y Redalyc, para revisar los conceptos generales del síndrome anémico, anemia por déficit de hierro, anemia megaloblástica, anemia hemolítica y anemia de células falciformes, en función de la etiología, epidemiología, manifestaciones clínicas, diagnóstico y pronóstico. Resultados: el síndrome anémico es una entidad frecuente en varias regiones de Colombia, con alta carga epidemiológica, complicaciones y pronóstico importantes. Se realizó la descripción general de las presentaciones más frecuentes del síndrome anémico. Conclusión: hacen falta estudios para todas las regiones del país, particularmente, en el suroccidente colombiano..Au
Introduction: anemia is a public health problem both in developed and undeveloped countries; this entity has repercussions in socioeconomic development of communities and, especially, compromises pregnant women, children and young people health. Objective: to describe the general aspects of anemia syndrome, its most frequent presentations and the state of the art of this problem in southwestern Colombia. Methods: a literature search with a span of 30 years (1990-2020) was performed in Medline, Google Scholar, Lilacs and Redalyc databases, in order to describe the general concepts of anemic syndrome, iron deficiency anemia, megaloblastic anemia, hemolytic anemia and sickle cell anemia, regarding on its etiology, epidemiology, clinical manifestations, diagnosis and prognosis. Results: anemic syndrome is a frequent entity in several Colombian regions, with high epidemiological burden, complications and important prognoses. The general description of the most frequent presentations of anemia syndrome was made. Conclusion: additional studies are required for each region, particularly in southwestern Colombia..Au
Subject(s)
Humans , AnemiaABSTRACT
Objective Combined with the medical records of two patients with megaloblastic anemia (MA) after allogeneic hematopoietic stem cell transplantation (AHSCT),the relevant literature was reviewed.Methods The medical records of two patients with MA after AHSCT were analyzed retrospectively.The primary disease was diagnosed by analyzing the blood cells,bone marrow cell morphology,cell chemical dyeing,bone marrow biopsy and immune classification.After AHSCT,MA was diagnosed through bone marrow cell morphology,folic acid and vitamin B12 detection.Results AT 32nd day after transplantation,bone marrow cells morphological examination of case 1 showed:nucleated cells proliferation activity,granulocytes proliferation activity,giant rod nucleus granulocytes visible;different stages of the red blood cells proliferation activity,higher proportion of immature red blood cells,most of whose nucleus developed later than the cytoplasm;megakaryocytes and platelets scattered distribution.Blood contents of folic acid and VB12 were far below the reference range.After administration of folic acid and VB12 for 2 weeks,routine blood test showed the volume of red blood cells returned to normal.Reexamination of bone marrow cell morphology showed megaloblastic cells disappeared.Three months after transplantation,bone marrow cells morphological examination in case 2 showed:nucleated cells proliferation activity,low granulocytes proliferation,giant rod nucleus granulocytes visible;different stages of the red blood cells proliferation activity,higher proportion of orthochrmatic normoblasts,most of whose nucleus developed later than the cytoplasm;scattered distribution of megakaryocytes and platelets.Blood contents of folic acid were far below the reference range,but the content of VB12 was normal.After administration of folic acid and VB12 for 2 weeks,the routine blood test showed the volume of red blood cells returned to normal.The reexamination of bone marrow cell morphology showed megaloblastic cells disappeared.Conclusion After AHSCT,attention should be paid to the detection of folic acid and VB12 in vivo.Folic acid and VB12 are timely supplemented when necessary to avoid the occurrence of MA in patients with AHSCT.
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A fenilcetonúria, doença metabólica hereditária, autossômica recessiva, é a mais frequente das aminoacidopatias. Quando não diagnosticada e tratada precocemente, causa retardo mental grave. Os programas de triagem neonatal transformaram a histó- ria natural dessa doença, possibilitando o diagnóstico neonatal e a instituição imediata do tratamento dietético. Atualmente, os pacientes com controle adequado têm vida normal. Nas últimas décadas, alterações nutricionais têm sido relacionadas ao tratamento dietético e aos seus desvios, especialmente após a primeira década de vida. Neste artigo apresenta-se o caso de um adolescente que desenvolveu anemia megaloblástica por deficiente ingestão de vitamina B12 e uma revisão da literatura sobre o tema.(AU)
Phenylketonuria, inherited metabolic disease, autosomal recessive, is the most common of aminoacidopathies. If not diagnosed and treated early, causes severe mental retardation. The newborn screening programs have transformed the natural history of this disease, allowing the neonatal diagnosis and the immediate institution of dietary treatment. Currently, patients with adequate control have normal life. In recent decades, nutritional changes have been related to dietary treatment and its deviations, especially after the first decade of life. In this article we present the case of a teenager who developed megaloblastic anemia due to poor intake of vitamin B12 and a literature review on the topic(AU)
Subject(s)
Humans , Male , Adolescent , Phenylketonurias/diet therapy , Vitamin B 12 Deficiency , Anemia, Megaloblastic/complications , Phenylalanine , Phenylketonurias/complications , Nutrition Therapy , Amino Acid Metabolism, Inborn Errors/complicationsABSTRACT
Objective To understand the etiopathogenesis of pancytopenia (PCP) in Sichuan area and to analyze the statistical difference in the aspects of sex ,season and age .Methods 224 cases of PCP were performed the etiological statistics on sex ,season and age by SPSS11 .0 .Results Among 224 cases of PCP ,46 cases(21% ) were megaloblastic anemia ,followed by 36 cases(16% ) of myelodysplastic syndromes (MDS) and 27 cases(12% ) of aplastic anemia(AA) .224 cases of PCP included 110 males(49 .10% ) and 114 females(50 .90% ) ,there was no statistical difference between sexes (P>0 .05) .In the seasons groups ,most of the patients went to see doctor and were diagnosed in the fourth quarter (32% ) and the first quarter was least (13% ) ,the difference between them had statistical significance(P<0 .05);In the age groups ,the age group of 45- <65 years old was the highest(36 .71% ) and the age group of less than 18 years was lowest(3 .57% ) ,the difference between them had statistical significance(P<0 .05) .Conclu-sion Megaloblastic anemia is the main etiology causing PCP in Sichuan area ,and the next is MDS and AA .The sex has no statisti-cal significance to the patients with PCP ,while the incidence rate in the aspects of season and age has statistical significance .
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Objective To explore guide adult giant young cell anemia cause. Methods Retrospective analysis 48 cases adult giant young cell anemia clinical data. Results The adult giant young cell anemia majority in elderly patients of(34/48) 70.8% ,its cause a majority in gastrointestinal diseases (41/48) for 85.4% , among them 9 cases of chronic gastritis(18. 8% ) Gastrointestinal diverticula 8 cases, the digestive tract of release,duodenal ulcer and gastric 16.7% each 4 cases total resection for 8.3, hiatal hernia and gastric ulcer each 3 cases of gastric polyps, oral 6.3% lesions, jejunum resection 2 cases 4.1 percent of all the rest a few Crohn,Crohn's disease,intestinal lymphoma,chronic colitis each 1 case of 2.0%.The gastrointestinal lesions accounted for only 14.6% cases. Conclusion Giant young cell anemia majority with old people,and to the digestive system disease primarily