Haematological Changes in Tuberculosis with Special Reference to Iron Metabolism

Tuberculosis is an ancient human disease that has long been a major public health challenge in the world and remains a major health problem in most developing countries. Tuberculosis is uncommon in most parts of the western world, except for the geriatric population and in patients with AIDS, where it is assuming increasing importance. In the third world, however, it remains a major problem. In South Africa it is still very common and is a major cause of death. METHODSFor the present case control study, 45 cases were selected from patients attending the OPD and admitted in the Department of Tuberculosis and Chest Disease, S.N. Medical College, Agra, during 2000 - 2003. 23 were male and 22 were female. RESULTSIn the current study a total of 45 cases of pulmonary tuberculosis (sputum positive) were studied. 23 were males and 22 were females. The age ranged from 18 years to 65 years. 27 cases were evaluated prior to initiation of therapy whereas the remainder were evaluated 3 months after initiation of therapy of which 3 were evaluated after 4 months of therapy. CONCLUSIONSThe short period of therapy did not result in a decline in the frequency of iron deficiency anaemia or anaemia of chronic disorders. Megaloblastosis was not encountered in any of the patients after therapy.

Association between IPTA Gene Polymorphisms and Hematological Abnormalities in Hepatitis C Virus-Infected Patients Receiving Combination Therapy

BACKGROUND/AIMS: Hematological abnormalities during hepatitis C virus (HCV) combination therapy with pegylated interferon alpha and ribavirin often necessitate dose reduction. Variants of the ITPA gene have been reported to protect against anemia during the early stages of HCV combination treatments but have also been associated with larger decreases in platelet counts. We aimed to identify the association between specific ITPA gene polymorphisms and hematological abnormalities in patients undergoing HCV combination therapy. METHODS: In this retrospective study, 175 patients treated with HCV combination therapy were enrolled at St. Martin De Porres Hospital in Taiwan between 2006 and 2012. Two single nucleotide polymorphisms (SNP) within or adjacent to the ITPA gene (rs1127354, rs6051702) were genotyped. We investigated the effect of ITPA gene variants on hematological abnormalities during the therapy. RESULTS: The ITPA rs1127354 minor variants were significantly associated with protection against anemia at week 4 (p=1.86 x 10(-6)) and with more severe decreases in platelet counts during HCV combination therapy. SNP rs6051702 was not associated with the hemoglobin decline to >3 g/dL at week 4 in our study (p=0.055). CONCLUSIONS: The ITPA SNP rs1127354 is a useful predictor of ribavirin-induced anemia in Taiwanese patients and may be related to more severe decreases in platelet counts during the early stage of HCV combination therapy.

Association between IPTA Gene Polymorphisms and Hematological Abnormalities in Hepatitis C Virus-Infected Patients Receiving Combination Therapy

BACKGROUND/AIMS: Hematological abnormalities during hepatitis C virus (HCV) combination therapy with pegylated interferon alpha and ribavirin often necessitate dose reduction. Variants of the ITPA gene have been reported to protect against anemia during the early stages of HCV combination treatments but have also been associated with larger decreases in platelet counts. We aimed to identify the association between specific ITPA gene polymorphisms and hematological abnormalities in patients undergoing HCV combination therapy. METHODS: In this retrospective study, 175 patients treated with HCV combination therapy were enrolled at St. Martin De Porres Hospital in Taiwan between 2006 and 2012. Two single nucleotide polymorphisms (SNP) within or adjacent to the ITPA gene (rs1127354, rs6051702) were genotyped. We investigated the effect of ITPA gene variants on hematological abnormalities during the therapy. RESULTS: The ITPA rs1127354 minor variants were significantly associated with protection against anemia at week 4 (p=1.86 x 10(-6)) and with more severe decreases in platelet counts during HCV combination therapy. SNP rs6051702 was not associated with the hemoglobin decline to >3 g/dL at week 4 in our study (p=0.055). CONCLUSIONS: The ITPA SNP rs1127354 is a useful predictor of ribavirin-induced anemia in Taiwanese patients and may be related to more severe decreases in platelet counts during the early stage of HCV combination therapy.

Alteraciones hematológicas en la diabetes mellitus / Blood disorders in diabetes mellitus

Although it has been treated in a limited way the relationship between diabetes and hematopoietic system, there is evidence demonstrating thedeleterious effect of hyperglycemia on the three cell lines: red blood cells, white cells and platelets. Different forms of anemia associated with hyperglycemia are analyzed and erythrocyte alterations observed in diabetes. In chronic decompensated patients have been demonstrated alterationsof monocytes, lymphocytes and polymorphonuclear particularly, with decreased chemotaxis, adherence, phagocytosis and opsonization. Hyperglycemia determines a prothrombotic state by platelet hyperreactivity, which is a marker of inflammation...

Clinical Characteristics of Malaria in Korean Patients / 감염

BACKGROUND: Vivax malaria has been a reemerging disease since 1993 in Korea, and the number of cases are rapidly increasing. Clinical manifestations of malaria are affected by genetic factors and individual patient's characteristics. In this study, we evaluated clinical manifestations and prognosis of malaria in Korean patients. METHODS: Medical records of the patients confirmed as malaria by peripheral blood smear in Asan Medical Center from June, 1989 to October, 1997 were reviewed retrospectively. The patients with vivax malaria and falciparum malaria were compared with respect to clinical manifestations, complications, and prognosis. We also compared our data to meta-analysis reports from western countries. RESULTS: Twenty-eight cases of malaria were included. The number of cases increased by year. Seventeen of them were diagnosed as vivax malaria, and 11 as falciparum malaria. Fifteen indigenous malaria were all vivax malaria, 9 of which had finished the military service in the border between North and South Korea several months before the onset. Eleven of 13 imported malaria were falciparum malaria, 8 of which were acquired in Africa. All 28 patients had fever, but cyclic pattern was shown only in 6 patients of vivax malaria. Hematologic abnormalities were the most common laboratory findings, and there were no significant differences in the frequency of thrombocytopenia, anemia, and leukopenia between vivax malaria and falciparum malaria. Altered mentality, elevated transaminase, total bilirubin, and serum creatinine were more frequent in falciparum malaria than in vivax malaria. Korean patients showed anemia, thrombocytopenia, leukopenia, and elevation of transaminase more frequently than western patients. CONCLUSION: The number of malaria cases has been increasing by year. All Korean patients with malaria had fever, and the most common laboratory findings were thrombocytopenia, anemia, and leukopenia.

Effects of Nitrous Oxide on Serum Vitamin B12, Folate and Hematopoiesis in Surgical Patients / 대한마취과학회지

The administration of nitrous oxide can cause bone marrow depression like that aasociated with vitamin B12 defieiency and hematologic abnormalities. We investigated whether the addition of nitrous oxide for up to 4 hours to isoflurane anesthesia causes injury to 40 healthy laminectomy patients. In each patient, serum vitamin B12, folate and hematologic parameters (RBC, Hb, MCV, MCHC, WBC, platelet, reticulocyte, neutrophil) were measured on preinduction and postoperative 1st, 3rd, 5th, 7th day. Fourty patients divided into two groups randomly. In group 1 (n=20), 100% oxygen plus 1.0-2.0 vol% isoflurane was given; Group 2 (n=20), 50 % nitrous oxide, oxygen plus 1.0-2.0 vol% isoflurane was given. The results were as follows; 1) Comparing with the serum vitamin B12 and folate in both groups, there were no statistical signifieant changes between two groups until postoper- ative 7th day. 2) Nitrous oxide using 4 hours didn't influence on the hematologic parame ters until postoperative 7th day. This study suggests that the administration of nitrous oxide for up to 4 hours didnt influence on serum vitamin B12, folate and hematologic parameters until postoperative 7th day. But further studies may be necessary for more prolonged anesthetic time and methods regarding nitrous oxide.