Anémie chez les donneurs de sang volontaires après vérification de l'hémoglobine pré-don au Centre de Transfusion Sanguine de Libreville / Anemia in voluntary blood donors after verification of pre-donation hemoglobin at the Libreville Blood Transfusion Center

Introduction : La nécessité de disposer de produits sanguins labiles (PSL) de qualité est un impératif de la transfusion sanguine. Le don de sang n'est pas sans risque pour le donneur. Ce qui soulève la question de la perte de fer par spoliation sanguine. Ce constat a conduit à la réalisation de cette étude dans le but de rechercher l'anémie chez le donneur de sang volontaire jugé apte après évaluation de l'hémoglobine pré-don et d'en déterminer la cause. Patients et méthodes : Il s'agissait d'une étude transversale prospective réalisée au Centre National de Transfusion Sanguine (CNTS) de Libreville. La population d'étude était constituée de donneurs de sang, nouveaux ou anciens, volontaires en bonne santé chez qui les examens suivant ont été réalisés pour le diagnostic de l'anémie et celui de la carence en fer tout en excluant d'autre étiologies: l'hémogramme, le dosage de la Protéine C Réactive (CRP), le fer sérique, la ferritine, l'hepcidine et le test de diagnostic du paludisme (TDR).Résultats : Sur l'ensemble des deux cent quinze volontaires inclus, trente - quatre (15,8%) présentaient une anémie parmi lesquels douze femmes et vingt- deux hommes d'un âge moyen de 32,8 ±8,0. Le nombre de dons effectués était corrélé à la survenue de l'anémie selon le genre et l'âge du donneur. Il en a été de même pour les valeurs de la ferritine, du fer sérique.Conclusion : Le nombre important d'anémie est lié à un seuil bas de l'hémoglobine pré-don. Le caractère microcytaire hypochrome de l'anémie laisse supposer une origine ferriprive.

Introduction: The need to have quality labile blood products (LBP) is an imperative of blood transfusion. Blood donation is not without risk for the donor. This raises the question of the loss of iron by blood spoliation. This finding led to the realization of this study with the aim of looking for anemia in voluntary blood donors deemed suitable after evaluation of the pre-donation hemoglobin and to determine the cause.Patients and methods: This was a prospective cross-sectional study carried out at the National Blood Transfusion Center (CNTS) in Libreville. The study population consisted of blood donors, new or old, healthy volunteers in whom the following examinations were carried out for the diagnosis of anemia and that of iron deficiency while excluding other etiologies: blood count, C-Reactive Protein (CRP), serum iron, ferritin, hepcidin and malaria diagnostic test (RDT). Results: Of the two hundred and fifteen volunteers included, thirty-four (15.8%) presented anemia, including twelve women and twenty-two men with an average age of 32.8 ±8.0. The number of donations made was correlated with the occurrence of anemia according to the sex and age of the donor. It was the same for the values of ferritin, serum iron. Conclusion: The large number of anemia is linked to a low threshold of pre-donation hemoglobin. The hypochromic microcytic character of the anemia suggests an iron deficiency origin.

Mieloptisis y cáncer gástrico: Una asociación infrecuente / Myelophthisis and gastric cancer. An unusual association

Se denomina mieloptisis a la infiltración de la médula ósea por células no hematopoyéticas. En pacientes con cáncer gástrico esta invasión es extremadamente infrecuente y la supervivencia suele ser menor a tres meses. Presentamos el caso de un hombre de 35 años con compromiso de la médula ósea secundario a un carcinoma gástrico difuso de células en anillo de sello.

The infiltration of the bone marrow y non-hematopoietic cells is called myelophthisis. In patients with gastric cancer, this invasion is extremely infrequent and the survival is usually less than three months. We present the case of a 35-year-old man with bone marrow involvement secondary to diffuse gastric carcinoma of signet ring cells.

Bicytopenia and leukoerythroblastosis: a rare initial presentation of signet ring cell gastric adenocarcinoma

Gastric adenocarcinoma is a common neoplasia and is responsible for up to 30% of the overall deaths due to cancer. Advanced disease is mostly characterized by peritoneum, liver, and lung involvement. The spread of the disease to the bone is rare, and bone marrow dissemination is even rarer. In this setting, leukoerythroblastosis may be the initial manifestation of the disease. The authors report the case of a 64-year-old Caucasian man who sought medical care complaining of back pain, weakness, and weight loss. The physical examination revealed pallor, and the laboratory work-up depicted severe anemia and thrombocytopenia; the peripheral blood smear was consistent with leukoerythroblastosis. The ongoing investigation through a bone marrow biopsy showed massive involvement of the bone marrow by a signet ring cell adenocarcinoma. During hospitalization, the patient presented melena, and an upper digestive endoscopy depicted an ulcerated and infiltrative lesion in the cardia, upon which the histological examination revealed a signet ring cell adenocarcinoma. This case highlights the bone marrow invasion represented by bicytopenia and leukoerythroblastosis as the initial manifestation of this histological type of gastric cancer. Although treatment attempts were made with chemotherapy and radiotherapy, the patient died early on, showing the aggressive behavior of this form of tumoral presentation.

Anemia mielotísica por osteopetrose em um cão: relato de caso / Mielotisic anemia caused by osteopetrosis in a dog: case report

A osteopetrose é uma doença rara, caracterizada pelo aumento generalizado da densidade óssea. Tem como característica principal, a reabsorção osteoclástica defeituosa, resultando no acúmulo de massa óssea. Além disso, pode ocorrer retardo do crescimento, desnutrição progressiva, anemia e caquexia. O presente relato descreve o caso de uma cadela, com aproximadamente nove meses de idade, sem raça definida, com histórico de apatia e disorexia. Hemogramas seriados demonstraram pancitopenia persistente. Vários exames laboratoriais foram realizados para excluir doenças como erliquiose, leishmaniose e cinomose, porém todos foram negativos. O mielograma constatou hipocelularidade relativa por provável aplasia/hipoplasia medular. Exames radiográficos evidenciaram o aumento da radiopacidade óssea e hipertrofia da região cortical, e a necropsia confirmou a redução do canal medular. O exame histopatológico confirmou a osteopetrose. Conclui-se que a osteopetrose pode causar comprometimento na produção de células sanguíneas, sendo uma causa rara de anemia mielotísica, além de alterações neurológicas secundárias à má-formação dos ossos do crânio.

Osteopetrosis is a rare disease characterized by generalized increase in bone density. The defective osteoclastic resorption results in the accumulation of bone mass. Furthermore, there may be growth delay, progressive malnutrition, anemia and cachexy. This report describes the case of a nine month old, mixed breed, female dog presented with apathy and disorexia. Laboratory tests were performed to rule out Ehrlichiosis, Leishmaniasis, and Canine distemper, but all were negative. Hemogram showed persistent pancytopenia and myelogram showed relative hypocellularity, probably due to spinal cord aplasia/hypoplasia. Radiographs showed increased bone opacity and hypertrophy of the cortical region, and the necropsy confirmed the reduction of the medullary canal. Histopathological examination confirmed osteopetrosis. In conclusion, osteopetrosis can compromise blood cell production, and is a rare cause of mielotisic anemia. It can also cause neurological deficits due to cranium bone deformation.

Mielopatia por deficiência de cobre / Cupper deficiency myelopathy

A deficiência de cobre (CU) adquirida ganha reconhecimento como causa de anemia e neutropenia. Na última década, ela é reconhecida como produtora de mielopatia ou mieloneuropatia degenerativa, que mimetiza a deficiência de vitamina de B12, podendo apresentar-se em concomitância com essa última. Foram discutidos etiologias, fisiopatologia, diagnósticos diferenciais e tratamentos, assim como achados radiológicos caraterísticos na ressonância nuclear magnética (RNM), principalmente na imagem ponderada T2, da medula cervical e dorsal, confrontando-as com dados laboratoriais direcionados à patologia, conseguindo-se maior acurácia diagnóstica. Observou-se que o diagnóstico precoce pode reverter a doença do ponto de vista laboratorial, de imagem e neurológico ou estabilizar a progressão. Sendo assim, recomendamos incluir na pesquisa laboratorial das cirurgias bariátricas, gastrectomias, síndromes de má-absorção e na administração oral de zinco (Zn)...

Acquired copper (Cu) deficiency has been recognized to promote anemia and neutropenia. During the last decade degenerative myelopathy or myeloneuropathy diseases that can be mimicked by vitamin B12 deficiency or in another cases both of them (Cu and B12 deficiency) can coexist. We researched etiologies, physiopathology, differential diagnostic, treatment and radiologic findings in MRI, that showed high T2 signal in posterior cervical and thoracic cord and when assembled with laboratorial data we achieved accurate diagnostics. We observed that precocious diagnostic could revert the disease and improve neurologic deficit or stabilize its progression. However, we recommend laboratorial research in bariatric surgery, gastrectomy, malabsortion syndromes and high zinc levels administration...

Fungemia por Trichosporon beigelii: reporte del primer caso en Costa Rica / Fungemia for Trichosporon beigelli: report of first case in Costa Rica

Se reporta el primer caso en Costa Rica, de fungemia por Trichosporon beigelii, en un niño de 7 años, con leucemia mielocítica aguda y que ingresa a la Unidad de Cuidado Intensivo del Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera" con sangrado gastrointestinal y cuadro febril. De los catéteres y de tres hemocultivos se aisla Trichosporon beigelii resistente a Anfotericina B. Tiene evolución rápida y fallece. Se discute la creciente importancia del aislamiento de este microorganismo en pacientes inmunosupresos.

Aplasia pura roja : infrecuente manifestación hematológica de mielopatía autoinmune / Pure red aplasia : infrequent hematological manifestation of autoimmune myelopathy

Se presenta una paciente de 65 años de edad, con imagen tomográfica tumoral en lóbulo anterosuperior de pulmón izquierdo, que al resecarse se comprobó que era un nódulo de mediastino de 5 cm de diámetro, sin atipías, pero con infiltración linfoide. A continuación presentó linfocitosis de 10 meses de evolución seguida de anemia hemolítica. Luego de 2 años de remisión clínica se presentó con anemia aguda diagnosticada como Aplasia Pura Roja. Sus patologías revirtieron con corticosteroides. Se hace una actualización acerca de los vínculos entre las enfermedades de la médula ósea y la inmunopatología.

The Effect of Alfacalcidol in the Treatment of Idiopathic Myelofibrosis in Children

Idiopathic myelofibrosis (IMF), which is characterized by marrow fibrosis, leukoerythroblastic anemia, teardrop poikilocytosis and splenomegaly due to extrumedullary hematopoiesis, has known to have no form of therapy. On the ground of the possibility of reversing collagen deposion in IMF using 1, 25dihydroxycholecalciferol [1, 25(OH)2D3], we report here our observations of 5 patients (M:F=1:4) with IMF before and after treatment with 0.5 microgram/day of alfacalcidol, precursor of 1, 25(OH)2D3. In 3 fo 5 patients the hemoglobin rose and in 4 of 5 the platelet count increased. Follow-up marrow examination revealed that marrow trephine reticulin fibrosis decreased according as the amelioration of clinical and laboratory findings. But these did not persist except one patient in spite of the sustained use of alfacalcidol. Our results suggest that alfacalcidol may have a therapeutic role in some patients with IMF. More extensive studies will be clarify the action of alfacalcidol in IMF.

Modified classification of anemia by RDW / 영남의대학술지

The author obtained index of red cell volume distribution width(RDW) and other red cell indices in 210 patients of various hematoncologic conditions and 200 healthy control group using, an automated blood analyzer, Coulter Counter Model S-plus II. This study performed to classify various etiologic anemia based on the MCV and RDW, to evaluate availability to the differential diagnosis in korean anemic distoders somewhat different from etiologies of anemias in foreginers. In the most of cases, the increase or decrease of MCV were always combined the pararell changes of MCH and MCHC: But the values of MCV and RDW were not correlated in control group and patient group. So the terms of heterogenous of homogenous anemia were meaningful morphologic classification than hypochromic or normochromic anemia. The heterogenous microcytic anemia contained iron deficiency anemia. In heterogenous normocytic anemia, myelophthisic anemia, acute leukemia were contained. In heterogenous macrocytic anemia, megaloblastic anemia, hemolytic anemia were contained. The homogenous microcytic anemia was observed in anemia of chronic disorders. In homogenous normocytic anemia, acute blood loss, chronic leukemia, multiple myeloma were contained. The aplastic anemia was belonged to homogenous macrocytic anemia. The diagnostic significance of RDW in hemoglobinopathies is most importhant. But this study was not contained hemoglobinopathies. Instead RDW was very helpful to differential diagnosis of most common anemias, iron deficiency anemia and anemia due to chronic disorders in Korea.