Reference range values of hematological parameters in Saudi healthy adults.

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Serum ferritin and other iron indices in adult Nigerians with chronic renal failure--review of management of anaemia.

Iron studies were carried out in twenty five adult male and female patients with chronic renal failure and thirty one "healthy" individuals as control. Results showed moderately severe anaemia in all the patients with a mean haemoglobin concentration of 7.4 mg/dl (range 6-9.8 gm/dl). Transferin saturation of 28.8% in the patients was similar to the value of 29.2% in the control group. However, the mean serum ferritin value of 610 micrograms/L in the patients was significantly higher than the corresponding values of 165 micrograms/L and 58 micrograms/L in the control groups respectively. In patients with chronic renal failure, three out of ten bone marrow aspiration showed no stainable iron, and in five patients, iron was grossly increased with corresponding increases in serum ferritin values. In addition, four of the five patients had severe megaloblastic changes in the marrow.

Serial evaluation of iron stores in pregnant Nigerians with hemoglobin SS or SC.

Iron status of nonpregnant and pregnant Nigerian patients with hemoglobin SS or SC were assessed using serial hematological parameters, measured by Coulter counter, and serial serum ferritin concentrations measured by radioimmunoassays. The median value of 393 micrograms/L (range, 175 to 900 micrograms/L) for serum ferritin in nonpregnant patients with Hb SS and SC was significantly higher than that found in nonpregnant patients with Hb AA (median, 89.8 micrograms/L; range, 13 to 250 micrograms/L). Apart from packed cell volume values, there were no other significant differences between patients with Hb SS or SC and Hb AA in the other parameters assessed: mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration. In both the normal pregnant patients (Hb AA) and pregnant patients with Hb SS and SC the serum ferritin values decreased as pregnancy advanced to 28 weeks and rose gradually thereafter. At similar stages of gestation serum ferritin values were significantly higher in patients with Hb SS or SC than in those with Hb AA. Pregnancy seems to have induced a significant rise in mean corpuscular volume and mean corpuscular hemoglobin values in the patients with Hb SS or SC, especially in the third trimester, than in patients with Hb AA. The pattern of change in mean corpuscular hemoglobin concentration values was similar in both groups of patients. From the data obtained, it seems the iron status in the patients with Hb SS or SC was good, and pregnancy did not push the patients into an iron deficiency state. The use of prophylactic iron supplementation in pregnant patients with Hb SS or SC appears unjustified.

Serial serum ferritin and other hematological parameters in normal Nigerian primigravidae.

Serial hematological indices using Coulter Counter and serum ferritin using radioimmunoassay techniques were determined in 20 healthy Nigerian primigravidae with hemoglobin genotype AA. PCV fell significantly (P less than 0.001) to a minimum value at 28 weeks that was 6% lower than the mean value at 8 weeks postpartum. PCV at 36 weeks was still significantly (P less than 0.001) lower than the post partum value. There was an insignificant but progressive increase in MCV values throughout pregnancy. Changes in MCH and MCHC were insignificant. Ferritin levels in both the non-pregnant and pregnant subjects were high and probably reflected the high iron content of Nigerian foods. Though the cord serum ferritin level was significantly higher (P less than 0.001) than maternal ferritin at delivery there was no significant correlation between the two.

Serum ferritin values in Nigerian pregnant women.

Serum ferritin values have been studied in 28 indigenous Nigerian pregnant women during the second and third trimesters of pregnancy. The mean serum ferritin value in the second trimester is higher than that in the third trimester, however, the difference is not statistically significant. When our results are related to those of Fenton and co-workers in 1977 (Fenton V, Cavill I, Fisher J: Iron stores in pregnancy. Br J Haem 37: 145, 1977) it appears that serum ferritin decreases in early pregnancy and that this decrease is maintained through the second and third trimesters and towards term, irrespective of adequate iron supplementation. It also seems that the pre-pregnancy serum ferritin level is achieved 5-8 weeks post-delivery. Our results also underline the sensitivity of serum ferritin evaluation in pregnancy, and reinforce the concept that fetal requirement for iron occurs significantly during the later half of pregnancy.

Evaluation of serum ferritin levels and other hematological parameters in a Nigerian population.

Hematological parameters, including serum ferritin, were estimated in a healthy Nigerian population and in patients with other clinical conditions. The hematological values fell within the reported range for healthy populations in other parts of the world. The mean serum ferritin value in the male population was 72.4 ng/mL compared with the female value of 34.3 ng/mL. There was a strong correlation between the percentage of transferrin saturation and the serum ferritin level in males only (r = .40, P < .002).In patients with sickle cell disease, SC-group patients had a significantly higher hemoglobin concentration (P < .001) than the SS group. However, the SS group had higher values for mean corpuscular hemoglobin, mean corpuscular volume, and transferrin saturation than the SC group. Also, the mean ferritin level in the SS group (296.3 ± 61.9 ng/mL) was significantly higher (P < .01) than in the SC group (mean 180.8 ± 97.2 ng/mL).When sickle cell anemia was complicated by chronic osteomyelitis, the ferritin level was much higher (mean, 1,470 ng/mL) than at the steady state. Finally, in patients with leukemia, serum ferritin levels were much higher than in the healthy population.

Iron studies in patients with sickle cell disease.

The prevalence of iron deficiency anaemia during the first three decades of life was investigated in eighty-five patients with SS and SC haemoglobins. The parameters used were the haematocrit, serum iron, total iron binding capacity (TIBC), percentage saturation of transferrin and availability of iron in the bone marrow. The mean haematocrit values were similar throughout the three decades, but increased with age (r = 0.41). The mean serum iron was significantly lower (P less than 0.01) in the first decade than in the second or third decade. Females had lower serum iron in the first and second decades and higher values in the third decade than their male counterparts. The transferrin saturation was significantly lower (P less than 0.01) in the first decade than in the third decade. No haemosiderin was found in the marrow aspirates at a transferrin saturation of less than or equal to 15%. Of the eighty-five bone marrow aspirates studied for stainable iron, fifty-eight (68.2%) had nil iron. The data presented show that iron deficiency anaemia is a common finding in patients with haemoglobinopathies. The need to incorporate oral iron with folic acid and paludrine in the treatment of sickle cell disease is suggested.

Iron studies in pregnant and non-pregnant women with haemoglobin SS or SC disease.

Iron studies were performed in 22 pregnant and 18 non-pregnant women with haemoglobinopathies. Mean packed cell volume and mean haemoglobin concentration were significantly lower (p < 0.001) in haemoglobin SS patients than in haemoglobin SC patients, in both the pregnant and non-pregnant groups. Transferrin saturation was significantly lower in pregnant patients (haemoglobin SS and SC) than in the non-pregnant group (p < 0.001). Serum ferritin values in the haemoglobin SS and SC pregnant patients were not significantly different (p > 0.05). There was a strong correlation between serum ferritin levels and transferrin saturation in the pregnant group (r = 0.71; p < 0.001). Fourteen of the 22 pregnant women (63 per cent) and 9 of the 18 non-pregnant women (50 per cent) had scanty or no iron in the bone marrow; the serum ferritin levels increased progressively with greater amount of haemosiderin in the bone marrow. There was evidence of iron deficiency in both the pregnant and non-pregnant women with haemoglobinopathies and this suggests the need for further study on the routine administration of iron in the management of patients with sickle cell disease.

Genetically determined deficiency of glucose 6-phosphate dehydrogenase (type-A-) is expressed in the liver.

G6PD activity was determined in liver biopsy specimens from 31 patients (25 men and six women). The G6PD genotype of the patients was determined by carrying out on lysates of their red blood cells quantitative assays of the enzyme and starch-gel electrophoresis. In 21 subjects with normal G6PD activity in red cells, a relatively wide variation of G6PD activity was found in liver extracts. By contrast, in 10 subjects with G6PD deficiency, the activity of the enzyme in liver extracts was always low. The difference between the distribution of liver G6PD activity values of G6PD-normal and G6PD-deficient subjects was statistically significant (p less than 0.01). We conclude that G6PD deficiency of the African type is also expressed in the liver. These findings may have a bearing on hyperibilirubinemia, which cannot be entirely attributed to hemolysis, often encountered in G6PD-deficient patients.

Observation on haematological patterns in pulmonary tuberculosis in Nigerians.

Twenty-one cases of pulmonary tuberculosis seen in the last two years in the chest clinic of the University College Hospital, Ibadan were studied for their haematological patterns at diagnosis and three months after. One group was put on anti-tuberculosis drugs only while the other group was put on anti-tuberculosis drugs and oral iron. The haematological results after 3 months show a significant rise in packed cell volume (PCV) less than 0.01 in the group given oral suppliments. Megaloblastic bone marrow changes occurred in 20 per cent of the patients after 3 months. Seventy-five per cent of the patients had myeloid hyperplasia of the bone marrow at diagnosis and only one of the patients had hypoplastic marrow. It is suggested that oral iron and folate be added to anti-tuberculosis therapy in these patients as part of their management.

Iron deficiency in pregnant women in Ibarapa District of Western Nigeria.

Ninety-nine pregnant women with anaemia (haematocrit less than 0.30) were detected by antenatal screening in Ibarapa District. Studies on 23 anaemic women and 17 non-anaemic women from the same clinic on the same day showed that eight out of 23 anaemic women had a transferrin saturation of less than 15%. The mean level (19.5%) for the anaemic patients was significantly less than that found in the nonanaemic controls; mean 33.0% (P less than 0.01). Bone marrow studies on 32 anaemic women revealed megaloblastic change and absent iron in 27 of the 32 patients. In a trial of parenteral iron treatment in 66 patients the mean haematocrit of Imferon treated patients rose from 0.27 to 0.32 in 6 weeks but remained at 0.28 or less in the controls. There was a significant difference between the iron-treated group and the comparable group receiving no imferon (P less than 0.001 at 6 weeks). The method of using parenteral iron treatment to make a diagnosis of iron deficiency anaemia is discussed together with the possible advantages and disadvantages of giving iron.

Non-Hodgkin's lymphoma in Ibadan, Nigeria.

One hundred patients with non-Hodgkin's lymphoma were admitted to the University College Hospital in Ibadan, Nigeria between 1960 and 1975. Their cases have been analyzed with respect to clinical findings, histological classification, and response to therapy. There was a preponderance of males over females (2:1) and the majority of the patients (87 percent) had reticulum cell sarcoma. Therapy consisted mainly of single-agent chemotherapy but a few patients had either surgical excision combined with chemotherapy or multiple-agent chemotherapy. The results of treatment were poor because of the very high default rate, late presentation, inadequate supply of drugs, and lack of radiotherapeutic facilities.

Clinical trial of Ferastral in iron-deficient, non-pregnant patients in Ibadan, Nigeria.

Fifteen patients with proven iron-deficiency anaemia treated with intramuscular injections of Ferastral, iron-poly (sorbitol-gluconic acid) complex, have been studied. Fourteen showed a satisfactory rise in haematocrit. No local or systemic complications were observed. One patient with iron-deficiency anaemia due to a bleeding malignant lesion did not achieve a satisfactory haematocrit level although the bone marrow showed iron repletion following the injection. It is concluded that Ferastral is an effective drug in the treatment of iron-deficiency anaemia.

The treatment of iron-deficiency anaemia with a new intramuscular iron preparation (Ferastral).

The treatment of iron-deficiency anaemia in pregnancy with a new intramuscular iron preparation, iron-poly (sorbitol-gluconic acid) complex (Ferastral), has been assessed and compared with oral iron therapy. Sixty-one of the eighty-four patients studied, many of whom had mild to moderate degree of anaemia were treated with Ferastral. The results were satisfactory, the mean increase of haematocrit at the sixth post treatment week was 28.7% for the whole series. Complete correction of anaemia was achieved in most patients between the 4th and 6th week of treatment. The mean haematocrit of the group treated with oral iron was initially significantly higher than for the group treated with Ferastral. At the first follow-up, two weeks after beginning treatment, the mean values for both groups were similar; at four weeks, those receiving Ferastral had a significantly higher mean PCV than those on oral iron, and remained so through the period of observation. No side-effects were detected using 10 ml of Ferastral intramuscularly on alternate days. The mean hospitalization time of patients with severe to moderate anaemia was reduced when given parenteral therapy, and the frequency of blood transfusion in these patients was also decreased.