Cord blood full blood count parameters in Lagos, Nigeria.

INTRODUCTION: Full blood count (FBC), one of the most frequently requested for laboratory investigations, is a simple, fast and cheap test and is a reliable indicator of health. Due to its usefulness in the assessment of health status of individuals, its parameters in cord blood, a major source of haemopoietic stem cell transplantation and an ideal source for laboratory investigations for newborns were determined to provide a useful guide to local neonatologists and stem cell transplant physicians. METHODS: Three millilitres of umbilical cord blood was collected from 130 normal birth weight newborns (69 males and 61 females) whose cord were clamped immediately after delivery, at a teaching hospital in Lagos, Nigeria and full blood count parameters were determined using Sysmex autoanalyzer, model KX-21N. Consented mothers of the newborns were selected based on, age between 18 and 45 years; uneventful pregnancy and delivery and haemoglobin (Hb) concentration ≥ 10 g/dL. RESULTS: There were no statistical gender differences in the mean values of Hb concentrations (M = 13.27 ±1.60 g/dL; F = 13.32±1.61g/dL; p = 0.93), total white cell count (M = 3.16±5.43 × 10(9)/L; F = 13.07±4.98 × 10(9)/L; p= 0.92), platelet count (M= 223.64± 64.21 × 10(9)/L; F = 226.69±80.83 × 10(9)/L; p = 0.81) and other parameters. CONCLUSION: Mean values of full blood count parameters obtained in this study are comparable to reports from other studies in developing countries and could be a useful guide for neonatologists and stem cell transplant physicians in our geographical location.

Prevalence of HIV-related autoimmune haemolytic anaemia in Lagos, Nigeria.

BACKGROUND: Despite a high frequency of anaemia, a positive direct antiglobulin test (DAT) and bone marrow hyperplasia HIV-infected patients, lack of reticulocytosis may cause underdiagnosis autoimmune haemolytic anaemia (AIHA) in them. This study was carried out to determine the prevalence of autoimmune haemolytic anaemia in HIV-infected patients and to compare the haematological/immunological characteristics of subjects with anaemia and those without. MATERIALS AND METHODS: A total of 350 HIV-infected subjects attending the Lagos University Teaching Hospital who consented were recruited for the study. This included 250 subjects with anaemia (haemoglobin concentration <10 g/dl) as cases and 100 subjects without anaemia as controls. Five milliliters of venous blood drawn from each subject was used for the full blood count, reticulocyte count and DAT. RESULTS: Subjects with anaemia had lower mean CD4 cell count (284.3 cells/µl) and higher mean reticulocyte per cent (1.5%) than the non-anaemic subjects. The frequency of reticulocytosis was higher in female subjects than in males. Only 0.8% (2 of 250) of the study group screened positive to DAT, p = 0.0339. None of the subjects in control group screened positive to DAT. CONCLUSION: Autoimmune haemolytic anaemia is a rare complication of HIV infection in our geographical location.

The 8p12 myeloproliferative syndrome.

The occurrence of a myeloproliferative disorder in association with an aggressive lymphoproliferative disorder is a distinctly unusual phenomenon. We report a case of concurrent leukaemia-lymphoma syndrome characterized by a BCR/ABL-negative myeloproliferative disease, eosinophilia and a lymphoma. The bone marrow chromosome analysis showed the karyotype 46, XY, t(8;9) (q12; p33), which indicated presence of FGFR1 gene translocations. 8p12 myeloproliferative syndrome (EMS) / stem cell leukaemia-lymphoma syndrome (SCLL) belongs to the tyrosine kinase fusion genes chronic myeloproliferative diseases. The patient was managed conservatively with hydroxyurea, allopurinol and blood component therapy. The patient eventually died of intracerebral haemorrhage due to severe thrombocytopaenia. Based on our experience the overlap in the clinical presentation of this disease with lymphomas, can lead to a delay in diagnosis of EMS/SCLL. Given the aggressive nature of this disease, an accurate clinical and molecular diagnosis of this entity has become increasingly important.