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Blood Cells, Molecules & Diseases May 2022Here we describe a retrospective study of a 10-year-old girl, adopted from India, and referred to the Rare Anemias Unit for the diagnosis of a severe haemolytic anaemia...
Haemoglobin Bristol-Alesha in a child with non-spherocytic severe haemolytic anaemia and marked anisochromic poikilocytosis with basophilic stippling and amorphous intracellular content.
Here we describe a retrospective study of a 10-year-old girl, adopted from India, and referred to the Rare Anemias Unit for the diagnosis of a severe haemolytic anaemia of unknown etiology. Blood film examination revealed markedly abnormal red cell morphology characterised by a mixture of very pale (hypochromic) cells with basophilic stippling and macrocytic cells containing coarse basophilic dots and an amorphous material of unknown origin. With a presumptive diagnosis of pyruvate kinase deficiency (PK), the patient had been splenectomised at 7 years of age with a partial recovery of the anaemia and a decrease of the blood transfusion rate. Three years after splenectomy, the patient was revisited and a haemoglobin stability test was performed with a positive result. Accordingly, the correct diagnosis was an unstable haemoglobinopathy. Targeted next generation sequencing (t-NGS) revealed haemoglobin Bristol-Alesha, a hyper unstable haemoglobinopathy associated with severe haemolytic anaemia. Since unstable haemoglobins do not necessarily have specific red cell morphological abnormalities, our findings reinforce the need to include, the haemoglobin stability test, in the first diagnostic approach of hemolytic anaemias of unknown etiology.
Topics: Anemia, Hemolytic; Child; Erythrocytes; Female; Hemoglobinopathies; Hemoglobins, Abnormal; Humans; Retrospective Studies
PubMed: 35091138
DOI: 10.1016/j.bcmd.2022.102652 -
Frontiers in Veterinary Science 2022Red blood cells (RBC) morphologic evaluation through microscopy optical (OM) and SEM, provides information to forecast, evaluate, and monitor the functioning of many...
Red blood cells (RBC) morphologic evaluation through microscopy optical (OM) and SEM, provides information to forecast, evaluate, and monitor the functioning of many organs. Factors, such aging and diseases affect RBC morphology in both, human and animals. SEM is useful to evaluate RBC morphology, although its use in diagnosis and evaluation in dogs is limited, due to the availability and cost. The aim of this research was to assess the normal RBC morphology in adult, senior and geriatrician dogs, clinically healthy by OM and SEM. In addition to evaluating the age effect, sex, body size, and their interaction on erythrocyte morphometry. To carry out the research 152 blood samples were evaluated from dogs of different sexes and body sizes (small, medium, and large). Three groups were made based on dogs age: group I adults (1-7.9 years old), group II senior (8-11.9 years old), and group III geriatricians (>12 years old). Erythrocyte parameters were evaluated by OM (diameter, height, and axial ratio). Per each dog, the parameters of 20 erythrocytes were measured. A total of 2,600 cells were scanned with the AmScope™ Software scale. In addition, the RBC morphology was evaluated by SEM. Statistical analyses used analysis of variance and a general linear model, which allows the comparison of multiple factors at two or more levels ( < 0.05). The results of this study showed that diameter and height were lower in adult dogs than in senior and geriatrician dogs ( < 0.05). Whereas, sex, body size, and the interaction did not show a significant effect ( > 0.05). Additionally, some images of anisocytosis, polychromasia, and poikilocytosis (echinocytes, acanthocytes, codocytes, spherocytes, stomatocytes, dacryocytes quatrefoil, and elliptocytes) were obtained by OM and SEM. Our study provides information about the morphological and morphometry alterations of adult, senior, and geriatrician dogs RBC. This work contributes to future investigations and the diagnosing diseases, where it is necessary to evaluate the morphology of RBC.
PubMed: 36439358
DOI: 10.3389/fvets.2022.998438 -
Journal of Toxicology 2022Away from hemorheological properties, the effect of heroin addiction on erythrocytes is poorly investigated. This study aimed to investigate the oxidative impacts of...
Away from hemorheological properties, the effect of heroin addiction on erythrocytes is poorly investigated. This study aimed to investigate the oxidative impacts of heroin administration on erythrocytes. Study subjects included chronic intravenous heroin addicts and control subjects. Hematological analysis and redox parameters were measured, including serum concentration of methemoglobin ([MethHb]), serum glutathione peroxidase-1 ([GPX-1]), serum glutathione peroxidase (GPX) activity, erythrocytic protein carbonyl content, and oxidized to reduced glutathione (GSSG/GSH) ratio. Hematological analysis revealed that addicts had a significantly higher red cell distribution width, consistent with the mild anisocytosis and poikilocytosis of erythrocytes. As compared to control subjects, significantly higher levels of serum [Met-Hb], [GPX-1], and GPX activity ( < 0.001) were reported among addicted subjects. A significant association between [MetHb] and GPX activity was observed with = 0.764 ( < 0.001). Furthermore, significantly higher erythrocytic protein carbonyl contents and GSSG/GSH ratio were evident among heroin addicts ( < 0.005) that were significantly associated with = 0.429 (=0.01). Results demonstrate preliminary evidence that heroin addiction is implicated in impaired redox status of erythrocytes. Considering the pharmacokinetics of heroin, erythrocytic antioxidant mechanisms, and turnover rate, further investigation is required to evaluate the extent and clinical outcomes, especially upon over-dose administration.
PubMed: 36212505
DOI: 10.1155/2022/3996051 -
Journal of Hematology Dec 2018The study shows the effect of hyperglycemia on RBCs in terms of morphological changes and their chromic status in women with gestational diabetes mellitus (GDM).
BACKGROUND
The study shows the effect of hyperglycemia on RBCs in terms of morphological changes and their chromic status in women with gestational diabetes mellitus (GDM).
METHODS
A total of 100 pregnant women were enrolled from Maternity and Children Hospital, Qassim, Saudi Arabia including 40 women with confirmed GDM (group-1), 30 women with either type 1 or type 2 diabetes (group-2) and 30 women with normal pregnancy without GDM or pre-gestational diabetes (control group-3). Demographic, anthropometric, medical and biochemical data were obtained from the study subjects. Complete blood count (CBC) and peripheral smears were performed from routine blood samples. Red blood cells (RBCs) morphological analysis was carried out by a hematologist and deviations in size, shape, and staining properties of the RBCs were recorded.
RESULTS
The groups were similar in demographic characteristics (P > 0.05). RBCs showed normocytic and normochromic features in 83.3% patients of group-3 as compared to 57.5% in group-1, 30% in group-2, respectively. Microcytic hypochromic cells and anisocytosis were mostly encountered in group-2 in 53.3% and 93.3% patients respectively (P = 0.000). Forty percent of RBCs in goup-1 showed microcytic and hypochromic characteristics as compared to group-3 (P = 0.015). Additionally, 42.5% group-1 patients had anisocytosis as compared to group-3 (P = 0.003). Poikilocytosis, target cells and macrocytes were mostly observed in group-2.
CONCLUSIONS
Persistent hyperglycemia changes shape, size and hemoglobin contents of RBCs which are associated with the hyperglycemic status and exposure time.
PubMed: 32300429
DOI: 10.14740/jh449w -
Fetal Diagnosis and Therapy 2020Rare causes of fetal anemia requiring intrauterine transfusion (IUT) are challenging for fetal medicine specialists.
BACKGROUND
Rare causes of fetal anemia requiring intrauterine transfusion (IUT) are challenging for fetal medicine specialists.
OBJECTIVES
The aim of this study was to describe the perinatal patterns and prognosis in a consecutive series of fetuses transfused for fetal anemia of rare or unknown etiology, and to propose a protocol of investigation for fetal anemia of undetermined cause and for the management of subsequent pregnancies.
METHOD
We conducted a retrospective descriptive study on fetuses transfused for severe anemia of rare or unknown etiology managed in our national referral center (Centre National de Référence d'Hémobiologie Périnatale) and born between 2010 and 2017.
RESULTS
During the study period, 584 IUT were performed in 253 fetuses. Among those IUT, 23 (3.9%) were performed for a rare or unknown cause of anemia in 13 fetuses (5.1% of transfused fetuses). The median gestational age at diagnosis was 26 weeks of gestation (WG; range 21-33). Hemoglobin levels ranged from 1.6 to 9.1 g/dL (0.18-0.83 multiples of median) before the first IUT. The fetuses received between 1 and 6 IUT (39% received at least 2 IUT). The definitive etiologies for central anemia were: congenital syphilis, neonatal poikilocytosis, type II congenital dyserythropoietic anemia (CDA), and neonatal hemochromatosis. There was 1 case with suspected type I CDA and 1 with suspected Diamond-Blackfan anemia. There was 1 case of peripheral anemia, secondary to cerebral hemorrhages of different ages, related to a variant of the COL4A1 gene. In 6 fetuses corresponding to 4 mothers, no precise diagnosis was found despite a complete workup. In our series, there were 8 live births, 4 terminations of pregnancy, and 1 intrauterine fetal death.
CONCLUSIONS
Fetal anemia of rare or unknown diagnosis represents 5% of all transfused fetuses in our cohort. Fetal and neonatal anemias can be recurrent in further pregnancies, with variable expressivity.
Topics: Abortion, Induced; Anemia; Biomarkers; Blood Transfusion, Intrauterine; Female; Fetal Death; Fetal Diseases; Fetal Hemoglobin; Gestational Age; Humans; Live Birth; Pregnancy; Retrospective Studies; Risk Factors; Treatment Outcome
PubMed: 31505487
DOI: 10.1159/000501554 -
BMJ Case Reports Mar 2021Haemophagocytic lymphohistiocytosis (HLH) is a rare diagnosis that carries a high degree of mortality. We present this case of a previously healthy 22-year-old woman,...
Haemophagocytic lymphohistiocytosis (HLH) is a rare diagnosis that carries a high degree of mortality. We present this case of a previously healthy 22-year-old woman, who was admitted acutely ill to the hospital. One week prior, she had been seen by her primary care physician for fatigue and malaise. At that time, she was noted to have anterior and posterior cervical lymphadenopathy. She was referred to the emergency room and was diagnosed with acute Epstein-Barr virus (EBV) mononucleosis based on her clinical symptoms and positive heterophile antibody test. She was discharged after an uneventful 48-hour stay on the wards. She represented 7 days after discharge with cough, fatigue, nausea, vomiting, epigastric abdominal pain, diarrhoea, weight loss and subjective fevers. She had also reported haematemesis, epistaxis and melaena. Vital signs included temperature 36.9°C, blood pressure 90/50 mm Hg, heart rate 130 beats per minute and respiratory rate 32 breaths per minute. Physical examination was notable for an acutely ill appearing woman with scleral icterus, hepatosplenomegaly and palpable cervical and axillary lymphadenopathy. Complete blood count showed pancytopaenia with haemoglobin 59 g/L (normal 120-160 g/L), white blood cell count 2.7×10/L (normal 4-10.5×10/L) and platelet count 50×10/L (normal 150-450×10/L). The white blood cell count differential included 58% neutrophils (normal 38%-77%) with immature neutrophils in band form elevated at 45% (normal <14%), 16% lymphocytes (normal 20%-48%), 7% monocytes (normal <12%) and no eosinophils (normal <6%). Blood smear revealed anisocytosis, poikilocytosis and hypochromia. Coagulation panel showed elevated levels of d-dimer level at 1.39 µg/mL (normal <0.45 µg/mL), prolonged prothrombin time at 34.4 s (normal 11-15 s), prolonged activated partial thromboplastin time of 55.6 s (normal 25-34 s), prolonged international normalised ratio at 3.31 (normal <1.1) and low fibrinogen 60 mg/dL (normal >200 mg/dL). Lipid panel showed cholesterol at 114 mg/dL (normal 125-200 mg/dL), triglycerides 207 mg/dL (normal 30-150 mg/dL), high-density lipoprotein cholesterol 10 mg/dL (normal 40-60 mg/dL) and low-density lipoprotein cholesterol 63 mg/dL (normal <100 mg/dL). Other lab abnormalities included elevated ferritin of 6513 ng/mL (normal 10-150 ng/mL) and elevated lactate dehydrogenase of 1071 unit/L (normal 95-240 unit/L). Soluble interleukin-2 receptor alpha level was elevated at 60 727 units/mL (normal 223-710 units/mL). Fluorodeoxyglucose-positron emission tomography (FDG-PET) scan showed abnormal tracer localisation within the paratracheal, hilar, pelvic, abdominal and subcarinal lymph nodes, along with FDG-PET positive hepatosplenomegaly. A bone marrow biopsy showed hypercellular marrow (95% cellularity) with trilineage haematopoiesis, haemophagocytic cells, polytypic plasmacytosis and T-cell lymphocytosis, along with positive latent membrane protein-1 immunohistochemical staining for EBV. EBV quantitative DNA PCR showed >1 million copies. These findings were consistent with a diagnosis of HLH secondary to EBV infection. Despite intense therapy with the HLH-94 protocol, the patient expired from her illness after a prolonged hospital course.
Topics: Adult; Epstein-Barr Virus Infections; Female; Herpesvirus 4, Human; Humans; Infectious Mononucleosis; Lymphohistiocytosis, Hemophagocytic; Pancytopenia; Young Adult
PubMed: 33789863
DOI: 10.1136/bcr-2020-241222 -
Environmental Science and Pollution... May 2024Mercury (Hg) is regarded as a serious hazard to aquatic life and is particularly prevalent in aquatic ecosystems. However, there is little evidence available regarding...
Mercury (Hg) is regarded as a serious hazard to aquatic life and is particularly prevalent in aquatic ecosystems. However, there is little evidence available regarding the toxicity of mercury chloride (HgCl) in vital organs of fish. This study was conducted to assess the effects of HgCl (0.039 mg/L and 0.078 mg/L) on oxidative stress-mediated genotoxicity, poikilocytosis, apoptosis, and renal fibrosis after 15, 30, and 45 days of the exposure period. According to the findings, HgCl intoxication in fish resulted in a significantly (P < 0.05) elevated lipid peroxidation (LPO), protein carbonyls (PC), lactate dehydrogenase (LDH) activity levels in kidney tissues and significantly (P < 0.05) increased reactive oxygen species (ROS), poikilocytosis, DNA tail length, and the frequency of apoptotic cells (AC%) in blood cells. Kidney's ultra-structure and histopathology revealed its fibrosis, which was evident by mRNA expression of targeted genes KIM1, NOX4, TGFβ, and NFϏβ. Different indicators of oxidative stress, apoptosis, and genotoxicity were altered in a dose and time-dependent manner, according to a two-way ANOVA analysis. There was a considerable positive link between oxidative stress and kidney fibrosis in the fish Channa punctatus, and it is evident from regression correlation and PCA data analysis. The kidney's ultra-structure evaluation and histopathology both revealed a noticeable fibrosis state. Additionally, a significant (P < 0.05) downregulation in PPARδ reveals that fish body was unable to combat diseases such as kidney fibrosis induced by HgCl. This study shed fresh light on the mechanisms underlying nephrotoxicity caused by HgCl exposure.
Topics: Animals; Oxidative Stress; Mercuric Chloride; Water Pollutants, Chemical; Fishes; Kidney; Fresh Water; Lipid Peroxidation; Apoptosis; Channa punctatus
PubMed: 38760601
DOI: 10.1007/s11356-024-33514-4 -
The Science of the Total Environment Sep 2021Experimental evidence from the etiology of cancer studies suggests that a correlation between Bisphenol-A (BPA) exposure and alterations in hematopoiesis leads to blood...
Experimental evidence from the etiology of cancer studies suggests that a correlation between Bisphenol-A (BPA) exposure and alterations in hematopoiesis leads to blood cancer. In our study zebrafish were used to assess the lethality, developmental effect, embryonic apoptosis and changes in transcription factor of hematopoiesis through EGFR/ERK signaling pathways in response to BPA. The in silico interaction of EGFR and BPA was analysed by molecular dynamic simulation. According to our results, BPA induced a significant lethal effect in hatching retardation, reduction in heart rate and teratogenic effects on zebrafish embryos and larvae at three different concentrations 100, 500 and 2500 μg/L. The mortality of adult zebrafish exposed to the acute toxicity of BPA from 5 to 30 mg/L concentrations was determined for 96 h. The peripheral blood cells and vital organs such as kidney, liver and spleen from BPA exposed fish showed predominantly abnormal myeloid blast cells along with severe morphological changes in erythrocytes at sublethal concentration 245 μg/L. The BPA showed the highest binding affinity to zebrafish EGFR with a docking score of -7.5 kcal/mol with an RMSD of 3.0 nm during MD simulation. We found that EGFR/ERK overexpression leads to induce hematopoietic cell proliferation and impaired differentiation, which enhances the myeloid repopulating activity and the accumulation of immature myeloblast cells. BPA also caused a corresponding increase in expression of hematopoietic transcription factor c-MYB and RUNX-1 leading to polychromasia, poikilocytosis, acanthocytes and anisocytosis and promoted myeloblastosis by inhibiting GATA-1 expression. These morphological changes often resulted in the prior condition of acute myeloid leukemia (AML). Comprehensively, our data suggest that BPA can trigger the malignancy of AML cells by alteration of respective hematopoietic transcription factors via EGFR/ERK signaling in the zebrafish model.
Topics: Animals; Benzhydryl Compounds; ErbB Receptors; Granulocyte Precursor Cells; Hematopoiesis; Larva; Zebrafish
PubMed: 34004533
DOI: 10.1016/j.scitotenv.2021.147530 -
Porcine Health Management May 2023Tail biting is a multifactorial problem. As the health status is one of the factors commonly linked to tail biting, this study focuses on the health of identified...
BACKGROUND
Tail biting is a multifactorial problem. As the health status is one of the factors commonly linked to tail biting, this study focuses on the health of identified biters. 30 (obsessive) biters are compared to 30 control animals by clinical and pathological examination as well as blood and cerebrospinal fluid samples. In that way, altogether 174 variables are compared between the groups. Moreover, connections between the variables are analysed.
RESULTS
In the clinical examination, 6 biters, but only 2 controls (P = 0.019) were noticeably agitated in the evaluation of general behaviour, while 8 controls were noticeably calmer (2 biters, P = 0.02). Biters had a lower body weight (P = 0.0007) and 13 biters had overlong bristles (4 controls, P = 0.008). In the pathological examination, 5 biters, but none of the controls had a hyperceratosis or inflammation of the pars proventricularis of the stomach (P = 0.018). However, 7 controls and only 3 biters were affected by gut inflammation (P = 0.03). In the blood sample, protein and albumin levels were below normal range for biters (protein: 51.6 g/l, albumin: 25.4 g/l), but not for controls (protein: 53.7 g/l, albumin: 27.4 g/l), (protein: P = 0.05, albumin: P = 0.02). Moreover, 14 biters, but only 8 controls had poikilocytosis (P = 0.05). Although not statistically different between groups, many animals (36/60) were affected by hypoproteinemia and hyponatremia as well as by hypokalemia (53/60) and almost all animals (58/60) had hypomagnesemia. For hypomagnesemia, significant connections with variables linked to tail damage and ear necrosis were detected (r/V/ρ ≥ 0.4, P ≤ 0.05).
CONCLUSION
The results suggest that behavioural tests might be helpful in identifying biters. Moreover, cornification and inflammation of the pars proventricularis is linked to becoming a biter. Furthermore, the results highlight the need for appropriate and adjusted nutrient and mineral supply, especially with regard to magnesium.
PubMed: 37161469
DOI: 10.1186/s40813-023-00314-0 -
Comparative Biochemistry and... Dec 2021Despite extensive research on the toxic effects of microplastics (MPs), there is no obtainable data on the use of phytobioremediation against MPs toxicity in fish. This...
Despite extensive research on the toxic effects of microplastics (MPs), there is no obtainable data on the use of phytobioremediation against MPs toxicity in fish. This study aimed to investigate the protective role of lycopene, citric acid, and chlorella against the toxic effects of MPs in African catfish (Clarias gariepinus) using hematology, biochemical, antioxidants, erythron profiles (poikilocytosis and nuclear abnormalities) and the accumulation of MPs in tissues as biomarkers. Five groups of fish received: normal diet (control); MPs (500 mg/kg diet) (Group 2); MPs (500 mg/kg diet) + lycopene (500 mg/kg diet) (Group 3); MPs (500 mg/kg diet) + citric acid (30 g/kg diet) (Group 4); and MPs (500 mg/kg diet) + chlorella (50 g/kg diet) (Group 5) for 15 days. Group 2 had significantly higher amounts of MPs in the stomach, gills, and feces, electrolyte imbalances (HCO, Fe, Na, K, Ca, Cl, and anion gap, hematobiochemical alterations, and decreases in the activities of superoxide dismutase, catalase, total antioxidant capacity, and glutathione S-transferases compared to the control group. Additionally, Group 2 had significant increase in the percentage of poikilocytosis, and nuclear abnormalities in RBC's compared to the control group. The co-treatment of MPs-exposed fish with lycopene, citric acid, and chlorella-supplemented diets ameliorated the hematological, biochemical, and erythron profile alterations, but only slightly enhanced the antioxidant activity. Overall, lycopene, citric acid, and chlorella can be recommended as a feed supplement to improve hematobiochemical alterations and oxidative damage induced by MPs toxicity in the African catfish (C. gariepinus).
Topics: Animals; Antioxidants; Biodegradation, Environmental; Calcium Chelating Agents; Catfishes; Chlorella; Citric Acid; Gills; Lycopene; Oxidative Stress; Polyethylene; Protective Agents
PubMed: 34517132
DOI: 10.1016/j.cbpc.2021.109189