-
Journal of Laboratory Physicians Jan 2009To assess the efficacy of a peripheral smear examination as a screening tool for β-thalassemia trait.
OBJECTIVE
To assess the efficacy of a peripheral smear examination as a screening tool for β-thalassemia trait.
MATERIALS AND METHODS
17 623 Leishman-stained peripheral smears were evaluated during the period from July 2006 to September 2007. The following parameters were studied: hemoglobin, red blood cell count, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration and red cell distribution width. All the cases that showed microcytosis, hypochromia, erythrocytosis and absence of anisopoikilocytosis were suspected of having the thalassemia trait (TT), and all these cases were further evaluated with Alkaline Hemoglobin Electrophoresis for confirmation.
RESULTS
Of the 17 623 smears examined, 60 cases were considered suspicious of having TT. Alkaline hemoglobin electrophoresis carried out on all these cases revealed an elevated HbA(2) (Mean = 7.5%). Five cases evaluated were found to have other hemoglobinopathies (1 Sickle cell trait, 3 Hb-E, 1 thalassemia intermedia).
CONCLUSION
Careful screening of peripheral smear is an invaluable screening tool for thalassemia trait (PPV - 95%). There must be awareness among the peripheral centers about the importance of peripheral smear screening and the affected persons should be counseled.
PubMed: 21938243
DOI: 10.4103/0974-2727.54802 -
Bulletin of Experimental Biology and... Jul 2001Electron microscopy revealed morphological changes in erythrocytes from rats with chronic alcoholic intoxication kept on protein- and vitamin B-deficient rations. All...
Electron microscopy revealed morphological changes in erythrocytes from rats with chronic alcoholic intoxication kept on protein- and vitamin B-deficient rations. All animals had anisopoikilocytosis (up to 50%). Most pronounced changes in erythrocyte population attesting to accelerated erythrocyte aging (stomato- and microcytosis, discocyte swelling, and spontaneous hemolysis) were found in alcohol-fed rats kept on deficient ration.
Topics: Alcoholism; Alcohols; Animals; Avitaminosis; Erythrocytes; Male; Protein Deficiency; Rats
PubMed: 11687858
DOI: 10.1023/a:1012548816530 -
Toxicology and Industrial Health Apr 2007Benzene exposure from vehicular sources and its health impact are relatively unexplored in India. We have investigated in this study hematology and lymphocyte subsets of...
Benzene exposure from vehicular sources and its health impact are relatively unexplored in India. We have investigated in this study hematology and lymphocyte subsets of 25 petrol pump attendants, 25 automobile service station workers and 35 controls matched for age, sex and socioeconomic conditions. The participants were non-smoking males of Kolkata (former Calcutta) in eastern India. Compared with controls, the workers had 3.8- times more trans,trans-muconic acid in urine, suggesting higher level of benzene exposure. The exposed subjects had decreased erythrocyte, hemoglobin, lymphocyte and platelet levels, but increased neutrophil, band cells, RBC aniso-poikilocytosis and target cells. In addition, CD4+, CD8+ and CD19+ cells were decreased by 37, 20 and 47% respectively, but CD 16+ 56+ NK cells were increased by 20%. P-selectin expression on platelet surface of the workers was significantly elevated (P < 0.05), indicating upregulation of platelet activity. In summary, the study revealed high level of benzene exposure from vehicular sources in India, and the exposed subjects had hematological and immunological alterations.
Topics: Adult; Air Pollutants, Occupational; Benzene; Blood Platelets; Humans; India; Male; Middle Aged; Occupational Exposure; P-Selectin; Sorbic Acid; Vehicle Emissions
PubMed: 18220159
DOI: 10.1177/0748233707080907 -
Journal of Ayub Medical College,... 2004There has been little systematic study on the clinical spectrum of pancytopenia. This study was done to describe the etiology, presentation and outcome of patients with...
BACKGROUND
There has been little systematic study on the clinical spectrum of pancytopenia. This study was done to describe the etiology, presentation and outcome of patients with pancytopenia presenting in a general medical ward.
METHODS
Hundred patients with pancytopenia were included in the study from October 2001 to October 2002. Patients on cancer chemotherapy were excluded. Blood counts, bone marrow examinations and trephine biopsies were performed according to standard methods.
RESULTS
In all cases, megaloblastic anemia constituted the largest group (n = 39), and also seen in conjunction with hemolytic anemia and septicemia. Hypersplenism secondary to portal hypertension (cirrhosis) was the second most common diagnosis (n = 19). Aplastic anemia, septicemia and myelodysplasia were other common causes. Two patients were the suspected cases of viral hemorrhagic fever. Thirteen (13%) patients expired. Absolute neutrophil count (ANC) less than 500/microliter was seen in 14 (14%) patients, among which 6 (15.3%) had megaloblastic anemia, 3 (37.5%) had aplastic anemia, and 2 (40%) had myelodysplasia. Eleven patients with platelet counts < or = 10 x 10(9)/L, 6 (54.5%) presented with bleeding; and 2 of these 8 had aplastic anemia and 1 patient with megaloblastic anemia. MCV values > 100 fL and > 110 fL were more frequent in patients with megaloblastic anemia with most prominent anisopoikilocytosis, microcytosis and fragmented RBCs. Macrocytosis was noted in 35 (89.7%) patients with megaloblastic anemia and 12 (63.1%) with hypersplenism, 4 (50%) with aplastic anemia. Hypersegmented neutrophils were noted in the blood films of 36 (92.3%) patients with megaloblastic anemia.
CONCLUSION
Megaloblastic anemia, hypersplenism and aplastic anemia are the common causes of pancytopenia in our study.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anemia, Aplastic; Anemia, Megaloblastic; Child; Female; Humans; Hypersplenism; Male; Middle Aged; Pancytopenia
PubMed: 15125172
DOI: No ID Found -
Journal of Pediatric Hematology/oncology Feb 2007Hereditary pyropoikilocytosis is an inherited red cell membrane disorder with characteristic morphology: striking anisopoikilocytosis with red cell fragmentation and...
Hereditary pyropoikilocytosis is an inherited red cell membrane disorder with characteristic morphology: striking anisopoikilocytosis with red cell fragmentation and microspherocytes. Clinical and laboratory physicians must be aware of the potential impact of this disorder on accuracy of complete blood count results reported by automated hematology instruments. Recognition of the morphologic and laboratory findings are important for recognizing this potentially severe anemia.
Topics: Anemia, Hemolytic, Congenital; Erythrocytes, Abnormal; Female; Humans; Infant, Newborn; Pedigree
PubMed: 17279012
DOI: 10.1097/MPH.0b013e3180320b6f -
Annals of Emergency Medicine Sep 2007We report a case of acute hemolytic anemia in a 21-year-old Nigerian woman after high-dose misoprostol (4 mg), used for medical abortion. The major causes of inherited...
We report a case of acute hemolytic anemia in a 21-year-old Nigerian woman after high-dose misoprostol (4 mg), used for medical abortion. The major causes of inherited or immune hemolytic anemia were excluded. The patient's peripheral blood smear showed acanthocytes and anisopoikilocytosis, which progressively disappeared in the days postingestion. We evaluated RBC features, and we observed reduced RBC Na+ and K+ content and abnormalities in membrane cation transport pathways and in Ca2+ activated K+ channel (Gardos channel), suggesting possible direct effects of misoprostol on RBCs. Although further studies need to be carried out, the present case suggests that high-dose misoprostol, a prostaglandin E1 analogue, severely affects RBC features and causes an acquired acute hemolytic anemia, which is self-limited when misoprostol is withdrawn.
Topics: Abortifacient Agents, Nonsteroidal; Abortion, Induced; Acanthocytes; Acute Disease; Adult; Anemia, Hemolytic; Chorea; Diagnosis, Differential; Female; Humans; Misoprostol; Pregnancy
PubMed: 17084939
DOI: 10.1016/j.annemergmed.2006.09.001 -
European Journal of Haematology Mar 2008A congenital dyserythropoietic anaemia (CDA) was recognised in a French Caucasian male patient. Blood smears showed a pronounced aniso-poikilocytosis. Bone marrow light...
A congenital dyserythropoietic anaemia (CDA) was recognised in a French Caucasian male patient. Blood smears showed a pronounced aniso-poikilocytosis. Bone marrow light microscopy showed signs of dyserythropoesis, but no internuclear chromatin bridges. Electron microscopy disclosed erythroblast nuclei with the Swiss cheese aspect and the presence of cytoplasmic organelles, assessing the diagnosis of CDA I. The presence of internuclear chromatin bridges may thus be missing in CDA I. The patient proved to be homozygous for the Arg1042Trp mutation in codanin-1 (the 'Bedouin mutation'). By the age of 25, the patient's vision started to deteriorate as a result of retinal angioid streaks and macular abnormalities. Evolution was controlled and the patient, being nearly 50 yr old now, still has a partial use of his eyes. This second case of retinal angioid streaks reported in CDA I adds to the non-haematological features likely to be associated with this condition.
Topics: Amino Acid Substitution; Anemia, Dyserythropoietic, Congenital; Angioid Streaks; Arginine; Bone Marrow Cells; Child; Glycoproteins; Homozygote; Humans; Male; Middle Aged; Nuclear Proteins; Tryptophan
PubMed: 18081704
DOI: 10.1111/j.1600-0609.2007.01004.x -
Annales de Biologie Clinique 2012We report on a case of hereditary pyropoïkilocytosis fortuitously diagnosed in a 34-year old woman issued from Benin. Laboratory tests indicated a moderate haemolytic...
We report on a case of hereditary pyropoïkilocytosis fortuitously diagnosed in a 34-year old woman issued from Benin. Laboratory tests indicated a moderate haemolytic anaemia with a marked microcytosis. Blood film examination revealed a striking anisopoikilocytosis characterized by elliptocytes, numerous red blood cells (RBC) fragments and microspherocytes. The histogram of RBC volume distribution showed two populations of RBC: a normocytic and a very microcytic population, this later corresponding to the RBC fragmentation. These features strongly suggested a membrane disorder, particularly an hereditary pyropoïkilocytosis (HPP). The thermal unstability of the cytoskeleton was demonstrated by enhanced red cell fragmentation after in vitro exposure to heat which occurs at a lower temperature as compared to normal red cells. The diagnosis of HPP was confirmed by specialized investigations (osmotic gradient ektacytometry and erythrocytic membrane proteins electrophoresis). HPP is considered as a severe form of hereditary elliptocytosis characterized by jaundice and a severe haemolytic anaemia which usually appears during the neonatal period and the childhood. Our report is intriguing because of the delayed diagnosis of HPP in a patient who presented moderate clinical manifestations.
Topics: Adult; Delayed Diagnosis; Elliptocytosis, Hereditary; Female; Humans; Incidental Findings; Pregnancy; Pregnancy, Ectopic
PubMed: 22796621
DOI: 10.1684/abc.2012.0710 -
American Journal of Clinical Pathology Jul 1987Hereditary pyropoikilocytosis (HPP) is a severe, congenital hemolytic anemia occurring almost exclusively in black persons and characterized by extreme red blood cell...
Hereditary pyropoikilocytosis (HPP) is a severe, congenital hemolytic anemia occurring almost exclusively in black persons and characterized by extreme red blood cell anisopoikilocytosis. The authors report two unrelated white females with HPP. Both had severe hemolytic anemia at birth, red blood cell morphologic features characteristic for HPP, and increased thermal sensitivity of the red blood cells. Examination of the red blood cell membranes of both patients showed markedly unstable membrane skeletons when subjected to shear stress, spectrin dimer association defects with increased dimers, and partial spectrin deficiency. Limited tryptic digestion of the spectrin molecule from both patients yielded an abnormal pattern with a decrease in the normal 80,000-dalton alpha I domain and a concomitant increase of an abnormal 74,000-dalton peptide (Sp alpha 1/74). One parent and one sibling of one of the patients with HPP had hereditary elliptocytosis (HE) and the Sp alpha 1/74 defect. The other patient with HPP was different from others reported in that both parents were hematologically and biochemically normal. In addition, her daughter had HE and the Sp alpha 1/74 defect.
Topics: Adult; Anemia, Hemolytic, Congenital; Child; Elliptocytosis, Hereditary; Erythrocyte Membrane; Erythrocytes, Abnormal; Female; Humans; Microscopy, Electron, Scanning; Pedigree
PubMed: 3604989
DOI: 10.1093/ajcp/88.1.58 -
Biology of the Neonate 1997Using fetal blood sampling, the diagnosis of triploidy can be strongly suspected on the basis of the peculiar hematological picture. Triploid fetuses present with... (Comparative Study)
Comparative Study
Using fetal blood sampling, the diagnosis of triploidy can be strongly suspected on the basis of the peculiar hematological picture. Triploid fetuses present with anemia, marked anisopoikilocytosis, and grossly increased mean corpuscular volume, associated with thrombocytopenia and significant platelet anisocytosis. These findings are of considerable immediate diagnostic value. They allow physicians to immediately counsel parents about the prognosis of the fetus. In case of fetal or neonatal distress, this information could orientate decisions about obstetrical and pediatric management while waiting for the definitive diagnosis.
Topics: Blood Cell Count; Chromosome Aberrations; Chromosome Disorders; Diagnosis, Differential; Female; Fetal Blood; Hemoglobins; Humans; Karyotyping; Male; Polyploidy; Prenatal Diagnosis
PubMed: 9395838
DOI: 10.1159/000244494