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Frontiers in Neurology 2019Migraine is a debilitating primary headache disorder with a poorly understood aetiology. An extensive body of literature supports the theory of migraine as a systemic...
Migraine is a debilitating primary headache disorder with a poorly understood aetiology. An extensive body of literature supports the theory of migraine as a systemic vascular inflammatory disorder characterised by endothelial dysfunction. It is also well-known that chronic inflammation results in an excessive burden of oxidative stress and therefore cellular dysfunction. In this study the effects of excessive oxidative stress through the phases of female migraine-with-aura (FMA) were evaluated by examining the health of the systems of haemostasis. Blood was obtained from 11 FMA patients at baseline and during the headache phase of migraine, as well as from 8 healthy age-matched female controls. Samples were analysed using thromboelastography (TEG) to evaluate viscoelastic profiles, light microscopy for erythrocyte morphology, Scanning Electron Microscopy (SEM) for erythrocyte and fibrin clot structure, confocal microscopy for β-amyloid detection in fibrin clots. Viscoelastic profiles from platelet poor plasma showed decreased clot reaction times in FMA at baseline (95% CI [5.56, 8.41]) vs. control (95% CI [7.22, 11.68]); as well as decreased time to maximum thrombus generation for the same comparison (95% CI [6.78, 10.20] vs. [8.90, 12.96]). Morphological analysis of erythrocytes indicated widespread macrocytosis, poikilocytosis and eryptosis in the migraineurs. Analysis of fibrin networks indicated that this hypercoagulability may be a result of aberrant fibrin polymerisation kinetics caused by the adoption of a β-amyloid conformation of fibrin(ogen). The results reaffirm the hypercoagulable state in migraine, and would suggest that this state is most likely a result of a systemic inflammatory state which induces oxidative damage to both erythrocytes and fibrin(ogen) in female episodic migraine-with-aura. Furthermore, if the amylodogenic changes to fibrin(ogen) were observed in a larger cohort, this would support theories of micro-embolisation in migraine-with-aura.
PubMed: 31849822
DOI: 10.3389/fneur.2019.01262 -
Clinico-haematological alterations and therapeutic management of tick borne fever in cross bred cow.Journal of Parasitic Diseases :... Dec 2018A 5 years old crossbred cow was brought to the Veterinary Clinical Complex of Lala Lajpat Rai University of Veterinary and Animal Sciences Hisar with history of...
A 5 years old crossbred cow was brought to the Veterinary Clinical Complex of Lala Lajpat Rai University of Veterinary and Animal Sciences Hisar with history of progressive weakness, pale mucous membrane, anorexia, high fever (105 °F), tachycardia, laboured breathing and coffee coloured urine. Analysis of haematological parameters revealed severe anaemia, leucocytopenia, marked poikilocytosis of erythrocytes. Blood smear examination showed presence of signet ring shaped organisms, piroplasms and condensed dot forms of in the stained erythrocytes. Further animal was treated with buparvaquone @ 2.5 mg/kg b.wt deep I/M in neck region and long acting oxytetracycline at 25 mg/kg b. W. slow I/V daily in normal saline solution for 5 days. Berenil (Diminazene aceturate 5%) injection was also administered @ 1 ml/20 kg b.wt. I/M along with supportive therapy. Clinical signs started to subside 3 days post treatment. Complete recovery was achieved by 4 weeks post treatment however animal succumbed to death due to immunosuppression.
PubMed: 30538366
DOI: 10.1007/s12639-018-1034-7 -
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 -
Blood Dec 2017
Topics: Blood Platelets; Burns; Child, Preschool; Diagnostic Imaging; Elliptocytosis, Hereditary; Erythrocytes; Humans; Leukocytosis; Male; Spherocytes; Thrombocytosis
PubMed: 29269532
DOI: 10.1182/blood-2017-08-802678 -
Medical Archives (Sarajevo, Bosnia and... Apr 2017Various studies confirm the biocompatibility and efficacy of clips for certain target tissues, but without any comparative analysis of hematological parameters....
INTRODUCTION
Various studies confirm the biocompatibility and efficacy of clips for certain target tissues, but without any comparative analysis of hematological parameters. Therefore, we conducted a study to assess the possible association of the implantation of titanium and plastic clips in the neurocranium with possible morphological changes in the blood cells of experimental animals.
MATERIALS AND METHODS
As a control, the peripheral blood smears were taken before surgery from 12 adult dogs that were divided into two experimental groups. After placing titanium and plastic clips in the neurocranium, the peripheral blood of the first group was analyzed on the seventh postoperative day, while the peripheral blood of the second group was analyzed on the sixtieth day. By microscopy of the blood smears, the following parameters were analyzed: the presence of poikilocytosis of the red blood cells, degenerative changes in the leukocytes and leukogram.
RESULTS
There were no statistically significant differences between the mean values of the groups. Monocytosis was detected (first group 22.83 % and second 16.30 %), as well as neutropenia (46.80 %, in the second group). Degenerative changes to neutrophils and the occurrence of atypical lymphocytes were observed in the second experimental group (60 postoperative day).
CONCLUSION
A mild adverse effect from the biomaterials present in the neurocranium of dogs was detected, affecting the majority of leukocytic cells. A chronic recurrent inflammatory process was caused by the presence of the plastic and titanium clips in the brain tissue. No adverse effect of biomaterials on erythrocytes in the neurocranium was detected in the dogs studied. Further studies are necessary to explain the occurrence of degenerative changes in the neutrophils and lymphocytes.
Topics: Animals; Blood Cells; Dogs; Erythrocytes, Abnormal; Leukocytosis; Monocytes; Neutropenia; Plastics; Skull; Surgical Instruments; Titanium
PubMed: 28790535
DOI: 10.5455/medarh.2017.71.84-88 -
Korean Journal of Pediatrics Nov 2016Herein, we report a rare case of hemolytic anemia with reticulocytopenia following intravenous immunoglobulin therapy in a young infant treated for Kawasaki disease. A...
Herein, we report a rare case of hemolytic anemia with reticulocytopenia following intravenous immunoglobulin therapy in a young infant treated for Kawasaki disease. A 2-month-old boy presented with fever lasting 3 days, conjunctival injection, strawberry tongue, erythematous edema of the hands, and macular rash, symptoms and signs suggestive of incomplete Kawasaki disease. His fever resolved 8 days after treatment with aspirin and high dose infusion of intravenous immunoglobulin. The hemoglobin and hematocrit decreased from 9.7 g/dL and 27.1% to 7.4 g/dL and 21.3%, respectively. The patient had normocytic hypochromic anemia with anisocytosis, poikilocytosis, immature neutrophils, and nucleated red blood cells. The direct antiglobulin test result was positive, and the reticulocyte count was 1.39%. The patient had an uneventful recovery. However, reticulocytopenia persisted 1 month after discharge.
PubMed: 28018448
DOI: 10.3345/kjp.2016.59.11.S60 -
Journal of Community Hospital Internal... 2016Thrombotic thrombocytopenic purpura (TTP) is a life-threatening medical emergency which may be difficult to recognize given the wide spectrum in which it presents. A...
Thrombotic thrombocytopenic purpura (TTP) is a life-threatening medical emergency which may be difficult to recognize given the wide spectrum in which it presents. A delay in treatment may be catastrophic as untreated cases of TTP have a mortality rate exceeding 90%. Given the high fatality rate of untreated TTP and its range of presenting symptoms, we present our unusual case of TTP in a post-splenectomy patient with early treatment and positive outcome. This case describes a 54-year-old female who presented with hematuria and gingival bleeding, followed by the development of a bilateral lower extremity petechial rash. Her past medical history was significant for multiple episodes of TTP, the last of which resulted in a splenectomy and a 20-year history of remission thereafter. On exam, she was alert, well appearing, and neurologically intact. Her only significant finding was a bilateral lower extremity petechial rash. Laboratory studies revealed mild anemia and thrombocytopenia, an elevated lactate dehydrogenase, and a decreased haptoglobin. Peripheral smear showed poikilocytosis, helmet cells, and schistocytes. Corticosteroid therapy was promptly initiated, her platelets were monitored closely, and she underwent urgent therapeutic plasma exchange. Due to the risk of significant morbidity and mortality that may result from delayed treatment of TTP as well as the significant variations of presentation, TTP requires a consistently high index of suspicion. Our patient suffered multiple relapses of TTP within a 30-year span, underwent splenectomy in early adulthood, and presented with atypical symptoms during her most recent relapse illustrating how persistent TTP can be as well as how unusually it may present. Providers should be aware of the vast spectrum of presentation and remember that TTP may recur following splenectomy despite prolonged remission.
PubMed: 27609730
DOI: 10.3402/jchimp.v6.32258 -
Molecular Genetics & Genomic Medicine May 2016X-linked sideroblastic anemia (XLSA) is a disorder characterized by decreased heme synthesis and mitochondrial iron overload with ringed sideroblasts in bone marrow....
BACKGROUND
X-linked sideroblastic anemia (XLSA) is a disorder characterized by decreased heme synthesis and mitochondrial iron overload with ringed sideroblasts in bone marrow. XLSA is caused by mutations in the erythroid-specific gene coding 5-aminolevulinate synthase (ALAS2). Anemia in XLSA is extremely variable, characteristically microcytic and hypochromic with poikilocytosis, and the red blood cell distribution width is increased and prominent dimorphism of the red cell population. Anemia in XLSA patients responds variably to supplementation with pyridoxine.
METHODS AND RESULTS
We report four patients with XLSA and three mutations in ALAS2: c.611G>A (p.Arg204Gln), c.1218G>T (p.Leu406Phe) and c.1499A>G (p.Tyr500Cys). The in silico predictions of three ALAS2 mutations and the functional consequences of two ALAS2 mutations were assessed. We performed in silico analysis of these mutations using ten different softwares, and all of them predicted that the p.Tyr500Cys mutation was deleterious. The in vitro prokaryotic expression showed that the p.Leu406Phe and p.Tyr500Cys mutations reduced the ALAS2 specific activity (SA) to 14% and 7% of the control value, respectively.
CONCLUSION
In view of the results obtained in this study, a clear relationship between genotype and phenotype cannot be established; clinical variability or severity of anemia may be influenced by allelic variants in other genes or transcription factors and environmental conditions.
PubMed: 27247955
DOI: 10.1002/mgg3.202 -
Veterinary Research Forum : An... 2014An 8-day-old newborn female twin Holstein calves with a history of weakness, anorexia, emaciation and convulsion were presented to Tabriz University Veterinary Teaching...
An 8-day-old newborn female twin Holstein calves with a history of weakness, anorexia, emaciation and convulsion were presented to Tabriz University Veterinary Teaching Hospital. On admission, the calves were febrile and recumbent. Physical examination revealed many ticks from the external body surface of the animals, right and left prescapular lymphadenopathy, severe opisthotonos, nystagmus, pedaling, blindness, hyperpnea and hypersthenia. Buccal and vaginal mucous were pale and no other physical abnormalities were diagnosed. Fecal flotation, complete blood count, bone marrow aspiration, cerebrospinal fluid (CSF) analysis, necropsy and histopathological examination were performed. Fecal flotation showed no helminth eggs or coccidial oocysts. On blood smears obtained from the earlap, >70 percent of erythrocytes were infected with piroplasms organisms and schizonts were obvious in smears of lymphocytes lymph node. Blood count revealed a lymphopenia, poikilocytosis, anisocytosis and non-regenerative anemia (packed cell volume; mean, 16%). Histopathological examination revealed Arthus reaction through the walls of cerebral blood vessels, which resulted in local necrosis of the brain. Analysis of CSF showed no abnormality in appearance or biochemical and cell counts. Although the calves were treated with a single intramuscular injection of buparvaquone and oxytetracycline once daily they did not respond to the treatment and died. In conclusion, the present cases showed a rare cerebral form of theileriosis by vertical transmission that confirmed by the presence of piroplasms on blood films and multinuclear schizonts on lymph node aspiration smears, gross and histopathological examinations and unsuccessful treatment in a newborn twin Holstein calves.
PubMed: 25568725
DOI: No ID Found -
PloS One 2014Rabbits (Oryctolagus cuniculus) are a popular companion animal, food animal, and animal model of human disease. Abnormal red cell shapes (poikilocytes) have been...
Rabbits (Oryctolagus cuniculus) are a popular companion animal, food animal, and animal model of human disease. Abnormal red cell shapes (poikilocytes) have been observed in rabbits, but their significance is unknown. The objective of this study was to investigate the prevalence and type of poikilocytosis in pet rabbits and its association with physiologic factors, clinical disease, and laboratory abnormalities. We retrospectively analyzed blood smears from 482 rabbits presented to the University of California-Davis Veterinary Medical Teaching Hospital from 1990 to 2010. Number and type of poikilocytes per 2000 red blood cells (RBCs) were counted and expressed as a percentage. Acanthocytes (>3% of RBCs) were found in 150/482 (31%) rabbits and echinocytes (>3% of RBCs) were found in 127/482 (27%) of rabbits, both healthy and diseased. Thirty-three of 482 (7%) rabbits had >30% acanthocytes and echinocytes combined. Mild to moderate (>0.5% of RBCs) fragmented red cells (schistocytes, microcytes, keratocytes, spherocytes) were found in 25/403 (6%) diseased and 0/79 (0%) healthy rabbits (P = 0.0240). Fragmentation and acanthocytosis were more severe in rabbits with inflammatory disease and malignant neoplasia compared with healthy rabbits (P<0.01). The % fragmented cells correlated with % polychromasia, RDW, and heterophil, monocyte, globulins, and fibrinogen concentrations (P<0.05). Echinocytosis was significantly associated with renal failure, azotemia, and acid-base/electrolyte abnormalities (P<0.05). Serum cholesterol concentration correlated significantly with % acanthocytes (P<0.0001), % echinocytes (P = 0.0069), and % fragmented cells (P = 0.0109), but correlations were weak (Spearman ρ <0.02). These findings provide important insights into underlying pathophysiologic mechanisms that appear to affect the prevalence and type of naturally-occurring poikilocytosis in rabbits. Our findings support the need to carefully document poikilocytes in research investigations and in clinical diagnosis and to determine their diagnostic and prognostic value.
Topics: Acanthocytes; Animal Diseases; Animals; Erythrocytes, Abnormal; Female; Hematologic Diseases; Male; Prevalence; Rabbits
PubMed: 25402479
DOI: 10.1371/journal.pone.0112455