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Cureus Mar 2022Sickle cell disease is an autosomal recessive disorder resulting in the substitution of CTG by CAG in the sixth codon of the beta-globin gene. As a result of this, the...
Sickle cell disease is an autosomal recessive disorder resulting in the substitution of CTG by CAG in the sixth codon of the beta-globin gene. As a result of this, the hydrophilic glutamic acid residue is replaced by hydrophobic valine residue, leading to the formation of hemoglobin tetramer HBS. This alteration in the beta-globin chain makes the red blood cells prone to sickling, especially in the presence of risk factors such as stress, hypoxia, and infection. These sickled red blood cells have the tendency to adhere to the endothelium and lead to vessel occlusion and distal tissue ischemia. The recent coronavirus disease 2019 (COVID-19) outbreak has impacted millions across the globe, putting individuals with co-morbidities at particularly high risk, and patients with sickle cell disease are no exception. We present the case of a 47-year-old African American male presenting to the emergency department with subjective fevers and a two-day history of pain in the arms, legs, and chest. A diagnosed case of sickle cell disease, the patient was on hydromorphone for pain management but ran out of his medications a few weeks before presentation. On examination, the patient was saturating well with mild tenderness upon palpation of the arms, legs, and chest. On complete blood count, the patient had a hemoglobin of 11.3 g/dL and a white cell count of 13.1 x10(3)/mcL. The patient had a normal mean corpuscular volume with reticulocytosis, hypochromia, ovalocytosis, poikilocytosis, polychromasia, and target cells. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) was positive. The chest X-ray did not reveal any significant findings. He was admitted to the medicine floor for the management of sickle cell crisis and was placed under airborne and droplet precautions. The patient was started on hydromorphone for pain management and intravenous fluid hydration. On the second day of admission, the patient reported increasing shortness of breath. He was saturating 90% on room air and 94% on 2 liters of supplemental oxygen. The white blood cell count increased to 18.42 x10(3)/mcL and the chest X-ray revealed reticular densities with patchy alveolar opacities in the left lung. Given the decline in respiratory status, the patient was started on remdesivir. Over the course of his hospital stay, the patient's pain and respiratory status improved, with the patient saturating 97% on room air. He was discharged home with instructions to follow isolation precautions for at least two weeks, folic acid, and adequate pain management. An appointment was also scheduled for the patient to follow with a sickle cell nurse practitioner upon discharge.
PubMed: 35494937
DOI: 10.7759/cureus.23604 -
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 -
Biological Trace Element Research Nov 2022The aim of the present study was to evaluate the arsenic-induced hemotoxicity and to evaluate the protective effects of Lactobacillus sporogenes in male albino Wistar...
The aim of the present study was to evaluate the arsenic-induced hemotoxicity and to evaluate the protective effects of Lactobacillus sporogenes in male albino Wistar rats. A total of 36 adult male albino Wistar rats were procured and divided into 3 groups of 12 animals each. Group 1 rats served as control, group 2 rats were administered sodium arsenite (@5 mg/kg BW/day), groups 3 rats were supplemented with L. sporogenes (@15 million spores/kg BW/day) along with sodium arsenite administered along with sodium arsenite orally daily for 28 consecutive days. Weekly body weights, hematological profile, and erythrocyte morphology were assessed. Significant (P < 0.05) reduction in mean weekly body weights (g) was observed in group 2 than group 1; however, a significant (P < 0.05) increase in weekly body weights was observed in group 3 as compared to group 2. A significant (P < 0.05) decrease in erythrocyte-related parameters and platelet counts, and a significant (P < 0.05) leukocytosis, relative lymphopenia, absolute neutrophilia, and monocytosis were noticed among arsenic-treated rats when compared to the control group. Blood smear of arsenic-treated rats contains echinocytes, microcytes, and spherocytes when compared to control. Scanning electron microscopic examination of blood revealed altered erythrocyte morphology in arsenic-treated rats with poikilocytosis and blebbing of the erythrocyte membrane. Supplementation of L. sporogenes along with arsenic resulted in improvement of all the hematological parameters and reduction in morphological abnormalities in comparison to the toxic control group. It is concluded that supplementation of L. sporogenes can effectively alleviate the arsenic-induced hematological alterations.
Topics: Animals; Arsenic; Arsenites; Bacillus coagulans; Body Weight; Male; Oxidative Stress; Rats; Rats, Wistar; Sodium Compounds
PubMed: 34993908
DOI: 10.1007/s12011-021-03055-9 -
American Journal of Veterinary Research Dec 2021To document RBC abnormalities in dogs with congenital ventricular outflow tract obstruction.
OBJECTIVE
To document RBC abnormalities in dogs with congenital ventricular outflow tract obstruction.
ANIMALS
62 dogs with pulmonic stenosis (PS) or aortic stenosis (AS) and 20 control dogs were recruited.
PROCEDURES
The proportions of RBCs that were schistocytes, acanthocytes, and keratocytes were assessed. Complete blood cell counts were performed. Tested variables included hemoglobin concentration, hematocrit, and erythrocyte count.
RESULTS
Median (interquartile range [IQR]) peak systolic Doppler-derived trans-stenotic pressure gradient (∆P) values were 161 mm Hg (108 to 215 mm Hg) and 134 mm Hg (125 to 165 mm Hg) for dogs with PS and AS, respectively. Hematologic abnormalities were detected in most dogs with AS or PS (54/62 [87%]) versus 8/20 [40%] in control dogs, with schistocytes found in 40 of 62 (65%; median, 0.1% RBCs; IQR, 0% to 0.3%), acanthocytes in 29 of 62 (47%; median, 0.3% RBCs; IQR, 0% to 0.9%), keratocytes in 39 of 62 (63%; median, 0% RBCs; IQR, 0% to 0.2%), and hemolytic anemia in 4 dogs with PS. No significant association was identified between these abnormalities and ∆P. However, 3 of 4 dogs with anemia had a ∆P > 200 mm Hg (range, 242 to 340 mm Hg). The dog with the highest ∆P value also had the most severe anemia and schistocytosis, and both resolved after balloon valvuloplasty.
CLINICAL RELEVANCE
Poikilocytosis is common in dogs with congenital ventricular outflow tract obstruction, with anemia only observed in few dogs with high ∆P values.
Topics: Animals; Dog Diseases; Dogs; Erythrocytes; Heart Ventricles; Pulmonary Valve Stenosis
PubMed: 34936577
DOI: 10.2460/ajvr.21.11.0188 -
Frontiers in Physiology 2021This study aims to assess the impact of microplastics (MPs) on erythrocytes using eryptosis (apoptosis) and an erythron profile (poikilocytosis and nuclear...
This study aims to assess the impact of microplastics (MPs) on erythrocytes using eryptosis (apoptosis) and an erythron profile (poikilocytosis and nuclear abnormalities), considered to be novel biomarkers in Nile tilapia (. In this study, four groups of fish were used: The first was the control group. In the second group, 1 mg/L of MPs was introduced to the samples. The third group was exposed to 10 mg/L of MPs. Finally, the fourth group was exposed to 100 mg/L of MPs for 15 days, following 15 days of recovery. The fish treated with MPs experienced an immense rise in the eryptosis percentage, poikilocytosis, and nuclear abnormalities of red blood cells (RBCs) compared with the control group in a concentration-dependent manner. Poikilocytosis of MP-exposed groups included sickle cell shape, schistocyte, elliptocyte, acanthocyte, and other shapes. Nuclear abnormalities of the MPs-exposed groups included micronuclei, binucleated erythrocytes, notched, lobed, blebbed, and hemolyzed nuclei. After the recovery period, a greater percentage of eryptosis, poikilocytotic cells, and nuclear abnormalities in RBCs were still evident in the groups exposed to MPs when crosschecked with the control group. The results show concerning facts regarding the toxicity of MPs in tilapia.
PubMed: 34650449
DOI: 10.3389/fphys.2021.742922 -
Journal of Clinical Pathology Mar 2023Recently, a new automated digital cell imaging analyser (Sysmex CellaVision DC-1), intended for use in low-volume and small satellite laboratories, has become available....
AIMS
Recently, a new automated digital cell imaging analyser (Sysmex CellaVision DC-1), intended for use in low-volume and small satellite laboratories, has become available. The purpose of this study was to compare the performance of the DC-1 with the Sysmex DI-60 system and the gold standard, manual microscopy.
METHODS
White blood cell (WBC) differential counts in 100 normal and 100 abnormal peripheral blood smears were compared between the DC-1, the DI-60 and manual microscopy to establish accuracy, within-run imprecision, clinical sensitivity and specificity. Moreover, the agreement between precharacterisation and postcharacterisation of red blood cell (RBC) morphological abnormalities was determined for the DC-1.
RESULTS
WBC preclassification and postclassification results of the DC-1 showed good correlation compared with DI-60 results and manual microscopy. In addition, the within-run SD of the DC-1 was below 1 for all five major WBC classes, indicating good reproducibility. Clinical sensitivity and specificity were, respectively, 96.7%/95.9% compared with the DI-60% and 96.6%/95.3% compared with manual microscopy. The overall agreement on RBC morphology between the precharacterisation and postcharacterisation results ranged from 49% (poikilocytosis) to 100% (hypochromasia, microcytosis and macrocytosis).
CONCLUSIONS
The DC-1 has proven to be an accurate digital cell imaging system for differential counting and morphological classification of WBCs and RBCs in peripheral blood smears. It is a compact and easily operated instrument that can offer low-volume and small satellite laboratories the possibilities of readily available blood cell analysis that can be stored and retrieved for consultation with remote locations.
Topics: Humans; Reproducibility of Results; Blood Cells; Leukocyte Count; Leukocytes; Hematologic Tests; Blood Cell Count
PubMed: 34620610
DOI: 10.1136/jclinpath-2021-207863 -
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 -
Frontiers in Physiology 2021The current study aims at evaluating the toxicity of hydroxychloroquine (HCQ) as a pharmaceutical residue in catfish () and the protective role of (SP). Four groups...
The current study aims at evaluating the toxicity of hydroxychloroquine (HCQ) as a pharmaceutical residue in catfish () and the protective role of (SP). Four groups were used in this study: (1) a control group, (2) a group exposed to 3.16 mg/l of HCQ, (3) a group exposed to 3.16 mg/l of HCQ + 10 mg/l of SP, and (4) a group exposed to 3.16 mg/l of HCQ + 20 mg/l of SP for 15 days of exposure. The HCQ-treated group showed a significant decline in the hematological indices and glucose, total protein, and antioxidant levels in relation to the control group, whereas the HCQ-treated group showed a significant increase in the levels of creatinine, uric acid, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) as well as the percentage of poikilocytosis and nuclear abnormalities of RBCs in relation to the control group. The histopathological evaluation of the liver indicated dilation of the central vein, vacuolization, degeneration of hepatocytes and pyknotic nuclei, as well as reduction of glomeruli, dilation of Bowman's space, and degeneration of renal tubules in the kidney of the HCQ-treated group. (SP) rendered the hematological and biochemical indexes as well as antioxidant levels and the histological architecture to normal status in a dose-dependent manner. Accordingly, the current study recommends the use of SP to remedy the toxic effects of HCQ.
PubMed: 34295262
DOI: 10.3389/fphys.2021.683669 -
BMC Veterinary Research Jul 2021Serious disease outbreaks in cattle are usually associated with blood pathogens. This study aims to detect blood pathogens namely Theileria species, Anaplasma species,...
Molecular detection of Theileria species, Anaplasma species, Candidatus Mycoplasma haemobos, Trypanosoma evansi and first evidence of Theileria sinensis-associated bovine anaemia in crossbred Kedah-Kelantan x Brahman cattle.
BACKGROUND
Serious disease outbreaks in cattle are usually associated with blood pathogens. This study aims to detect blood pathogens namely Theileria species, Anaplasma species, Candidatus Mycoplasma haemobos and Trypanosoma evansi, and determine their phylogenetic relationships and haemato-biochemical abnormalities in naturally infected cattle.
METHODS
Molecular analysis was achieved by PCR amplification and sequencing of PCR amplicons of 18SrRNA gene of Theileria species, 16SrRNA genes of Anaplasma and Mycoplasma species, MPSP genes of T. orientalis and T. sinensis, MSP4 gene of A. marginale, 16SrRNA gene of Candidatus Mycoplasma haemobos, and RoTat1.2 VSG gene of Trypanosoma evansi, in sixty-one (61) clinically ill Kedah-Kelantan x Brahman cattle in Pahang, Malaysia.
RESULTS
A total of 44 (72.13%) cattle were infected with more than one blood pathogen. Theileria species was the blood pathogen with the highest molecular detection rate (72.13, 95% CI 59.83-81.81%). Nucleotide blast analyses of all sequences demonstrated high degree of molecular similarity (98-100%) in comparison with their respective reference sequences. Analysis of 18SrRNA gene sequences of Theileria species and 16SrRNA gene sequences of Anaplasma species revealed Theileria sinensis and Anaplasma platys respectively as additional species detected in these cattle. MPSP-PCR analysis was conducted for further confirmation of T. sinensis. The blood picture of eight infected cattle groups revealed poikilocytosis, anisocytosis, rouleaux formation and degenerative left shift. High mean erythrocyte fragility values were common in infected cattle groups. Anaemia of the macrocytic normochromic type and spherocytes were observed in the T. evansi and Anaplasma platys + Theileria sinensis double species co-infected cattle group. Normocytic normochromic anaemia was observed in the T. sinensis infected cattle group. Significant (p < 0.05) increases in serum liver and kidney parameters, total protein, globulin, total and unconjugated bilirubin and decreased albumin values were observed in the T. evansi infected cattle when compared to clinically healthy cattle.
CONCLUSION
We present the first evidence of Theileria sinensis-associated bovine anaemia (TSABA) in Malaysian cattle. Because of the high occurrence of bovine theileriosis and detection of A. platys, there is an urgent need for appropriate preventive and control measures against these blood pathogens.
Topics: Anaplasma; Anaplasmosis; Anemia; Animals; Cattle; Cattle Diseases; Female; Malaysia; Male; Mycoplasma; Mycoplasma Infections; Theileria; Theileriasis; Trypanosoma; Trypanosomiasis
PubMed: 34275459
DOI: 10.1186/s12917-021-02902-0 -
Veterinary Sciences Jun 2021Anemia is considered a common finding in dogs with chronic kidney disease (CKD), typically as normochromic, normocytic, and non-regenerative. Although anemia can occur...
Anemia is considered a common finding in dogs with chronic kidney disease (CKD), typically as normochromic, normocytic, and non-regenerative. Although anemia can occur at any CKD IRIS (International Renal Interest Society) stage, its severity is related with the loss of kidney function. The aim of the present study was to retrospectively evaluate quantitative and morphological abnormalities of the erythrogram in dogs at different CKD IRIS stages. A total of 482 CBCs from 3648 initially screened were included in the study. Anemia was present in 302/482 (63%) dogs, in the majority of which it was normochromic, normocytic, and non-regenerative (295/302; 98%). The number of reticulocytes was <60,000/μL in the majority of dogs (248/295; 84%), with a correlation between poor regeneration rate and progression of CKD ( = 0.0001). The frequency of anemia significantly differed ( = 0.0001) among the IRIS stages: 108/231 (47%) in IRIS 2, 77/109 (71%) in IRIS 3, and 117/142 (82%) in IRIS 4. Dogs at IRIS stages 3 and 4 were more likely to have moderate to severe anemia, compared to dogs at IRIS stage 2 ( = 0.0001). Anisocytosis was the most frequent morphological abnormality (291/482; 60%), whereas the presence of poikilocytosis showed an association with progression of IRIS stages ( = 0.009). Among different morphological abnormalities, the frequency of fragmented red blood cells and Howell-Jolly bodies showed a significant association with the progression of CKD. Anemia was a frequent finding in CKD dogs, mostly associated with none to poor regeneration rate. Similar to human medicine, advanced CKD stages are more frequently characterized by morphological alterations, such as fragmented red blood cells and Howell-Jolly bodies, which may suggest a more severe condition of reduced bone marrow activity and microangiopathy.
PubMed: 34209294
DOI: 10.3390/vetsci8070123