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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 -
Transfusion and Apheresis Science :... Aug 2017Severe vitamin B12 deficiency is caused most commonly by autoimmune atrophic gastritis leading to loss of intrinsic factor. Vitamin B12 deficiency leading to...
Severe vitamin B12 deficiency is caused most commonly by autoimmune atrophic gastritis leading to loss of intrinsic factor. Vitamin B12 deficiency leading to megaloblastic anemia and demyelinating central nervous system disease is well known; however, a rare presentation of B12 deficiency described as pseudothrombotic microangiopathy is not well known. This complication presents with signs of mechanical hemolysis, elevated lactate dehydrogenase (LDH), thrombocytopenia, and a low reticulocyte count, which can be incorrectly diagnosed as thrombotic thrombocytopenic purpura and managed incorrectly. Decreased reticulocyte count and an LDH >2500IU/L is more commonly seen in B12 deficiency. However, recognizing the differences in marked poikilocytosis can be challenging, as seen with megaloblastic changes and true schistocytosis. To illustrate the challenge in differentiating between megaloblastic changes and true schistocytosis, we present the case of a 27-year-old woman who presented to her physician for symptomatic anemia and complaints of nausea, vomiting, and loose stool. She had a hemoglobin of 5.1g/dL, platelet count of 39×10/L, LDH of 9915IU/L, haptoglobin below assay limit, and a reticulocyte count of 2.5%. Peripheral smear showed macrocytic anemia, rare hypersegmented neutrophils, and schistocytes. Vitamin B12 level was less than 50pg/mL, methylmalonic acid was 0.33μmol/L, anti-parietal cell antibody was >1:640, and intrinsic factor blocking antibody was positive-confirming the diagnosis of pernicious anemia. While hospitalized, she was treated with vitamin B12 1000μg intramuscular injections daily and thereafter continued with monthly injections, which ultimately resolved her severe macrocytic anemia.
Topics: Adult; Anemia, Pernicious; Female; Hemoglobins; Humans; Leukocyte Count; Platelet Count; Vitamin B 12; Vitamin B 12 Deficiency
PubMed: 28711333
DOI: 10.1016/j.transci.2017.06.003 -
Journal of Pediatric Hematology/oncology Mar 2017Hereditary elliptocytosis is an inherited red blood cell membrane disorder characterized by typical peripheral blood smear findings of elliptocytes or rod-like red blood...
Hereditary elliptocytosis is an inherited red blood cell membrane disorder characterized by typical peripheral blood smear findings of elliptocytes or rod-like red blood cells. Hemoglobin H disease is a form of α-thalassemia disease resulting in mild to moderate hemolytic anemia. The authors report 1 case of a girl who was diagnosed with oculo-auriculo-vertebral spectrum and a coinheritance of hereditary elliptocytosis and deletional hemoglobin H disease. She had moderate, non-transfusion-dependent anemia. The red blood cells showed marked poikilocytosis and fragmentation. The parents were α-thalassemia carriers and the father had the typical red blood cell morphology of common hereditary elliptocytosis.
Topics: Adult; Child, Preschool; Elliptocytosis, Hereditary; Erythrocytes, Abnormal; Female; Genotype; Goldenhar Syndrome; Humans; Hyperbilirubinemia, Neonatal; Male; Sequence Deletion; alpha-Globins; alpha-Thalassemia
PubMed: 28060122
DOI: 10.1097/MPH.0000000000000750 -
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 -
Veterinary Clinical Pathology Mar 2017A 2.5-year-old spayed female American Pit Bull Terrier dog presented with a primary complaint of chronic refractory ascites. The dog's CBC displayed a moderate to severe...
A 2.5-year-old spayed female American Pit Bull Terrier dog presented with a primary complaint of chronic refractory ascites. The dog's CBC displayed a moderate to severe macrocytic, hypochromic, nonregenerative anemia, and a moderate leukopenia as result of a moderate neutropenia and monocytopenia. Microscopic examination of the blood smear showed marked anisocytosis, mild polychromasia, mild acanthocytosis and ovalocytosis, moderate schistocytosis and poikilocytosis, and 4 metarubricytes/100 WBC. Abdominal ultrasonography revealed a homogenous, mild to moderately hyperechoic appearing liver as well as marked amounts of speckled anechoic to slightly hypoechoic peritoneal fluid. Cytology of the ascitic fluid demonstrated a sterile transudate, with evidence of a chronic inflammatory reaction as well as erythroid and myeloid precursor cells, and a few megakaryocytes with occasional micromegakaryocytes. Histologic sections of bone marrow, spleen, and liver were examined, using routine H&E stains, as well as a variety of immunohistochemistry and other special stains. Histopathology of the bone marrow and spleen revealed varying degrees of fibrosis, erythroid, and myeloid hyperplasia, as well as multiple small hyperplastic clusters of megakaryocytes. The megakaryocytes displayed many features of atypia such as increased cytoplasmic basophilia and occasional abnormal chromatin clumping with mitoses. Histopathologic examination of the liver disclosed evidence of mild extramedullary hematopoiesis. This case represents the first report of canine idiopathic myelofibrosis associated with peritoneal extramedullary hematopoiesis, resulting in refractory ascites. Although idiopathic myelofibrosis is a relatively rare condition in dogs, this case demonstrates that ascites caused by peritoneal implants of hematopoietic tissue may be the initial manifestation of myelofibrosis.
Topics: Animals; Ascites; Ascitic Fluid; Bone Marrow; Dog Diseases; Dogs; Female; Hematopoiesis, Extramedullary; Immunohistochemistry; Liver; Megakaryocytes; Primary Myelofibrosis; Spleen; Ultrasonography
PubMed: 27874969
DOI: 10.1111/vcp.12430 -
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 -
The Journal of the Louisiana State... 2016A seven-year-old African-American male presented with a history of hematuria, proteinuria, jaundice, and anemia occasionally treated with transfusions since early...
A seven-year-old African-American male presented with a history of hematuria, proteinuria, jaundice, and anemia occasionally treated with transfusions since early childhood. The family history included a father and sister with similar symptoms of anemia, both of which had been diagnosed with hereditary pyropoikilocytosis. Due to the patient's family history and symptoms indicating a possible hematologic problem, a blood draw was performed. Laboratory studies showed an elevated alkaline phosphatase and bilirubin, and hemolytic anemia with unusual erythrocyte indices. The patient's vital signs and abdominal ultrasound were normal, and he had no known allergies. Examination of the patient's peripheral blood smear revealed extreme erythrocyte poikilocytosis with bizarre forms resembling the erythrocyte morphology sometimes seen in individuals with severe thermal burns.
Topics: Anemia, Hemolytic, Congenital; Burns; Child; Elliptocytosis, Hereditary; Erythrocytes; Erythrocytes, Abnormal; Humans; Male
PubMed: 26986859
DOI: No ID Found -
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 -
Veterinary Clinical Pathology Mar 2015Anemia and systemic oxidative stress may occur in dogs with chronic kidney disease (CKD). Only scarce information regarding the intraerythrocytic redox status under...
BACKGROUND
Anemia and systemic oxidative stress may occur in dogs with chronic kidney disease (CKD). Only scarce information regarding the intraerythrocytic redox status under these conditions is available at this time.
OBJECTIVE
The aim of this study was to evaluate the indicators of oxidative stress and intraerythrocytic antioxidant defense in dogs with anemia of CKD.
METHODS
Thirty dogs with CKD in stages 3 or 4 with nonregenerative anemia (HCT ≤ 37%) were compared to 20 healthy dogs. Complete blood count, reticulocyte %, blood smear evaluation, intraerythrocytic concentrations of total (GSHt), reduced (GSH), and oxidized glutathione (GSSH), and activities of glutathione peroxidase, glutathione reductase and superoxide dismutase (SOD), as well as plasma concentrations of thiobarbituric acid-reactive substances (TBAR) were determined.
RESULTS
Anemia of CKD dogs was nonregenerative (reticulocytes ≤ 0.2% with scarce anisocytosis and poikilocytosis). Intraerythrocytic GSSH and SOD, and plasma TBAR were higher in dogs with CKD. There was a positive correlation between the creatinine concentration and TBAR, and negative correlations between creatinine concentration and HCT, as well as between HCT and TBAR. In CKD dogs with a higher degree of anemia, SOD levels were higher and GSSH concentrations were lower. Despite the evidence of increased systemic oxidative stress, the compensatory response of SOD and the sustained intraerythrocytic concentrations of GSSH in CKD dogs with anemia indicated that the erythrocytes maintained the antioxidant defense.
CONCLUSIONS
There was no strong evidence that oxidative stress was associated with higher degrees of anemia in dogs with CKD.
Topics: Anemia; Animals; Antioxidants; Dogs; Erythrocytes; Female; Glutathione Peroxidase; Glutathione Reductase; Male; Oxidative Stress; Renal Insufficiency, Chronic; Superoxide Dismutase; Thiobarbituric Acid Reactive Substances
PubMed: 25512201
DOI: 10.1111/vcp.12225