CASE REPORT: CANINE MONOCYTIC EHRLICHIOSIS IN A MIX BREED DOG

The utility of HbA1c in diabetes diagnosis is reduced in settings associated with altered haemoglobin glycation. We have studied whether HbA1c varies with mean cell volume and mean cell haemoglobin concentration as measures of haemoglobin metabolism. Randomly selected adults from rural Victoria, Australia, were invited for biomedical assessment. After excluding patients with known diabetes and/or serum creatinine ≥ 0.12 mmol/l, 1315 adults were included. Demography, arthropometric measurements, oral glucose tolerance test, analyses of full blood count and HbA1c were undertaken. After adjusting for age, sex, ethnicity, BMI, town and socio-economic status, there were no significant differences in haemoglobin, mean cell volume or mean cell haemoglobin concentration by glycaemic status (defined by oral glucose tolerance test). HbA1c was significantly and independently associated with fasting glucose, town, mean cell haemoglobin concentration, ethnicity, age and BMI among men < 50 years (R² = 33.8%); fasting glucose, 2-h glucose, mean cell haemoglobin concentration and town among men ≥ 50 years (R² = 47.9%); fasting glucose, mean cell volume, mean cell haemoglobin concentration, town, 2-h glucose and age among women < 50 years (R² = 46.3%); fasting glucose, mean cell haemoglobin concentration, mean cell volume and 2-h glucose among women ≥ 50 years (R² = 51.6%). A generalized linear model showed a gradient from an adjusted mean HbA1c of 36 (95% CI 34-38) mmol/mol with a mean cell haemoglobin concentration of ≤ 320 g/l to 30 (95% CI 29-31) mmol/mol with a mean cell haemoglobin concentration of > 370 g/l. The gradient across mean cell volume was negative, but only by 1 mmol/mol (0.1%) HbA1c . A mean HbA1c difference of 5 mmol/mol (0.5%) across the mean cell haemoglobin concentration reference range suggests that an accompanying full blood count examination may be required for its use in the diagnosis of diabetes. Further studies are required to confirm this.

Background: Malignant mammary tumors in humans and bitches cause hematological disorders such as anemia, erythrocytosis, thrombocytosis, hyperproteinemia, and leucopenia. Novel studies have been conducted on the predictive and prognostic values of platelet (PLT) indices in human breast cancer (HBC). However, there is little information about the alterations in hematological parameters in canine mammary tumors (CMTs). The aims of this study were to evaluate the platelet indices and complete blood count (CBC) parameters in bitches with and without mammary tumor and to assess the above mentioned parameters with regard to histological tumor types and grades.Materials, Methods &amp; Results: A total of 71 bitches were enrolled in this study. The bitches in the study group were divided into 2 groups which consisted of malignant epithelial mammary tumors (group EMT; n = 43) and malignant mixed mammary tumors (group MMT; n = 12). Control group (group C) consisted of clinically and gynaecologically healthy 16 bitches. Blood samples were obtained to perform the CBC and PLT indices analysis. Histopathological examinations were carried out under a light microscope. Histological tumor types and malignancy grades were classified. The bitches with mammary tumor showed significantly increased PLT values and decreased hematocrit (HCT), hemoglobin (HGB) and mean corpuscular hemoglobin (MCH) values versus the healthy ones, regardless of the tumor type. However, in comparisons with the group C, mean platelet volume (MPV) and mean corpuscular hemoglobin concentration (MCHC) values were different only in the group MMT, while plateletcrit (PCT) and mean corpuscular volume (MCV) values were different only in the group EMT. Also white blood cell (WBC), PLT and PCT values were higher than the referenced laboratory ranges in grade 3 tumors. In the presented study, MPV was considerably correlated with PLT, platelet distribution width (PDW) and PCT. Also, PCT and PLT had high sensitivity and specificity to distinct EMT and MMT from the healthy bitches.Discussion: Microcytic and hypochromic anemia occurs due to the decrease in the amount of HGB. Levels of MCV, MCH, and MCHC in the HBC group were reported to be significantly lower than in humans without breast cancer. Although anemia did not occur in EMT and MMT groups, obtained significances in the HCT, HGB, MCV, MCH, and MCHC levels between the bitches with and without mammary tumor were in line with the previous reports. In this study, WBC levels in grade 3 tumors were significantly higher than grade1 tumors (P &lt; 0.05). Whereas levels of WBC in grade 1 and grade 2 tumors were in referenced laboratory ranges, it was higher in grade 3. Increased level of WBC in grade 3 was supposed to be due to the rise in malignancy as previously reported. Thrombocytosis was detected in 48.83% and 41.66% of the bitches in EMT and MMT groups, respectively. The higher percentage of CMTs with thrombocytosis in this study might be due to the difference in referenced upper limit of PLT in previous studies. The elapsed time between tumor formation and clinical presentation could be another influencing factor. Although PLT and PCT values were not significant according to the histological grading in this study, both parameters were found to be higher in grade 3 than the normal reference values. Further studies conducted with higher populations may lead the differences in these parameters to significance. With the support of further studies, alterations in the above mentioned parameters in bitches may contribute in the diagnosis process, management of treatment and may constitute an easy way to have an idea about the prognosis of mammary tumors.

Relationships between oxidative stress markers and red blood cell characteristics in renal azotemic dogs

To explore the roles of mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and hemoglobin A(2) (HbA(2)) in the laboratory screening of thalassemia, and to find optimal screening modality for different conditions. From September 2008 to May 2011, 1384 subjects underwent thalassemia screening at Department of Obstetrics and Gynecology of Nanfang Hospital. Of them, 1036 cases were diagnosed with thalassemia (408 α-thalassemia, 608 β-thalassemia, and 20 αβ compound thalassemia, thalassemia group) and 348 without thalassemia, non-thalassemia group. All subjects were screened respectively for MCV, MCH and HbA(2). Analyses were performed in all subjects to assess the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy respectively associated with MCV, MCH and HbA(2) alone, combination of MCV and MCH, and combination of MCV, MCH and HbA(2). (1) In the thalassemia group, the sensitivity of MCV alone was 92.9% (379/408) for α thalassemia, 99.3% (604/608) for β thalassemia and 100.0% (20/20) for αβ compound thalassemia. In the non-thalassemia group, the specificity of MCV alone was 75.0% (261/348). (2) In the thalassemia group, the sensitivity of MCH alone was 92.9% (379/408) in α thalassemia, 99.0% (602/608) in β thalassemia and 100.0% (20/20) in αβ compound thalassemia. In the non-thalassemia group, the specificity of MCH alone was 72.7% (253/348). (3) The sensitivity of Hb A(2) alone was 67.4% (275/408) for α thalassemia, 97.5% (593/608) for β thalassemia, and 100% (20/20) for αβ compound thalassemia while it's specificity was 72.4% (252/348) in the non-thalassemia group. (4) With positive indexes of MCV, MCH and MCV + MCH, when HbA(2) > 3.5% it had a high value in β-thalassemia screening, but when HbA(2) < 2.5% it had little value in α-thalassemia screening. (5) As a single marker, MCV and MCH had better sensitivity, specificity, positive predictive value, negative predictive value and diagnosis accuracy than HbA(2). MCV + MCH was the best for overall screening, but for β thalassemia screening, MCV + MCH + HbA(2) was the best. MCV and MCH are suitable for epidemic screening in a large population, physical examination and premarital check-up. Hb electrophoresis and thalassemia gene diagnosis are recommended for subjects with positive MCV and MCH indexes. Diagnoses of α and β-thalassemia gene are recommended for pregnant women with positive MCV and MCH indexes.

Poor iron status affects billions of people worldwide. The prevalence of obesity continues to rise in both the developed and developing nations. An association between iron status and obesity has been described in children and adults. The aim of the study was to assess the iron profile and dietary pattern in primary school-aged obese Egyptian children. A case-control study was conducted on 120 children, both obese (n=60) and control group (n=60), recruited from three primary governmental schools located in Dokki Sector, El-Giza Governorate, Egypt. Their ages ranged from 6 to 12 years. All children were subjected to full medical and dietetic history, anthropometric measurements, thorough clinical examination, and determination of complete blood count, serum iron, total iron-binding capacity, transferrin saturation (TS), and ferritin. Despite similar dietary iron intake in the two groups, obese children showed highly significantly decreased hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, serum iron, and TS, and increased mean corpuscular hemoglobin concentration and total iron-binding capacity when compared with the nonobese group. The obese group showed a highly significant increased rate of iron deficiency (ID) (TS<15% or mean corpuscular volume<76 fl) when compared with the nonobese group. Obesity was a significant risk factor for the development of ID (odds ratio: 7.09, 95% confidence interval: 3.16-15.92). The association between ID and obesity may have important public health and clinical implications. For primary school children with elevated BMIs, screening for ID should be considered. Increasing awareness of the importance of physical activity and carrying out nutritional education programs are required.

Background Complete blood count (CBC), red cell distribution width (RDW), mean platelet volume (MPV), mean corpuscular volume (MCV), mean cell hemoglobin (MCH), mean cell hemoglobin concentration (MCHC), or platelet (PLT) count are referred as predictors of adverse clinical outcomes in patients. The aim of the research was to identify potential factors of acute mortality in Polish emergency department (ED) patients by using selected hematological biomarkers and routine statistical tools. Methods The study presents statistical results on patients who were recently discharged from inpatient facilities within one month prior to the index ED visit. In total, the analysis comprised 14,881 patients with the first RDW, MPV, MCV, MCH, MCHC, or PLT biomarkers' measurements recorded in the emergency department within the years 2016–2019 with a subsequent one month of all-cause mortality observation. The patients were classified with the codes of the International Statistical Classification of Diseases and Related Health Problems after 10th Revision (ICD10). Results Based on the analysis of RDW, MPV, MCV, MCH, MCHC, and PLT on acute deaths in patients, we establish strong linear and quadratic relationships between the risk factors under study and the clinical response (P < 0.05), however, with different mortality courses and threats. In our statistical analysis, (1) gradient linear relationships were found for RDW and MPV along an entire range of the analyzed biomarkers' measurements, (2) following the quadratic modeling, an increasing risk of death above 95 fL was determined for MCV, and (3) no relation to excess death in ED patients was calculated for MCH, MCHC, and PLT. Conclusion The study shows that there are likely relationships between blood counts and expected patient mortality at some time interval from measurements. Up to 1 month of observation since the first measurement of an hematological biomarker, RDW and MPV stand for a strong relationship with acute mortality of patients, whereas MCV, MCH, MCHC, and PLT give the U-shaped association, RDW and MPV can be established as the stronger predictors of early deaths of patients, MCV only in the highest levels (>95 fL), whereas MCH, MCHC, and PLT have no impact on the excess acute mortality in ED patients.

Background: COVID-19 is still present in the world, though the extent varies by region and country. According to the World Health Organization, there have been over 617 million confirmed cases of COVID-19 and over 13 million deaths worldwide since the pandemic began on March 10, 2023. Aims and Objectives: This is a study conducted with the aim of providing biomarkers to predict COVID-19 disease progression and mortality based on red cell indices and platelet indices which are commonly measured as part of a complete blood count (CBC). Materials and Methods: A prospective study was conducted during the peak of the second wave of COVID-19 from March 2021 to June 2021. The study included 540 patients who were admitted to the Government General Hospital, Nizamabad, and had tested positive for COVID-19 by RT-PCR. Red Blood Cell (RBC), Hematocrit (HCT), Red cell indices like Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin (MCH), Mean Corpuscular Haemoglobin Concentration (MCHC), Red Cell Distribution width (RDW) and Platelet indices like Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), Plateletcrit (PCT), Platelet–Large Cell Ratio were taken from CBC analyzer Sysmex XN-1000 and analyzed statistically. The patients were then followed up for a period of 14 days to track their outcomes. Results: In the data, majority were male n=334 (62%) and n=280 (38%) were female. 70.37% (n=380) were survivors and 29.63% (n=160) were non-survivors. Red blood cell, red cell indices such as RDW-CV and RDW-SD, and platelet indices such as PCT and PDW were significantly higher in non-survivors compared to survivors with P&lt;0.05. Conclusion: Non-survivors had significantly higher levels of RDW-CV, RDW-SD, PCT, and PDW compared to survivors. These parameters in combination can be useful for predicting COVID-19 mortality at early stage in forthcoming waves.

Rac-Null Leukocytes Are Associated with Increased Inflammation-Mediated Alveolar Bone Loss

Introduction: This study aimed to investigate associations of red cell distribution width (RDW), RBC mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) with coronary artery calcium score (CACS) in patients without history of coronary artery disease (CAD). Methods: In this cross-sectional study, 832 consecutive patients without history of CAD who presented with acute chest pain and underwent coronary artery calcium scoring by MDCT were included. Differences in CACS among multiple RBC indices categories which were high RDW (&gt;55 fL) VS low-to-normal RDW, low MCV (&lt;80 fL) VS normal-to-high MCV, low MCH (&lt;27 pg) VS normal-to-high MCH, low MCHC (&lt;31 g/dL) VS normal-to-high MCHC were statistically calculated. Results: The cohort comprised of 60% men (500 of 832) with mean age of 59±14 years. Median Framingham’s 10-year risk for cardiovascular disease was 4% (Interquartile range; IQR 1%-16%). Sixty percent of patients had zero CACS followed by 21.5% with CACS 1-100, 9.9% with CACS 101-400 and 8.1% with CACS&gt;400. Mean ± SD of the RBC indices were 43±14 fL for RDW, 88±6 fL for MCV, 30±2 pg for MCH and 34±2 g/dL for MCHC. Compared to patients with normal-to-high MCV, those with low MCV (n=73) had significant lower CACS (0; IQR 0-5 VS 0; IQR 0-49; p 0.047). There was no statistically significant difference in CACS between RDW groups (p 0.45), MCH groups (p 0.19), MCHC groups (p 0.26) as shown in the figure. Multivariate analysis showed no statistically significant association of all the RBC indices with either CACS&gt;0 (high RDW - p 0.83, low MCV - p 0.17, low MCH - p 0.26, low MCHC − p 0.06) or CACS&gt;100 (high RDW - p 0.69, low MCV - p 0.18, low MCH - p 0.93, low MCHC − p 0.77). Conclusion: Our study did not show significant association of RDW, MCV, MCH and MCHC with either presence or severity of coronary calcification in patients without history of CAD

Biological Parameters Predictive Of Percent Dense Red Blood Cell Decrease Under Hydroxyurea Therapy

Our aim was to determine the stability of complete blood count (CBC) parameters in low-volume tubes under different storage conditions. Thirty apparently healthy volunteers were included in the study. Two venous blood samples were taken into low-volume K2EDTA tubes from each individual. The samples were analyzed immediately, then one tube was stored at room temperature and the other under refrigerated conditions (+4 °C), and subsequent measurements were performed at 24, 48 and 72 h. The CBC was performed on the Sysmex XN-1000 analyzer. Stability of CBC parameters was assessed based on total allowable error (TEa) goals. White blood cells (WBCs), red blood cells (RBCs), hemoglobin (Hb), mean corpuscular hemoglobin (MCH), plateletcrit (PCT), neutrophils, lymphocytes and basophils were found stable throughout 72 h at both room temperature and +4 °C. In addition, hematocrit (Hct), mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC) and eosinophils remained stable for 72 h at +4 °C. The remaining parameters exhibited stability for less than 72 h under both temperature conditions. As a result, the stability of CBC parameters in low-volume tubes improves with storage under refrigerated conditions. However, not all parameters remain stable until 72 h, even under refrigerated conditions. For this reason, CBC analysis should be performed as fast as possible without delay.

Associations between single nucleotide polymorphisms and erythrocyte parameters in humans: A systematic literature review.

In this study, mean cell volume (MCV), mean cell hemoglobin concentration (MCHC), and mean cell hemoglobin (MCH) were measured to quantify RBC damage by rotary blood pumps. Six-hour hemolysis tests were conducted with a Bio-pump BPX-80, a Sarns 15200 roller pump, and a prototype mag-lev centrifugal pump (MedTech Heart) using fresh porcine blood circulated at 5 L/min against a 100 mm Hg head pressure. The temperature of the test and noncirculated control blood was maintained at 37 degrees C. The normalized index of hemolysis (NIH) of each pump was determined by measuring the plasma-free hemoglobin level. The MCV was measured with a Coulter counter, and MCHC was derived from total hemoglobin and hematocrit. MCH was derived from MCV and MCHC. A multivariance statistical analysis (ANOVA) revealed statistically significant differences (n = 15, P < 0.05) in MCV, MCHC, and MCH between the blood sheared by the rotary blood pumps and the nonsheared control blood. Normalized to the control blood, the Bio-pump BPX-80 showed an MCV of 1.04 +/- 0.03, an MCHC of 0.95 +/- 0.04, and an MCH of 0.98 +/- 0.02; the mag-lev MedTech Heart had an MCV of 1.02 +/- 0.02, an MCHC of 0.97 +/- 0.02, and an MCH of 0.99 +/- 0.01; and the roller pump exhibited an MCV of 1.03 +/- 0.03, an MCHC of 0.96 +/- 0.03, and an MCH of 0.99 +/- 0.01. Per 0.01 increase in NIH, the BPX-80 showed a normalized MCV change of +10.1% and a normalized MCHC change of -14.0%; the MedTech Heart demonstrated a +6.9% MCV and -9.5% MCHC change; and the roller pump had a +0.5% MCV and -0.6% MCHC change. Due to shear in the pump circuits, the RBC increased while the MCHC decreased. The likely mechanism is that older RBCs with smaller size and higher hemoglobin concentration were destroyed fast by the shear, leaving younger RBCs with larger size and lower hemoglobin concentration. Subhemolytic trauma caused the intracellular hemoglobin to decrease due to gradual hemoglobin leakage through the micropores formed in the thinned membrane. In conclusion, the rate of change in MCV and MCHC with respect to NIH change provides useful information relating to selective destruction of RBCs, while the MCH level reflects subhemolytic damage.

Objective: To analyze the genotype-phenotype correlations among those thalassemia samples with the presence of -α(3.7,) --(SEA) and normal α(2) alleles on their α-globin gene clusters. Methods: Fourteen patients(including 1fetus, 4 males and 9 females, aged 0- 56 years old)who were suspected diagnosed by hematologic analysis and genetic testing among 16 080 participants in our laboratory since from August 2011 to August 2016, were enrolled. Complete blood cell count was performed on XE4000i automatic hemocyte analyzer. HbA0, HbF and HbA2 were tested by high performance liquid chromatography (HPLC). Gap-PCR was adopted to detect three common deletional thalassemia deletions. Reverse dot-blot (RDB) assay was applied for detecting 17 common β-globin gene mutations and three common non-deletional α(2) gene mutations. Two-round nested PCR assay was established to detect the genotype of HKαα in α-thalassemia. Results: Fourteen cases were identified as HKαα/--(SEA) (14/16 080), including a pedigree and a rare case of HKαα/--(SEA) co-inheritance with IVS-Ⅱ-654(C→T) heterozygote. In HKαα/--(SEA) thalassemia group, mean cell volume(MCV) was (69.54±5.92)fl, and mean cell hemoglobin(MCH) was(22.11±2.22)pg and hemoglobin(Hb) was (117.64±18.14) g/L. Compared with normal group, MCV, MCH and Hb in HKαα/--(SEA) thalassemia group, was significantly decreased(P<0.05). There were no significant differences between α-thalassemia control group(--(SEA) /αα) in most hematological parameters (P>0.05). Conclusion: The two-round nested PCR could effectively detect the HKαα/--(SEA) genotype. The hematologic characteristics changed significantly in HKαα/--(SEA) group compared with HbH thalassemia and normal group. The genotype and phenotype non-correlation in patients with α-thalassemia should especially be causious to avoid a misdiagnosis of genetic tests, especially in prenatal diagnosis.

Red blood cell nitric oxide synthase activation is increased in patients with sickle cell hemoglobin C disease.