Importance of Perls’ stain as a routine test in anaemia in adults

Abstract

Background: Anaemia is one of the frequent finding in patients of all age. Proper diagnosis is of utmost important to avoid fatal morbidity in untreated chronic cases. Aims: This study is meant to observe the role of Perls’ stain in routine practice in etiological evaluation of anaemia in adults. Methods: Prospective cross sectional study from June 2007 to July 2010. 128 cases of anaemia, alone or as a part of bicytopenia and pancytopenia, in 20-80 years of age, who were recommended by clinicians for bone marrow aspiration analysis after initial routine haematological investigation, were collected as samples. Perls’ stain was done on bone marrow smears to estimate marrow iron store in fragments and ring sideroblasts in all the smears. Result: Anaemia was most common haematological presentation(49%), mainly in males (62%) and majority in 20-30 years of age (31.3%) .Iron deficiency anaemia was most common cause of anaemia(59.6%) with 0 to1+ iron store. Megaloblastic anaemia, aplastic anaemia, thalassemia and other haemoglobinnopathies, anaemia of chronic disease(AOCD) , myelodysplastic syndrome(MDS) and secondary sideroblastic anaemia(SA) were other causes of anaemia found. 3.2% cases had ring sideroblasts of which 0.78% was MDS and 2.3% was secondary SA. Conclusion: Perls’ stain is a cheap and relatively simple test that can be used as a routine test in all bone marrow aspirates to provide provisional diagnosis of some relatively infrequent causes of anaemias which otherwise could be missed when only non invasive methods are relied upon for assessing body iron content. DOI: 10.21276/APALM.1067 Conclusion : Perls’ stain is a cheap and relatively simple test that can be used as a routine test in all bone marrow aspirates to provide provisional diagnosis of some relatively infrequent causes of anaemias which otherwise could be missed when only non invasive methods are relied upon for assessing body iron content.