Features Of Iron Deficiency Anemia Research Articles

Extraintestinal Amoebiasis: Amebic Liver Abscess in a 48-Year-Old Male Patient

Background: The liver is the most common organ for abscesses. Liver abscesses can be solitary or multiple. Approximately 90% of right-lobe liver abscesses are solitary abscesses, while only 10% of left-lobe abscesses are solitary abscesses. This can occur from hematogenous spread or directly from the site of infection in the peritoneal cavity.
 Case presentation: A 48-year-old male patient had been administered into the internal medicine ward with the chief complaint of pain in the upper right quadrant of the abdominal increased 3 days before being admitted to the hospital. The patient also complains that pain increase when the patient moves forward and is influenced by activity. The patient walked like a person who carried his stomach. The patient complained of watery stools 3 months ago in ten days, which frequency two to three times a day. The stools are bloody and slimy. Swelling of an upper right quadrant of abdominal since 1 month ago. Decrease of appetite since 1 month ago. Decrease of body weight since 1 month ago, about 5 kilograms. Fever since 2 weeks ago, not high, disappearing, no chill, no sweat. Nauseous since 1 week ago. The patient was admitted to the hospital with awareness of compos mentis, cooperative, and his general condition appeared to be moderately ill, blood pressure 120/80 mmHg, pulse rate 86 times/minute, regular pulse, adequate filling, respiratory rate 24 times/minute, temperature 37ºC. On physical examination, the conjunctiva of the patient’s eyes was anemic. Entamoeba histolytica was found on a routine stool examination.
 Conclusion: The main clinical manifestations of amoebiasis are right abdominal pain can be features of iron deficiency anemia and reactive thrombocytosis. Diagnosis is based on the finding of characteristic Entamoeba histolytica in the stool. Metronidazole 500 mg three times daily dose resulted in 80% cure and a dose of 750 mg/three times daily for 10 days gave 100% cure. Treatment of reactive thrombocytosis is by curing the basic disease.

Iron-Deficiency Anemia Related to Ancylostoma duodenale Infection in 67 Years Old Female Patient

Background. Ancylostomiasis is an infection caused by hookworms. It is estimated that hookworms infect 1.2 billion people worldwide and cause higher morbidity than other types, mainly due to iron deficiency anemia. Hookworm infection increases with age. The main clinical manifestations are abdominal pain, features of iron deficiency anemia and hypoproteinemia. Diagnosis is based on the finding of characteristic eggs in the stool.
 Case presentation. A 67-year-old female patient had been administered into the Internal Medicine Ward of Dr. M. Djamil Padang Hospital with the main complaint of weakness, fatigue, and lethargy which had increased since 3 days before being admitted to the hospital. The patient also had complaints of pale skin, fever, heartburn, decreased appetite and weight loss. The patient was admitted to the hospital with awareness of compost mentis, cooperative, and his general condition appeared to be moderately ill, blood pressure 130/90 mmHg, pulse rate 104 x/minute, regular pulse, adequate filling, respiratory rate 22 x/minute, temperature 37.8 C. On physical examination, the conjunctiva of the pantient’s eyes were anemic. Laboratory examination revealed Hemoglobin 4 g/dl, Hematocrit 16%, MCV/MCH/MCHC 62fl/15pg/25g/dL, Reticulocytes 0.5%, SI/TIBC 22/315 mg/dL, Ferritin 8.5 ng/mL, and peripheral blood smear showing severe hypochromic microcytic anemia and relative eosinofilia. Ancylostoma duodenale worm eggs were found on routine stool examination. Final diagnosis was Severe microcytic hypochromic anemia caused by an iron deficiency and Ancylostomiasis. Severe microcytic hypochromic anemia caused by iron deficiency and ancylostomiasis was established based on the patient’s history, physical examination and laboratory investigations.
 Conclusions. Hookworms infect many people worldwide and cause high morbidity, mainly due to iron deficiency anemia. The highest prevalence is found in the tropics and subtropics, including Indonesia. The main clinical manifestations are abdominal pain, features of iron deficiency anemia and hypoproteinemia. Diagnosis is based on the finding of characteristic eggs in the stool. Albendazole 400 mg single dose resulted in 80% cure and a dose of 200 mg/day for 3 days gave 100% cure. Treatment of anemia is by administering ferrous sulfate or ferrous gluconate orally 200 mg three times a day and continued for up to 3 months after normal hemoglobin levels are achieved to maintain iron stores.

Hematological profile of pregnant women at St. Paul\u2019s Hospital Millennium Medical College, Addis Ababa, Ethiopia

BackgroundIn pregnancy, hematological changes occur in order to meet the demands of the developing fetus and placenta, with major alterations in blood volume. Abnormal hematological profile affects pregnancy and its outcome. This study aimed to assess hematological profiles of pregnant women at a tertiary care teaching hospital.MethodThis cross sectional study was conducted among 284 consecutive pregnant women at St. Paul’s Hospital Millennium Medical College. Socio-demographic characteristics were collected using pre-tested structured questionnaire. About 4 ml of venous blood was collected from each participant for hematological parameters analysis using Cell-Dyn1800 (Abbott Laboratories Diagnostics Division, USA) and peripheral blood film review.ResultThere were differences in mean hematological parameters between trimesters: specifically differences in mean values of WBC (1stand 3rd), Hb(1stand2nd and 1st& 3rd), HCT (1stand2nd), RDW (1stand2nd and 1stand3rd), neutrophil and lymphocyte (1stand 2nd and 1stand3rd, for both) were statistically significant (p < 0.05). The prevalence rates of anemia and thrombocytopenia were 11.62 and 7.7%, respectively and were dominantly of mild type. On the bases of blood picture, we classified anemia’s of pregnancy as microcytic hypochromic (51.5%), normocytic hypochromic (27.3%), normocytic normochromic (18.2%), and dimorphic (3%).ConclusionSignificant changes in selected hematological parameters between trimesters, and an anemia and thrombocytopenia of mild type were documented in this study. The commonest morphologic features were mostly characteristic features of iron deficiency anemia. These warrant the need for monitoring hematological parameters of pregnant women at any stage of the pregnancy to avoid adverse outcomes.

Assessment of iron deficiency anaemia and its risk factors among adults with chronic kidney disease in a tertiary hospital in Nigeria.

A substantial proportion of patients with chronic kidney disease (CKD) develop iron deficiency anaemia (IDA). Despite the association of IDA with adverse cardiovascular outcomes, it remains underdiagnosed and poorly managed. Up to 70% of patients with CKD are anaemic at the time of initiating dialysis, while the predictors of IDA in these patients in our setting are unknown. This study aimed to determine the prevalence and risk factors for IDA in patients with CKD. This is a case-control study of 157 patients with CKD and 157 age and gender matched subjects without CKD. Information obtained from the participants were socio-demographic details, aetiology of CKD, medication history and features of IDA. All participants had serum ferritin, total iron binding capacity (TIBC), transferrin saturation (TSAT), highly sensitive C-reactive protein, serum creatinine and complete blood count determined. The median estimated glomerular rate (22.7 [3.4-59.5] vs. 110.2 [60.3-152.8] ml/min/1.73 m2, P < 0.01), the mean haemoglobin concentration (9.3 ± 2.6 vs. 11.4 ± 1.7 g/dl, P < 0.01), and TSAT (27.9% ± 6.4% vs. 34.8% ± 8.1%, P < 0.04) were significantly lower in patients with CKD. The mean age, serum ferritin and TIBC were similar in both groups. The prevalence of absolute (24.8% vs. 13.4%, P < 0.01) and relative (17.8% vs. 7.6%, P < 0.01) iron deficiencies were higher among individuals with CKD compared to the controls. Female gender (odd ratio [OR]:1.50, 95% confidence interval [CI]:1.0267-4.1163, P < 0.04) and severity of CKD (OR: 3.43, 95% CI: 1.5568-7.8324, P < 0.02) were independently associated with IDA. IDA is common among individuals with CKD while female gender and severity of CKD were factors that independently predicted IDA.

Pathogenetic and clinical features of iron deficiency anemia on the background of chronic pancreatitis

One of the leading reasons of anemia on the background of chronic pancreatitis is the atophic changes of the mucous membrane of the gastrointestinal tract, chronic enteritis, accompanied by accelerated passage of chyme in the intestine, malabsorption syndrome. In healthy people, the concentration of iron is carefully regulated by cells in the proximal parts of the small intestine, which regulate its intake to match the loss of element. Errors in iron balance frequently lead to iron deficiency anemia. Such patients often have the following states: cognitive disorders, greater risk of mortality and hospitalizations among adults and, especially, old people, violation of thermoregulation, dysfunction of the immune system, gastro-intestinal disorders, Helicobacter pylori infection.

Clinical and prognostic significance of anisocytosis measured as a red cell distribution width in patients with colorectal cancer.

: colorectal cancer (CRC) is the third most commonly diagnosed cancer worldwide, and detection of new prognostic markers is mandatory for patients to receive optimal oncological treatment. The aim of the study was to assess clinical and prognostic value of red cell distribution width (RDW) in patients with CRC. : RDW values in 90 patients with CRC undergoing surgery for primary disease were analyzed in pre- and postoperative setting, and correlated with clinical and hematological parameters. : Both pre- and postoperative RDW measurements were found to be associated with features of iron deficiency anemia, inflammatory response to tumor, advanced age and depth of tumor invasion. Optimal cutoff points were calculated to be 14% for preoperative and 13.6% for postoperative RDW measurements. Elevations in both pre- and postoperative RDW values had significant effects on survival in univariate and multivariate analyses. Effects were found to be independent of tumor related features, stage of the disease, development of anemia and aberrant inflammatory response to tumor. : RDW is an integrative parameter reflecting tumor specific features and shows significant association with overall survival in patients with CRC. This is especially important in patients with stage 2 disease where elevation in preoperative RDW values can contribute to recognition of higher risk patients.

A CLINICAL STUDY ON THE EFFECT OF DHATRI LAUHA IN GARBHINIPANDU (IRON DEFICIENCY ANAEMIA)

Women are treasured by the richness of continuing the human race . Pregnancy is a state in which all the physiological functions are hyper stimulated in order to meet the demands of the growing fetus. Anaemia during pregnancy is a very common condition which involves the fall in the hemoglobin concentration . The prevalence of Anaemia in low - income pregnant women in the 1 st , 2 nd and 3 rd trimesters is 9 %, 14 % and 37 %, respectively. Iron deficien cy Anaemia results in decreased work product ivity , increased child mortality , increased maternal mortality, slowed child development, and mild - to - moderate Anaemia may increase susceptibility to infectious disease. The features of Iron Deficiency Anaemia (I DA) share s lot similarities with lakshana of Panduroga. In this open labeled clinical trial, 50 pregnant women fulfilling the diagnostic and inclusion criteria of Panduroga / Iron Deficiency Anaemia (IDA) were administered with Dhatri Lauha with a dose of 500 mg thrice a day orally for 4 weeks . In the present study Dhatri Lauha showed a highly significant improvement in terms of subjective par ameters like Panduta, Hriddrava, Daurbalya , Shrama and Bhrama as well as in objective parameters like Hb %, RBC, PCV , MCV, MCH, MCHC (< 0.001). This study has revealed that Dhatri Lauha provided statistically significant improvement in the cardinal features of Garbhinipandu as well as it has showed good effect on jatharagni and nourishment of pregnant woman and foetus w ithout any side effects , due to the proper ties of the ingredients of trial drug such as deepana, pachana, balya, rasayana and rudhirak rit.

Iron deficiency anemia: current strategies for the diagnosis and management

Iron deficiency is one of the commonest nutritional deficiencies in the world. It is multifactorial and may be caused by lack of intake, blood loss and intestinal causes. Clinical features are highly variable, and most patients are asymptomatic. Typical laboratory features of iron deficiency anemia (IDA) include a hypochromic microcytic anemia, low serum iron level, high total iron binding capacity, low serum ferritin level. Usefulness of monitoring serum transferrin receptor level (sTfR) and hepcidin for identifying IDA have been examined in a few studies. Available data suggest that sTfR can potentially become a valuable tool for regular testing of patients in the future. Despite IDA is easily corrected with iron therapy, establishing the cause can be difficult, particularly in cases caused by disorders of iron transport. Education for clinician needs to focus on increasing awareness of the importance of failure respond to iron supplementation. The aim of this review was to outline the current strategies for the diagnosis and management of IDA in the light of the latest reports.

PA03.17. A clinical evaluation of Punarnavadi Mandura and Dadimadi Ghritha in management of pandu (Iron defeciency anaemia)

Purpose:Iron deficiency anaemia is currently the most micronutrient deficiency affecting 1.5 billion people globally. in our country 50% of children are Anemic. the features of iron deficiency anaemia are almost similar with that of Panduroga mentioned in Ayurvedic classics. Punarnavadi mandura and Dadimadi Ghrita are mentioned in the management of Pandu. Mandura (Fe2O3) directly increases serum ferritin,Punarnava decreases gastric irritation produced by Mandura,while Dadimadi Ghrita helps for better digestion and absorption. Hence,the study was planned to find the efficacy of these drugs in Pandu.Method:The present study was conducted on 50 children fulfilling inclusion criteria in between the age group of 10 to 14 years. The patients were selected from S.D.M.C.A & Hospital, Hassan. Punarnavadi Mandura 500 mg B.D and dadimadi Ghritha 10 ml B.D with luke warm water for a period of 84 days (3 lunar months) The cases were recorded according to the case proforma prepared for the study and observations were recorded.Result:Symptoms were statistically analyzed before and after treatment, their was statistically significant changes (P < 0.001) were observed in the signs and symptoms of Pandu rogi(IDA). There was a statistically significant response in hemoglobin and other hematological investigation like MCHC, MCV, PCV, Reticulocyte Count, peripheral Blood smear, serum iron, serum Ferritin and Total Iron Bindinig Capacity in the Group (P < 0.001).Conclusion:Punarnavadi Mandura and Dadimadi Ghrita are effective in the management of Pandu roga (Iron Deficiency Anemia).

Colonoscopic findings in coeliac disease on a gluten-free diet

to date, there are few data on colonoscopic findings in patients with celiac disease, and most of these obtained in patients with iron deficiency anaemia. we assessed colonoscopic findings in unselected patients with coeliac disease, since there are no studies available also considering morphological aspects, and there is literature suggestion of increased prevalence of colorectal tumours. colonoscopies with multiple biopsies were retrospectively analyzed in 42 coeliac disease patients on gluten-free diet above age 40; 16 had clinical or laboratory features of iron deficiency anaemia. Mucosal biopsies were evaluated for the presence of intraepithelial lymphocytes and of mucosal eosinophils, in addition to conventional histologic assessment, and compared with those obtained in 15 controls. macroscopic abnormalities (polyps, diverticula, inflammatory changes) were found in 26% of patients. Microscopic abnormalities (lymphocytic colitis, melanosis coli, rectal histiocytosis) were found in 36% of patients. None of these findings was found in controls. Coeliac disease patients had significantly higher eosinophil score than controls in the right colon, whereas this was not significantly different between groups in the left colon. colonoscopic findings in coeliac disease on gluten-free diet may reveal significant findings, even in patients without iron deficiency anaemia. There is the need of further studies in larger cohorts of patients to establish whether colonoscopy in these patients may be clinically useful.

Evidence That Stainable Bone Marrow Iron Following Parenteral Iron Therapy Does Not Correlate With Serum Iron Studies and May Not Represent Readily Available Storage Iron

We recently reported that parenteral iron therapy is associated with a characteristic pattern of iron staining on bone marrow aspirate smears. We now present clinical information from 6 patients who received parenteral iron and, at one or more points in follow-up, were found to have low or borderline low serum ferritin levels and/or serum iron levels, even though marrow aspirate smears revealed abundant stainable iron in the pattern characteristic of prior parenteral iron therapy. We conclude that stainable iron seen in this pattern does not correlate with serum iron studies and may not represent functionally available storage iron. This pattern of iron staining should not be used as evidence to withhold further iron therapy in patients who otherwise continue to have features of iron deficiency anemia.

The anemia of achylia gastrica revisited

Autoimmune atrophic gastritis is encountered in 20–27% of patients with obscure, or refractory iron deficiency anemia and is 4 to 6 times more common than celiac disease causing unexplained iron deficiency. The unique clinical features of iron deficiency anemia associated with achlorhydria and mucosal atrophy sparing the gastric antrum have all been accurately described by Faber and others over 100 years ago, including its refractoriness to oral iron treatment, female predominance, relatively young age, increased prevalence of thyroid disease and tendency to progress to pernicious anemia. A significant new development is the relation between autoimmune gastritis and Helicobacter pylori infection. H. pylori per se impairs gastric acid secretion and it is quite likely that a proportion of patients described originally as achylia gastrica represented H. pylori and not autoimmune gastritis. The demonstration of H. pylori antibodies in atrophic gastritis directed against epitopes on gastric mucosal cells implies an autoimmune mechanism triggered by H. pylori and directed against gastric parietal cells by antigenic mimicry of H +K +-ATPase, the most common autoantigen in pernicious anemia. These findings introduce a new element into the 100-year-old saga of achylia gastrica and open new options for its prevention and management.

Features of iron deficiency anemia without increment in soluble transferrin receptor concentration

Features of iron deficiency anemia without increment in soluble transferrin receptor concentration