Kinds Of Anemia Research Articles

Bone Marrow Morphology: A Key Diagnostic Tool in Various Hematological and Non Hematological Disorders

Bone marrow morphology means microscopic examination of bone marrow cells and tissue samples obtained by aspirate and trephine biopsy. An invaluable tool for diagnosis of many hematological and non-hematological disorders, various types of cancer staging and metastases detection. Different kinds of anemia and leukemia can be accurately diagnosed and monitored. Objective: To check the spectrum of diseases which could be identified and diagnosed with the help of bone marrow morphology examination thus demonstrating its diagnostic utility and to check diagnostic concordance between aspirate and core biopsy. Methods: Cross sectional study with consecutive sampling technique conducted over period of one year. Samples of both Bone Marrow Aspiration (BMA) and trephine biopsy (BMB) were collected from all patients included in study after consent using standard protocols. Air dried smears were prepared from bone marrow aspiration samples while trephine biopsy tissues were processed by histopathological techniques. Routine staining such as Wright Giemsa stain, H and E stain and special cytochemistry were used to visualize the cellular architecture of bone marrow. Results: Out of 471 samples, males were predominant with the frequency of 63.9% and maximum patients (31.8%) were from the age group of 35-40 years. Most common clinical indication to conduct bone marrow examination was unexplained Cytopenia which accounted for 35.2% cases, followed by suspicion of Leukemia (28.5%). Malignant hematological disorders were more common as compared to benign disorders (64% vs 17.5%). Acute leukemia was the most commonly identified cancer with frequency of 27.6%. Conclusions: Bone marrow morphology till date remains low risk, economical, crucial diagnostic tool in especially in under resource country like Pakistan. It can guide physicians to plan proper and timely management of patients.

Study the Effect and Safety of Oral Lactoferrin Therapy for Functional Iron Deficiency Anemia in Prevalent Hemodialysis Patients

Abstract Background Anemia is one of the main problems in hemodialysis patients, which is caused by inadequate production of erythropoietin. Functional iron deficiency (FID) anemia is a kind of anemia, which lack of functional iron therein leads to resistance and inappropriate response to erythropoietin in hemodialysis patients. Aim of the Work The aim of the present study was to study the effect and safety of oral lactoferrin therapy for functional iron deficiency anemia in prevalent hemodialysis patients. Patients and Methods This was Randomized clinical trial, was conducted at El Demerdash hemodialysis unit on 70 prevalent hemodialysis patients divided into 2 groups: (Group A): included 35 patients with functional iron deficiency anemia, received lactoferrin together with the recommended dose of ESA therapy for 3 months, (Group B): included 35 patients with functional iron deficiency anemia, received no lactoferrin apart from the recommended dose of ESA therapy for 3 months. Results There was no statistically significant difference between the two studied groups (group A and group B) as regard sex, occupation, residence and age. There was no statistically significant difference between the two studied groups (group A and group B) as regard height, weight and BMI. There was no statistically significant difference between the two studied groups (group A and group B) as regard history. There was no statistically significant difference between the two studied groups (group A and group B) as regard hemoglobin and WBCs. There was no statistically significant difference between the two studied groups (group A and group B) as regard PLT and Reticulocyte %. There was no statistically significant difference between the two studied groups (group A and group B) as regard ferritin, serum iron and TSAT. There was highly statistically significant difference between the two studied groups (group A and group B) as regard KT/V and URR at 3 months. There was nostatistically significant difference between the two studied groups (group A and group B) as regard KT/V and URR at baseline. Conclusion Oral lactoferrin could not be used as a substitute to totally replace IV ferrous sulphate in treating iron deficiency anemia in end stage renal disease (ESRD) on dialysis. Oral lactoferrin could not even control Hb level constant without dropping in patients with end stage renal disease (ESRD). Oral lactoferrin had some gastrointestinal effects on some patients which did not allow compliance on the medication.

Impact of Severe Anemia on Menorrhagia and Eclampsia in Iraqi Women

The aim of this study to deal with (19) women were reviewed the center of obstetrics and Gynecology Al- Harthyia center with affected and non-affected of severe anemia with patients age between 20 to 39 years old. The patient's charts are started from 1st September 2021 to the 1st of August 2022. Severe anemia during this period associated with menorrhagia and eclampsia for affected women with different kinds of anemia like iron deficiency or thalassemia disease. The level of severe anemia for pregnant or non-pregnant that will absolutely between 4 – 11 g/dL. Anemia in pregnancy women with hemoglobin concentration 11 g/dL explained by world health organization (WHO). The project was associated with prevalence numbers of menorrhagia women were (12) from the total (19) women which constitute the percentage 63.16% as well with women eclampsia from 4 patients that constitute 21.05%.

A New Artificial Intelligence Approach Using Extreme Learning Machine as the Potentially Effective Model to Predict and Analyze the Diagnosis of Anemia

The procedure to diagnose anemia is time-consuming and resource-intensive due to the existence of a multitude of symptoms that can be felt physically or seen visually. Anemia also has several forms, which can be distinguished based on several characteristics. It is possible to diagnose anemia through a quick, affordable, and easily accessible laboratory test known as the complete blood count (CBC), but the method cannot directly identify different kinds of anemia. Therefore, further tests are required to establish a gold standard for the type of anemia in a patient. These tests are uncommon in settings that offer healthcare on a smaller scale because they require expensive equipment. Moreover, it is also difficult to discern between beta thalassemia trait (BTT), iron deficiency anemia (IDA), hemoglobin E (HbE), and combination anemias despite the presence of multiple red blood cell (RBC) formulas and indices with differing optimal cutoff values. This is due to the existence of several varieties of anemia in individuals, making it difficult to distinguish between BTT, IDA, HbE, and combinations. Therefore, a more precise and automated prediction model is proposed to distinguish these four types to accelerate the identification process for doctors. Historical data were retrieved from the Laboratory of the Department of Clinical Pathology and Laboratory Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia for this purpose. Furthermore, the model was developed using the algorithm for the extreme learning machine (ELM). This was followed by the measurement of the performance using the confusion matrix and 190 data representing the four classes, and the results showed 99.21% accuracy, 98.44% sensitivity, 99.30% precision, and an F1 score of 98.84%.

Megaloblastic Anemia

Megaloblastic anemia is a kind of anemia, which is triggered by means of inhibition of DNA synthesis at some point of erythropoiesis. The most frequent motive of defects in red blood cell DNA synthesis is vitamin deficiency, especially vitamin B12 deficiency or folic acid deficiency. Micronutrient loss can additionally be a cause. Moderate deficiency can consist of swollen tongue and neurological problems, inclusive of peculiar sensations such as a tingling sensation, whereas severe deficiency can encompass reduced coronary heart feature and greater serious neurological issues

Case Report on Sickle Cell Anaemia (SS Pattern)

Sickle cell anemia is a kind of hemolytic anemia that is passed down in families. It is a kind of hemolytic anemia caused by inheriting the sickle hemoglobin gene. Africans, as well as individuals from the Middle East, the Mediterranean region, and India's aboriginal tribes, have a lower level of the sickle hemoglobin (HbS) gene. A kind of anemia that affects both children and adults is sickle cell anemia.
 Clinical Finding: Since 5 days, A 25-year-old man has been experiencing generalized bodily pain and anxiety.
 Examining the Problem: ALT (SGPT)- 97 U/L, AST (SGOT)- 56 U/L, total bilirubin – 5.4 mg percent, bilirubin conjugated – 1.7 mg percent, bilirubin unconjugated – 3.7 mg percent, total RBC count – 3.71 million/cu mm, total WBC count – 22100 cu mm, total platelets count – 6.46 lack/cu.
 Ultrasonography: Heterogeneous spleen.
 Therapeutic Intervention: Inj. Piptaz 4.5 gm TDS, inj. Levoflox 500 mg, tab. Hydroxyurea 500 mg, tab. Neurobion forte, inj. Pan 40 mg, inj. Tramadol 100 mg.
 Outcome: The client's condition has improved as a result of the treatment. He has no longer generalized bodily aches, and his anxiety levels have decreased.
 Conclusion: A 25-year-old man was admitted to Acharya Vinoba Bhave Hospital's Medicine ward with a history of sickle cell anaemia and complaints of nonspecific body aches and anxiousness. His condition improved after he received proper therapy.

Red Cell Distribution Width With Clinical Significance of B12 Deficiency Anaemia: A Mini Case Report

The occurrence of megaloblasts in the bone marrow characterizes megaloblastic anemia. Megaloblastic anemia is the result of folate and vitamin B12 deficiency in many cases. It is either caused due to nutritional deficiency of folates or due to its malabsorption. Usually accompanied by leukopenia or thrombocytopenia, this disease is characterized by megaloblastic bone marrow morphology along with myeloid, erythroid or platelet precursors. In this kind of anemia, the mature erythrocytes have abnormal shapes and are of various sizes. As a result, their Mean Cell Volume (MCV) is much greater than normal and Red Cell Distribution Width (RDW) is also deviated from normal level. Thus, in routine hematological procedure MCV, RDW needs to be thoroughly investigated, as it may be a useful indicator in diagnosis of suspected megaloblastic anemia with related oral manifestations, secondary to Vitamin B12 malabsorption, which thereby guides the further management.

The Effectiveness Of Moringa oleifera L (Moringa oleifera L) Fraction On The Improvement Of Hemoglobine Levels Of Betinine Rat (Rattus norvegicus) Anemia Model Of Iron Deficiency

The iron deficiency anemia is kind of anemia because the less of iron that make thefunction to tie oxygen is down. Young girl is one of sufferer group who’s prone to getanemia. The long consequence of anemia for the young girl will disturb fatal functionof some organ in their body. In general arise of headache symptoms and pain in thecentre of head. And the in pregnancy will increase some complication risk such asmaternal death. Premature born and perinatal death. One of nature ingredients(herbal) which is reported to have high iron content is kelor leaf (Moringa oleifera L) forabout 28, 29 mg/100 g kelor. The purpose of this research is to know the effectivenessof Kelor leave fraction ((Moringa oleifera L) to increase hemoglobin grade withpreclinical. Experimental research with complete random design (RAL) has been donein February till April 2019 in medical faculty laboratory of universitas sriwijayaPalembang. Sample of the research is female rat that has inclusion criteria as much30 rats. Divided into 5 group. That is negative control group. Positive control (ferrousfumarate 60%), n-heksan fraction, ethyl acetate, and 1% concentration of kelor leaveethanol, the data of Hb all of subject before and after treatment from subject of irondeficiency anemia has collected by using Easy Touch GCHb tool. The analysis data ofthis research used SPSS 2.2 version. The result of the research said that thehemoglobin grade before and after treatment showed significant increasing(p<0,05) forn – hexane fraction and acetate ethyl >45%. While ethanol fraction only 32%.

Anemia Penyakit Kronis

Anemia sering dijumpai pada pasien dengan penyakit kronis dan meningkatkan morbiditas dan mortalitas dari pasien. Prevalensi anemia penyakit kronis terdapat pada urutan kedua tersering setelah anemia defisiensi besi. Anemia penyakit kronis sering terjadi bersamaan dengan anemia defisiensi besi dan keduanya memberikan gambaran penurunan besi dalam serum. Namun, kedua jenis anemia ini perlu dibedakan karena terdapat perbedaan patogenesis dan tata laksana keduanya. Beberapa parameter besi lain perlu diperiksa untuk membedakannya. Terapi utama pada anemia penyakit kronis adalah dengan mengatasi penyakit yang mendasari.

The burden of anaemia in <i>Plasmodium falciparum</i> parasitized and non-parasitized children, Minna, north-central Nigeria

Plasmodium falciparum infection may cause severe anaemia, particularly in children. There are several kinds of anaemia, produced by a variety of underlying causes. This study however, was conducted for a period of 3 months between February and May, 2018, to assess the frequency and types of anaemia in malarial infection. A total of 301 children below 17 years were recruited from the community and selected healthcare facilities. Thick and thin films of the blood samples were prepared for parasite identification and a complete blood count was conducted to determine the presence of anaemia. Multinomial logistic regression was used to predict relationships between anaemia and P. falciparum. Children with anaemia as a result of low levels of hemoglobin and hematocrit were observed as 65% and 61% respectively. Meanwhile, in parasitized subjects, prevalent rates of anaemia decreases with age and the overall prevalence was recorded as 49%(150) and 47%(142) in children with low levels of hemoglobin and hematocrit respectively. It was also observed that P. falciparum parasite was not a significant factor in the anaemia transmission (p>0.05). Similarly, anaemia prevalence decreases as the severity intensified (from severe, to moderate and mild), with most prevalence observed in mild anaemia 31%(96). The attributable risk of anaemia by malaria in this study was observed in low hemoglobin anaemia as 7.12% which was lower than what was observed in low hematocrit anaemia 8.11%. This study provides a significant relationship between anaemia sub-types and malaria infection and proves anaemia to be a major public health problem in this community as over 60% of the study population had anaemia.Keywords: Anaemia; hematocrit; hemoglobin.

Investigation of Iron Metabolism for Regulating Megakaryopoiesis and Platelet Count According to the Mechanisms of Anemia

Iron deficiency anemia (IDA) is characterized by depletion of total body iron stores or a poor supply of plasma iron. By contrast, chronic inflammation makes iron unavailable for hematopoiesis through a cytokinemediated cascade and leads to a condition known as anemia of chronic disease (AOC). However, the laboratory data regarding the regulatory role of iron metabolism on platelet count has not been fully discussed yet. In this study, we investigated the relationship between iron status and platelet production according to different anemic mechanisms representing different iron metabolisms. The study included a total of 759 specimens. Blood samples were obtained through venipuncture. The complete blood count was measured using an Advia 2120 (Siemens Healthcare Diagnostics Inc., USA). Biochemical indices including iron level were estimated using a Toshiba chemical analyzer (Toshiba, Japan). In the AOC group, we found a significant relationship between platelet count and serum iron level (p < 0.27), whereas there was no correlation in the IDA group. Moreover, when the AOC patient group was subdivided by serum iron level, a remarkable difference was observed as follows. The platelet count was significantly correlated with serum iron level only in the AOC group with decreased serum iron levels (serum iron < 50 µg/dL) (p < 0.0001), while there was no correlation in the AOC group with normal serum iron levels (serum iron 50 - 100 µg/dL). Iron deficiency in AOC involves upregulated hepcidin production induced by elevated inflammatory cytokines. This can cause increased iron sequestration in macrophages and decreased iron absorption for bone marrow. The condition of decreased megakaryocytic iron supply makes megakaryocytes with higher ploidy which can release more platelets than lower ploidy. Moreover, reactive thrombocytosis in inflammatory states occurs by cytokine cascades involving interleukin 6 and thrombopoietin in AOC. These two features may enhance thrombocytosis in patients of AOC with decreased iron level. In the future, further study should be performed to elucidate regulating mechanism of iron metabolism for megakaryopoiesis in AOC patients, and guide proper supplemental therapy of iron to decrease thrombotic risk due to reactive thrombocytosis in various kinds of anemia.

Clinical application of low hemoglobin density in screening for iron deficiency and the differential diagnosis of anemia

To investigate the clinical usefulness of the low hemoglobin density (LHD) and other red blood cell parameters in screening for iron deficiency (ID) and distinguishing iron deficiency anemia (IDA) from other kinds of anemia. Whole blood count (CBC) and parameters of iron metabolism of the patients with ID (n = 251), IDA(n = 155), anemia of chronic disease(n = 90), renal anemia(n = 184), acute hemorrhagic anemia(n = 27) and non-anemia subjects(n = 82) were analysed by Advia 2120 hematology analyzer, Hitachi 7180 automatic biochemical analyzer, Beckman-Coulter DxI 800 immunoassay analyzer. SPSS 13.0 software was applied to anylyze data. The sensitivity of LHD in screening for ID was 67.2%, which was significantly higher than MCHC (38.8%) . There was a sensitivity of 91.2% for ID screening by combination of LHD and RDW. LHD only increased greatly in IDA (14.9%) group, while had no increase in other anemia. LHD is a reliable new marker with certain clinical usefulness. Combination of LHD and RDW is more suitable for screening ID. LHD is also a useful marker to distinguish IDA from other kinds of anemia.

Serum Angiogenin Level in Sickle Cell Disease and Beta Thalassemia Patients

Introduction: Angiogenesis has been investigated in different kinds of anemia. However, its role as a marker of angiogenesis has not been investigated in thalassemia or sickle cell disease (SCD). Objectives: We aimed to investigate serum angiogenin level in children and adolescents with beta thalassemia or SCD and its relation to possible risk factors of angiogenesis. Materials and Methods: This study included; 32 β-thalassemia major (β-TM) patients aged 14.2 ± 3.8 years, 20 β-thalassemia intermedia (β-TI) patients aged 14.3 ± 4.8 years, 20 SCD patients aged 14.1 ± 2.4 years; 8 with (HbSS) and 12 with sickle thalassemia (HbS/β-thalassemia) and 35 age and sex-matched controls. Data collected regarding; age, sex, disease duration, blood transfusion frequency, transfusion index, chelation type and duration, CBC, Hb electrophoresis, serum ferritin and serum angiogenin level (by ELISA). Results: Angiogenin level was significantly higher in patients with SCD [250 (100–300) pg/mL] compared to β-TM [180 (140–230) pg/mL] and controls [89 (80–103) pg/mL] (P < .001) especially those with HbSS (P = .06). There was a significant negative correlation between serum angiogenin and age of patients, age of onset and duration of chelation in β-TM (P < .01, P < .001, P = .003) and β-TI (P = .009, P = .03, P < .001) and with serum ferritin in β-TI group (r = −0.573, P = .008). In SCD, angiogenin level was negatively correlated with both frequency of blood transfusion (r = −0.731, P < .001) and duration of hydroxyurea therapy (P = .017). Conclusions: High angiogenin level detected among patients with SCD may be negatively influenced by regular blood transfusion and hydroxyurea therapy, while; early onset of chelation therapy may decrease angiogenin level in β-TM.

Gambaran Anemia pada Lanjut Usia di Panti Sosial Tresna Werdha Abiyoso Yogyakarta Tahun 2013

Background: Anemia is a main health problem of elderly. The aging process causes many psychological changes in nearly all body systems of elderly that causes many kinds of processes of nutrient absorptions in the body disturbed. There is an opinion says that generally elderly has lower hemoglobin levels compared to the younger people. Other research showed that elderly often suffered from calorie and protein malnutrition and micronutrient. It happened because the HCL and pepsin secretion was reduced. Consequently, the absorption of Vitamin B12 and iron decreased that causes Anemia.&#x0D; Method: It was a descriptive analysis with laboratory tests. The sample of this research was 60 year-old and older patients in TresnaWerdhaAbiyoso Nursing Home Yogyakarta. There were 96 patients. The data of research results were analyzed descriptively and presented in the forms of tables and graphs.&#x0D; Results: Of the 96 old patients, there were 31 patients suffered from anemia that consisted of 27 patients with mild anemia and 10 patients with moderate anemia. Based on the morphology of erythrocytes in elderly, there were two kinds of anemia. They were normocytic-normochromic anemia with 84 patients and microcytic-hypochromic anemia with 12 patients.&#x0D; Conclusion: The description of anemia in elderly who stayed in TresnaWerdhaAbiyoso Nursing Home Yogyakarta showed that 32.29% of the elderly suffered from anemia. 72.97% suffered from mild anemia. 27.03% suffered from moderate anemia. The anemia classifications based on morphology in elderly in Tresna Werdha Abiyoso Nursing Home Yogyakarta were 87.5% normocytic-normochromic anemia and 12.5% microcytic-hypochromic anemia.

High Prevalence but Insufficient Treatment of Iron-Deficiency Anemia in Patients with Inflammatory Bowel Disease: Results of a Population-Based Cohort

Background. Iron-deficiency anemia is described to be a common problem in patients with inflammatory bowel disease (IBD), which is frequently associated with a reduced quality of life. Therefore, the aim of this study is to assess the prevalence of iron deficiency anemia in a population-based cohort at time of first diagnosis and during the early course of the disease. Methods. As far as available, lab values of patients registered in the population-based “Oberpfalz cohort” were screened. In anemic patients, we further investigated all laboratory results to differentiate between iron deficiency and other reasons for anemia. All patients with any kind of anemia were interviewed separately according to symptoms of iron-deficiency anemia and administration of iron. Results. In total, we evaluated hemoglobin values of 279 patients (183 Crohn's disease, 90 ulcerative colitis, and 6 indeterminate colitis). Lab data which allowed further differentiation of the type of anemia were available in 70% of anemic patients, in 34.4% values of iron, ferritin and transferrin saturation had been measured. At time of first diagnosis, an iron-deficiency anemia was diagnosed in 26 of 68 patients with anemia (38.2%, 20 CD, 4 UC, and 2 IC patients), but only 9 patients (34.6%) received subsequent iron therapy. After one year, 27 patients were identified to have an iron-deficiency anemia (19 CD, 8 UC), 20 of them were treated with iron (71.4%). Of 9 patients with proven iron-deficiency anemia at time of first diagnosis and subsequent administration of iron, 5 (55.5%) had iron-deficiency anemia despite permanent treatment after one year. In total, 38 patients (54.3%) did not receive any iron substitution at all despite of proven iron-deficiency anemia, and only 13 patients of 74 patients were treated with intravenous iron (17.6%). Conclusion. We found a high prevalence of iron-deficiency anemia at different points during the early course of disease in this population-based cohort of IBD patients. Surprisingly, only in one-third of patients with proven anemia, further diagnostic approach was undertaken. Even patients with diagnosed iron-deficiency anemia were infrequently and inconsequently treated with iron preparations, despite the high impact on quality of life.

Transferrin Saturation (TS) Is a Surrogate Marker for Iron Deficiency Anemia (IDA),

Abstract 3175 Background:Iron deficiency anemia (IDA) is an important entity in clinical practice. Distinguishing between IDA and other kinds of anemia is challenging in many situations. Various laboratory indices have been studied in relation to IDA including red cell distribution width (RDW), mean cell volume (MCV), transferrin saturation (TS), total iron binding capacity (TIBC), serum ferritin and erythrocyte protoporphyrin (EPP). Methods:We chose 8015 subjects in the National Health and Nutrition Examination Survey (NHANES) database between 2003–2008 who had the required hematologic values. After applying the Centers for Disease Control (CDC) definition for anemia, the number of anemic subjects became 627 (8%). After applying the IDA model as suggested by Cogswell et al using the log ratio of transferrin receptor to ferritin, 46.1% of the anemic subjects had IDA. Then we developed receiver operator (ROC) curves for MCV, RDW, erythrocyte protoporphyrin, TIBC, and percent transferrin saturation for those anemic subjects with and without iron deficiency. From these variables, the area under the curves (AUC), sensitivity, specificity, positive likelihood ratios (LR+), and negative likelihood ratios (LR-) along with their confidence intervals (CI) were calculated. Furthermore we investigated the performance of each available measure by sub-setting the subject group into variables. Data analysis was done using SAS (version 9.2), R version 9.2 with the ROCR library, and MedCalc (version 11.2; MedCalc Software, Mariakerke, Belgium). ROCR and MedCalc have slightly different but individually valuable approaches to ROC curve analysis. Confidence intervals for sensitivity, specificity, and the likelihood ratios were calculated. Results:For the 627 anemic subjects, median age was 26.1 year with 95% being females. Fifty four percent were African American (AA). The MCV showed an AUC of 0.666, sensitivity of 73.7, specificity of 58.8, LR(+) of 1.79, LR(−) of 0.45 with a criterion of <81.6. RDW showed an AUC of 0.803, sensitivity of 77.2, specificity of 69.2, LR(+) of 2.51, LR(−) of 0.33 with a criterion >13.9. For 535 subjects with anemia the EPP showed an AUC of 0.831, sensitivity of 66.4, specificity of 84.9, LR(+) of 4.41, LR(−) of 0.40 with a criterion >93. For 542 subjects with anemia the TIBC showed an AUC of 0.756, sensitivity of 80.3, specificity of 61.5, LR(+) of 2.09, LR(−) of 0.32 with a criterion >406. Finally for the same 542 subjects the TS showed an AUC of 0.869, sensitivity of 80.3, specificity of 78.8, LR(+) of 3.79, LR(−) of 0.25 with a criterion <10.4 [Figure 1]. Comparing the LR(+) and LR(−) between the indices in the setting of inflammation showed that the EPP is the least affected but all indicators are, to some extent, affected by inflammation. Comparing the LR(+) and LR(−) between the indices in the setting of pregnancy showed that TS is the strongest performer. Finally; comparing the LR(+) and LR(−) between the indices in the AA versus non-AA showed that AA ethnicity has a small impact on the LR(−) but reduces the clinical utility of the LR(+) somewhat. [Display omitted] Conclusion:Alternative hematologic indices have diagnostic value in the diagnosis of IDA. Transferrin saturation (TS) is the most efficient alternative to ferritin in most circumstances. Erythrocyte proto-porphyrin (EPP) should be considered as an alternative tool in inflammatory conditions. Disclosures:No relevant conflicts of interest to declare.

Iron Chelation, Blood Transfusion and Splenectomy Decreases Angiogenesis in Patients with Thalassemia Major

Introduction: Thalassemia major (TM) is an important cause of severe anemia that necessitates regular blood transfusion to prevent the profound weakness and cardiac decompensation caused by the anemia. However, iron overloading is an inevitable consequence of prolonged transfusion therapy. In addition, extramedullary hematopoiesis and hemosiderosis cause spleen, liver and marrow enlargement. In recent years the role of angiogenesis has been investigated in physiologic and pathologic conditions. However, it is known that angiogenetic factors, especially vascular endothelial growth factor (VEGF), cause differentiation of the hemangioblast. The role of angiogenesis has been investigated in different kinds of anemia, such as malignancy related anemia and sickle cell anemia. However, the role of angiogenesis has not been investigated in thalassemia major (TM) patients. In this study the angiogenesis was researched in thalassemic patients by serum VEGF measurement.Material and method: Forty-four consecutive patients with TM were included in this prospective study. TM patients' findings were compared with those of a healthy control group (n=12). Blood samples were analyzed using commercially available ELISA kits for VEGFResults: VEGF levels were not affected by hemoglobin levels, ferritin levels, or chelation type (p>0.05). However, VEGF was positively affected by chelation starting age and negatively affected by yearly blood transfusion rate (p<0.05). In addition, VEGF of patients who underwent splenectomy was higher than those who didn't undergo splenectomy (p<0.05).In conclusion, VEGF causes differentiation of hemangioblasts, however, early starting transfusion age and regular blood transfusion decrease angiogenesis in thalassemic patients. The besides regular blood transfusion and effective chelation therapy, splenectomy decreases angiogenesis in this group of patients.

Poet's Corner

There are many disorders in which cyanocobalamin therapy has been tried, but in none has benefit been demonstrated by suitably controlled studies unless a deficiency of the vita¬ min has also been found. Doses have usually been massive (l,000ug by injection, weekly, daily, even three times a day). It is used to treat all kinds of anemia. Anemia does not im¬ prove because of such therapy if there is no vitamin B12 deficiency. Con¬ trolled studies have failed to demon¬

Is recombinant human erythropoietin (rh-epo) more than just a treatment of anemia in cancer and chemotherapy?

Recombinant human eythropoietin (rh-epo) is a well established treatment for many kinds of anemia including the anemia of cancer with or without myelosuppressive chemotherapy. This review considers the effects of rh-epo in humans, tumour-bearing and healthy experimental animals treated with cisplatin with or without rh-epo, and proposes that the ability of rh-epo to improve the quality of life in cancer patients may also be due to interference with the prostaglandin pathways.

Disease-related variations of the glycosylation of haptoglobin in the dog

Haptoglobin phenotypes have been shown in human medicine to be related to the prevalence of various diseases. Furthermore, abnormal glycosylation of haptoglobin has been reported as a consequence of liver disease, cancer and immunological disorders in man. To our knowledge, similar findings have not, so far, been reported in canine disease. The present paper describes a method for investigation of canine haptoglobin phenotypes and of microheterogeneity caused by altered glycosylation. The method consisted of isoelectric focusing (IEF) of dog serum, followed by immunoblotting. The results indicated the existence of only one canine haptoglobin phenotype with a characteristic microheterogeneity pattern in healthy dogs. Changes in this pattern were found in serum from dogs with liver disease, predominantly chronic progressive hepatitis, and with different kinds of anaemia. Pretreatment of serum with neuraminidase or glycopeptidase F (PNGase F) resulted in identical IEF patterns of haptoglobin from healthy and diseased dogs. Moreover, a fucose-specific lectin was capable of binding to some of the abnormal haptoglobin fractions, mainly those found in association with anaemia. The changes described were interpreted as alterations of the carbohydrate content, with or without fucosylation, of some haptoglobin fractions.