Mechanical Hemolytic Anemia Research Articles

Erythrocyte Membrane-protein Anomaly in March Hemoglobinuria

Erythrocyte Membrane-protein Anomaly in March Hemoglobinuria

Gastrointestinal bleeding in competitive runners

Competitive runners have been shown to develop previously undescribed clinical conditions, including "runner's anemia." This has been shown to be an iron-deficiency anemia of several etiologies including gastrointestinal bleeding. Although 8-23% of runners have been shown to have guaiac-positive stools after a marathon, the incidence of significant and prolonged bleeding is unknown. We report four cases of competitive runners with iron-deficiency anemia, gastrointestinal bleeding coinciding with running, and no definitive gastrointestinal pathology despite extensive evaluation.

The Anemias of Athletes

In brief: Diagnosing anemia in athletes is complicated, because athletes normally have lower hemoglobin and serum ferritin concentrations than nonathletes. This dilutional pseudoanemia-a beneficial adaptation that enhances athletic performance-needs no treatment. Athletes can also develop true anemia from iron deficiency and/or footstrike hemolysis. True anemia can be treated with iron supplements and diet modification to increase absorbable iron; footstrike hemolysis can be minimized by paying attention to body weight, gait, shoes, and terrain. The widespread notion that depletion of iron stores without anemia limits performance is probably wrong, but even very mild iron deficiency anemia impairs maximal performance. The physician who recognizes and manages the diverse anemias of athletes performs a vital service.

剣道により発症した行軍血色素尿症の3例：剣道負荷試験，赤血球膜SDS-PAGEについて

剣道により発症した行軍血色素尿症の3例：剣道負荷試験，赤血球膜SDS-PAGEについて

Runner's macrocytosis: A clue to footstrike hemolysis. Runner's anemia as a benefit versus runner's hemolysis as a detriment

This report of a runner in whom progressive macrocytosis developed with Increasing mileage deals with the hematologic adaptations to exercise, introduces the concept of “runner's macrocytosis” as a compensated hemolysis of older red cells, and makes a case for “runner's anemia” as a benefit versus “runner's hemolysis” as a detriment. It presents the characteristic hematologic profile of footstrike hemolysis and explores the influence of racing, different levels of training, and different shoes. It shows that runner's hemolysis can be reduced by reducing mileage but not necessarily by changing shoes, and it suggests that runner's hemolysls can impair race performance by preventing the attainment of an optimal red cell mass and, In time, by evolving Into Iron-deficiency anemia.

Occult gastrointestinal blood loss in marathon runners.

Excerpt Runners have developed several unique health problems, including anemia. A review of studies of runner's anemia shows that ferritin (1-2), serum haptoglobin (1-3), and serum iron...

A Case of March Hemoglobinuria Following “Kendo” (Japanese Fencing) Exercise

A Case of March Hemoglobinuria Following “Kendo” (Japanese Fencing) Exercise

Erythrocyte survival in patients with porcine xenograft aortic and mitral valves.

Ten patients with porcine xenograft aortic and mitral valve prostheses were studied three to 36 months (mean 15 months) postoperatively for evidence of hemolysis. Studies included complete blood count, reticulocyte count, red cell indices, percentage of schistocytes on blood smears, bilirubin concentration, lactic dehydrogenase, serum iron, total iron binding capacity, haptoglobin, serum folate and vitamin B12 levels, Coombs' test, methemoglobin reduction test, autologous 51Cr erythrocyte survival, and urinary examination for iron and hemosiderin. All patients were hemodynamically stable. Nine patients had normal valve function and no evidence of hemolysis. One patient with paravalvular aortic regurgitation had mechanical hemolytic anemia with a negative Coombs' test. Porcine valve xenografts do not seem to be associated with hemolysis unless complicated by a paravalvular leak.

Runner's Anemia and Iron Deficiency

Systemic iron deficiency was found in 63 (56%) of 113 joggers and competition runners (33 women and 80 men). Thirteen women and ten men had latent anemia. A majority of the women were fertile with iron loss from menstruation; the men were runners training long distances. The average transferrin iron-binding capacity was 80 mu mol/l serum in the women and 77 (iron-binding groups) in the men. The haptoglobin and iron concentrations in serum were remarkably low (most often below 10 and 20 mu mol/l, respectively). Three of the long-distance runners ran 25 km daily. They returned with so much free hemoglobin in their plasma that an accompanying iron loss (integrated over months), if not balanced by diet, would lead to iron deficiency and anemia. Oral iron therapy (200 mg ferrous sulphate per day) normalized the hemoglobin concentration and improved the transferrin saturation fraction in 61 persons. The competition runners reported personal records.

Mechanical Hemolytic Anemia After Repair of Ruptured Chordae Tendineae of Mitral Valve Apparatus

A case of mechanical hemolytic anemia following mitral valvuloplasty for ruptured chordae tendineae is described. We postulate that intravascular hemolysis is the result of whiplash motion caused by the loose ends of the ruptured chordae tendineae and the disrupted suture material attached to the mitral valve apparatus.

Enhanced ratio of urinary amylase to creatinine clearance in a man with march hemoglobinuria

We describe a young soldier who developed increases in the ratio of urinary amylase clearance to creatinine clearance during episodes of march hemoglobinuria. Clearance ratios returned to baseline values as hemoglobinemia and hemoglobinuria resolved. Hemoglobinuria may interfere with the renal handling of amylase in humans.

So-called March Hemoglobinuria Caused by “Kendo” Exercise: A Report of Two Cases

So-called March Hemoglobinuria Caused by “Kendo” Exercise: A Report of Two Cases

A case report of successful surgical treatment for severe mechanical hemolytic anemia following open heart surgery of ventricular septal defect with pulmonary valvular stenosis.

A case report of successful surgical treatment for severe mechanical hemolytic anemia following open heart surgery of ventricular septal defect with pulmonary valvular stenosis.

A Different Drummer

Hemoglobinuria, occurring—albeit infrequently—after a long or run, was originally attributed to exertion and thus labeled exertional. Later, when it was observed that the exertion always entailed prolonged locomotion, this syndrome was renamed hemoglobinuria. Only after Davidson 1 had provided convincing evidence that trauma to the capillary bed of the soles was responsible for the fragmentation of erythrocytes, did the traumatic nature of this pigmenturia become apparent. The traumatic etiology became even more obvious when Streeton 2 reported a variant of march hemoglobinuria occurring not after marching, but after karate exercises. The trauma was brought about not by the impact of the sole but by that of the fist and ulnar aspect of the hand on concrete and wooden surfaces. Just as in the case of the stomping marcher, it could be prevented by the interposition of foam rubber at the areas of impact. Another variant of traumatic—the term

Acute tubular necrosis in a patient with march hemoglobinuria.

MARCH hemoglobinuria is a hemolytic disorder in which transient hemoglobinemia with hemoglobinuria develops in susceptible persons after strenuous exercise.1 Some patients with this disease have had transient abnormalities of the urinary sediment,2 but other renal impairments have not been reported.3 This report describes the occurrence of acute tubular necrosis in a man with march hemoglobinuria after a marathon race.Case ReportC.B. (M.G.H. 00–64–20), a 37-year-old man, was admitted to the Massachusetts General Hospital because of pigmenturia and oliguria after a 26-mile marathon race. Previously in excellent health and on no medications, he had first begun long-distance running 1 year . . .

March haemoglobinuria.

March haemoglobinuria.

March Hemoglobinuria Associated With Asymptomatic Congenital Heart Disease

March hemoglobinuria occurred repeatedly in a 16year-old boy during training for cross-country running. The patient's plasma hemoglobin binding capacity was markedly reduced or absent during the track season, and reduced below normal during the rest of the year, except when he remained sedentary for several days. Results of hematologic studies were normal. He had the history and findings of a congenital heart lesion (most likely a small ventricular septal defect). There is a possible relationship between the patient's hemoglobinuria after exertion and the cardiac lesion.

March hemoglobinuria associated with asymptomatic congenital heart disease

March hemoglobinuria associated with asymptomatic congenital heart disease

Effect of exercise on blood volume.

Effect of exercise on blood volume.

The Haemolytic Anaemias,

This is volume 3 of the second edition of an encyclopedic treatment of hemolytic disorders. It is unfortunate that volumes 1 and 2 were published seven and five years respectively before volume 3, because the earlier volumes are now incomplete, in light of subsequent developments. Volume 3 considers hemolytic anemias which are secondary or symptomatic in origin. The organization of the material is such that the monograph is presented in three chapters. Chapter 1 (13) deals with hemolytic states associated with Hodgkin's disease, leukemia, and other malignancies — particularly those involving the reticuloendothelial structures. Chapter 2 (14) discusses hemolytic disease associated with lupus erythematosus, ulcerative colitis, liver and renal diseases, and the vasculitides in general. Chapter 3 (15) examines hemolytic states associated with a heterogenous group of diseases, including infections, sarcoidosis, pregnancy, hypersplenism, vitamin deficiencies, radiation, hyperoxia, marrow hypoplasia, burns, cardiac surgery, valvular disease of the heart, and march hemoglobinuria.