Symptomatic Anemia Research Articles

Prevalence and Clinicopathological Features of Autoimmune Metaplastic Atrophic Gastritis in the Eastern Province of Saudi Arabia: A Regional Study.

Introduction. Autoimmune metaplastic atrophic gastritis (AMAG, also termed autoimmune gastritis) is a chronic gastritis of autoimmune pathogenesis. Although its clinical and pathological features are well-documented in many countries, data from Middle Eastern populations remain scarce. This study examined the prevalence of AMAG in gastric specimens from the region, specifically from Saudi Arabia. Methods. We conducted a retrospective review of the pathology database of gastric specimens with a diagnosis of AMAG between 2020 and 2023. Detailed clinical, endoscopic, and pathological features of identified features were described. Result. Of the 978 gastric biopsies received, 17 patients were diagnosed with AMAG. The cohort comprised 11 women (64.7%) and 6 men (35.3%), presenting at a median age of 50 years (range: 32-85). Clinical manifestations varied widely, from abdominal pain (n = 6), dyspepsia (n = 2), symptomatic anemia with significant vitamin B12 deficiency (2 of 17) to asymptomatic/incidentally diagnosed patients (5 of 17). The tissue samples showed varying histological characteristics, with some showing lymphoplasmacytic infiltrate, mucosal atrophy, and hyperplasia of enterochromaffin-like cells. Conclusion. The observed prevalence of AMAG in our study aligns with global averages reported for other populations. The diverse clinical presentations highlight the need for awareness of findings in AMAG in gastric biopsies to ensure appropriate clinical management.

A Comprehensive Analysis of Clinical Presentations, Laboratory Findings, and Etiologies of Pancytopenia: A Tertiary Care Experience.

Background Pancytopenia, while a common manifestation of a multitude of diseases, remains a relatively lesser-researched topic, especially in developing countries. Its management depends largely on identifying the etiology, which can range from simple infections to more sinister causes like leukemia. This study aims to investigate the clinical presentations, hematological findings, and etiologies of pancytopenia in a developing country. Methods A cross-sectional study was conducted at Hayatabad Medical Complex, Peshawar, and included 106 patients who were diagnosed with pancytopenia. Thorough demographic details, histories, clinical examinations, laboratory investigations, bone marrow biopsies, and final diagnoses were recorded and analyzed using statistical tools. Results Pancytopenia was most common in the age group 11-30 years with a male-to-female ratio of 1.4:1. Infections were the leading etiology (17.9%), followed by megaloblastic anemia (17%), hypersplenism (16%), and malignancy (15.1%). Among infections, enteric fever was the most frequently observed cause. The most common presentation was with signs and symptoms of anemia, followed by infections and thrombocytopenia. The most common blood smear finding case-wise was a combination of anisocytosis, microcytosis, and target cells. In patients who underwent bone marrow biopsy, the commonest finding (34%) was suggestive of malignancy with hypercellularity and abnormal cells. Aplastic anemia, hypersplenism, and malignancy were associated with a retic count of <1.5%. Platelet counts of less than 50,000 were associated with the presence of signs and symptoms of thrombocytopenia. Conclusion Pancytopenia can be a presenting feature of a reversible condition like underlying infection and megaloblastic anemia, which contribute a major portion of its etiologies. Early diagnosis and treatment can reverse pancytopenia and prevent over-investigation.

Vesical Varices: An Unusual Cause of Hematuria

AbstractPortal hypertension is a common complication of cirrhosis and may lead to the formation of venous collateral channels. Usually, varices due to portal hypertension develop in the lower esophagus, stomach, rectum, or other parts of the digestive tract. Extraintestinal ectopic varices are rare. Here, we present a patient with ectopic urinary bladder varices, who presented with hematuria and symptomatic anemia. The bleeding was managed with minimally invasive endovascular approach.

Symptomatic Anemia Due to Cameron Lesions: A Case Report

Symptomatic Anemia Due to Cameron Lesions: A Case Report

Type 1a Duodenojejunal Tubular Duplication Cyst with Complex Rotational Anomaly Masquerading as Chronic Anemia

ABSTRACT Enteric duplication cysts and reversed intestinal rotation (RIR) are rare congenital anomalies, with their coexistence being exceptionally uncommon. We report a 4-year-old girl who presented with chronic anemia and intermittent abdominal symptoms since infancy. Detailed workup for medical causes of anemia was inconclusive. Computed tomography of the abdomen revealed intestinal malrotation with a grossly dilated small bowel loop. Intraoperative findings revealed a long duodenojejunal tubular duplication with a separate mesentery (Type 1a) and RIR. The patient underwent a Ladd’s procedure, resection of the duplication cyst, and end-to-end anastomosis. This case underscores the anatomical rarity, varied clinical presentation, and challenges in making an accurate and timely diagnosis in such a case.

Genotype-phenotype correlation analysis of patients with thalassemia in Quanzhou city, Southeast of China

BackgroundThe carrying rate of thalassemia is high in Quanzhou city. However, there are few large-scale studies on the correlation analysis between genotype and phenotype of thalassemia in Quanzhou. In this study, the genotype and phenotype data of 1076 individuals with thalassemia in Quanzhou city were analyzed to provide reference data for screening and diagnosis of thalassemia in this region. Material and MethodsReverse dot blot hybridization (RDB-PCR), Gap-PCR and nested PCR were used to detect the thalassemia genotype. Clinical and hematological parameters of 1076 individuals of thalassemia were collected to analyze the correlation between genotype and phenotype. ResultsAmong 2997 subjects, 1076 cases diagnosed as thalassemia gene carrier or patients, with detection rate 35.9%, among which Southeast Asian deletion (--SEA) / αα was the most common α-thalassemia genotype (48.4%) and one rare genotype was detected: HKαα/--SEA (0.1%). Subjects with thalassemia alone showed the least severe symptoms of anemia with higher red blood cell count (RBC) and hemoglobin (Hb), lower red blood cell distribution width (RDW) than those with iron deficiency (ID) or iron overload (IO) (p<0.05). The Hb, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) levels in gene carriers of α-thalassemia were higher than those of β-thalassemia, while RBC, RDW and serum ferritin (SF) levels were lower than the later(p<0.05). Among individuals with --SEA/αα, the Hb, MCV, MCH, mean corpuscular hemoglobin concentration (MCHC) and SF levels of subjects≥19 years old were higher than those of ≤18 years old. For cases ≥19 years old, the RBC, Hb and SF levels in male were higher than that in female, while MCHC level was lower than female(p<0.05). ConclusionThe difference of hematological phenotypes in patients with thalassemia is not only affected by their genotype, but also the influence of gender and age.

Portosinusoidální vaskulární choroba s portální hypertenzí – popis případu

Portosinusoidal vascular disease (PSVD) is a rarely recognized liver condition caused by the involvement of small hepatic vessels. The diagnosis is established based on a set of clinical and/or histopathological criteria, with the absolute requirement of excluding liver cirrhosis through biopsy. Clinically, PSVD often presents with complications related to portal hypertension, although not all patients exhibit these signs. This article discusses the case of a 71-year-old patient with known splenomegaly, which had not been fully investigated and lacked a hematological explanation. The patient was evaluated for severe symptomatic microcytic anemia, likely secondary to portal hypertension, despite the absence of overt bleeding symptoms. During hospitalization, ligation of large, high-risk esophageal varices was performed, and no other sources of anemia were identified. Pre- or post-hepatic causes of portal hypertension were ruled out. Liver elastography results were within normal ranges, and liver function tests were normal except for a marginal isolated elevation of gamma-glutamyltransferase. Liver function remained intact. Liver biopsy findings were consistent with a diagnosis of PSVD. The patient did not have any identifiable associated conditions and was not taking any medications known to pose a risk. Therefore, treatment was focused solely on managing the complications of portal hypertension. Outpatient follow-up included the eradication of esophageal varices. Treatment with oral iron supplements led to the normalization of hemoglobin levels, which remained stable for months after the discontinuation of therapy, and liver function tests continued to be normal.

Efficacy of Epoetin Alfa in Managing Symptomatic Anaemia in Low-Risk Myelodysplastic Syndromes: A Retrospective Analysis.

Background Myelodysplastic syndromes (MDS) are clonal myeloid disorders characterised by ineffective haematopoiesis, leading to anaemia that often requires dependence on red blood cell (RBC) transfusions. Epoetin alfa (Eprex®) is now a mainstay in the management of symptomatic anaemia in low-risk MDS patients, reducing transfusion dependence and improving the quality of life in this patient group. Objective This retrospective study aimed to assess the efficacy of epoetin alfa in treating symptomatic anaemia in low-risk MDS patients, focusing on transfusion independence and its relationship with baseline erythropoietin (EPO) levels and haemoglobin (Hb) response. Methods Data from 56 patients with low-risk MDS treated with epoetin alfa at Norfolk and Norwich University Hospital,Norwich, United Kingdom, between 2018 and 2023 were retrospectively analysed. Baseline EPO levels, transfusion history, Hb response, and the duration of transfusion independence were assessed. Statistical analyses were performed to evaluate the correlation between baseline characteristics and treatment outcomes. Results Among the patients, 98.2% had baseline EPO levels below the 500 IU/L threshold, with a median EPO level of 74.3 IU/L. Following an eight-week trial of 30,000 units of epoetin-alfa, 41.1% of patients showed improved Hb levels, 41.1% maintained stable Hb levels, and 17.9% experienced a decline. A significant correlation was found between lower baseline EPO levels (<250 IU/L) and a positive treatment response (p = 0.0065). Additionally, patients who required fewer transfusions before treatment had longer durations of transfusion independence (correlation coefficient = -0.40, p = 0.015). Dose escalation to 60,000 units provided a benefit to 53.3% of patients with initially stable Hb levels. The average duration of transfusion independence was 8.1 months, and patients with improved Hb levels had the longest periods of transfusion independence (p = 0.005). Conclusion Epoetin alfa is an effective therapy for managing symptomatic anaemia in low-risk MDS patients. This study highlights its efficacy and provides valuable predictive information, particularly showing that patients with lower baseline EPO levels are more likely to respond to treatment. While prior transfusion dependence did not significantly predict response to therapy in this cohort, it was associated with the duration of transfusion independence.

The Current Role of Hydroxyurea in the Treatment of Sickle Cell Anemia.

Despite advancements in treatment of sickle cell disease (SCD), hydroxyurea, a ribonucleotide reductase inhibitor, remains the cornerstone of therapy. While its primary effect is the elevation of fetal hemoglobin (HbF), hydroxyurea's mechanisms of action are multifaceted. Hydroxyurea (HU) reduces leukocyte and platelet counts, decreases the expression of endothelial adhesion molecules CD36 and CD49d, and increases nitric oxide and cyclic nucleotide levels, which may facilitate vascular dilation and further HbF induction. Numerous studies have demonstrated that hydroxyurea therapy reduces the frequency of painful episodes, acute chest syndrome, and the need for erythrocyte transfusions and hospitalizations. Long-term use of hydroxyurea leads to reduced morbidity and mortality. Hydroxyurea should be initiated in children from 9 months of age, including asymptomatic individuals, and is recommended for adults experiencing pain crises that significantly interfere with daily activities or quality of life, as well as those with severe or recurrent vaso-occlusive crises, ACS, or severe symptomatic anemia. Hydroxyurea is not recommended during pregnancy or lactation due to potential teratogenic effects and transfer into breast milk. However, its use may be considered in high-risk patients, particularly during the second and third trimesters. Concerns about secondary tumor development have not been substantiated in long-term follow-up studies. Alternative therapies, including L-glutamine, crizanlizumab, and voxelotor, are not presently approved or available for clinical use in Europe.

Cost Reduction in Blood Transfusions After Implementation of Decision Protocol Based on Hemoglobin and Anemia Symptoms: A Pre-Post Analysis

Cost Reduction in Blood Transfusions After Implementation of Decision Protocol Based on Hemoglobin and Anemia Symptoms: A Pre-Post Analysis

Where did my O units go? Assessing a Month of O RBC Utilization in a Level 1 Trauma Center

Abstract Introduction/Objective The availability of red blood cells (RBCs) can be unpredictable and influenced by various factors affecting inventory levels. Anticipating future requirements can prove difficult, particularly in medical facilities catering to both trauma and chronically ill patients. By analyzing the fluctuation in blood indications, we can improve our planning and promote the responsible use of O RBCs. Methods/Case Report O units transfused in December 2023 in a level 1 trauma center were reviewed for transfusion indication, which was categorized into symptomatic anemia (SA), bleeding, sickle cell-related transfusion (SCRT), and surgery-related transfusion (SRT). Results (if a Case Study enter NA) During this month, our institution transfused 320 O units, of which 79% (254/320) were D positive. Most RBCs were given to patients with bleeding (43%,136/320) and SA (36%, 115/320). About half of the units used for acutely bleeding patients had massive transfusion protocol (MTP) activated (48%, 51/105), with 2/3 of those units used for trauma patients. Because most of our patients are African Americans, SCRT was also evaluated. Only 17/320(5%) of the units were given to our sickle cell disease patients. Lastly, we evaluated SRT because of our busy surgical service. We noted that 46 (14%) are SRT units, with 20% used prophylactically on the same admission and 50% used post-operatively. Conclusion It’s important to note that while patients with acute bleeding can cause a sudden depletion in the blood supply, patients with chronic anemia and bleeding can still make up a significant portion of those who require RBCs in a level 1 trauma hospital. In such a setting, where cases requiring MTP can be unpredictable, managing inventory levels can be challenging, and it requires careful monitoring to ensure that the appropriate blood units are used.

A 6-month Review of O pRBC Utilization in Non-O Blood Type Patients in a Level 1 Trauma Center

Abstract Introduction/Objective Using O pRBCs for non-O patients for acute events is not unusual in a level 1 trauma hospital. However, we occasionally utilize this blood type to meet the needs of our patients that are not acutely bleeding. In this study, we evaluated the utilization of O units in non-O patients to improve our transfusion practices. Methods/Case Report We reviewed the indications of the O pRBCs transfused to non-O patients from October 2023 to March 2024. We evaluated the number of units used in acute events such as massive transfusion protocol (MTP), acute blood loss, sickle cell disease (SCD) patients in crises, bleeding associated with surgery and in patients with symptomatic anemia. Results (if a Case Study enter NA) There were 258 O pRBCs transfused to non-O blood type from October 2023 to March 2024. 135(52%) of these units were used for bleeding patients, of which 91%(124/135) were used for acute events. Most of the units utilized for acute hemorrhage had activated MTP (92%, 89/124) due to trauma (88%, 78/89). Only 12%(31/258) were used by SCD patients, with a little over half of these units being used acutely and the rest used prophylactically. About 69% of the 16 units used in surgery were due to bleeding. Lastly, 76 units (29%) were used for symptomatic anemia patients with 45% of these units transfused for anemia of prematurity. Conclusion In a level 1 trauma hospital, advocating for conserving O units is crucial to ensure enough units are available for trauma. As anticipated, acute bleeding was found to be the leading cause for patients with non-O blood types to receive O pRBCs. Notably, the prevalence of using O units for acute and prophylactic transfusion is relatively the same for SCD patients and phenotypically matching the Rh and Kell systems likely plays a role.

Hyperbaric Oxygen Therapy: An Evidence-Based Primer for Emergency Physicians

BackgroundHyperbaric medicine is a subspecialty that many emergency physicians may not encounter frequently in their daily practice. As such, we hope to provide a review, where we present an overview of hyperbaric oxygen therapy, complications from the therapy, and a description of how the treatments are administered. We also discuss seven emergency indications that may benefit from transfer to a hyperbaric facility for treatment. Objective of the ReviewOur aim is to provide an overview of hyperbaric oxygen therapy as it pertains to an emergency physician. We hope that this review will help emergency physicians identify conditions that may benefit from transfer to a hyperbaric facility. DiscussionWe discuss seven emergency conditions that may benefit from transfer to a hyperbaric facility for management – decompression sickness, arterial gas embolism, central retinal artery occlusion, carbon monoxide poisoning, crush injury, necrotizing soft tissue infection, and symptomatic anemia. We also describe special considerations for how to transfer patients needing evaluation by a hyperbaric physician. ConclusionsThis review aims to describe hyperbaric oxygen therapy, identify conditions that may benefit from treatment with hyperbaric oxygen, and discuss management of patients with those conditions as it pertains to an emergency physician.

S4741 Distal Jejunal Metastatic Melanoma Presenting as Symptomatic Anemia

S4741 Distal Jejunal Metastatic Melanoma Presenting as Symptomatic Anemia

A study to reveal the rationales of overnight transfusion in a training and research hospital

BackgroundMonitoring of overnight transfusions would be beneficial to improve blood transfusion safety. The objective of this study was to prospectively evaluate the practice and need for overnight transfusions (OT) in a teaching and research hospital. MethodsThe study was conducted on data from patients who received packed red blood cells (PRBCs) transfusions between 11 September and 13 October 2023 at a Training and Research Hospital in Ankara, Turkey. Clinical data of patients were obtained from the Hospital Database Management System (HDBS) and blood transfusion order forms. The critical time point of the transfusion process was recorded using HDBS. ResultsA total of 1502 PRBCs transfusions were noted during the study period, of which 400 (26.6%) were OT. OT was most frequently administered to patients with symptomatic anemia (34.6%; 138/400) and patients with an Hb level <7 (27.7%; 111/400). The time interval in which OT was most frequently ordered was between 15:00 and 17:00 [20.2% (81/400)], while the most frequent time to start transfusion was between 17:00 and 19:00 [22% (88/400)]. The average time taken from ordering OT to starting OT was 3 hours 41 minutes. The most of patients (36.8%; 91/248) were discharged after 48 hours of transfusion or were still in the hospital for more than 48 hours (20.3%; 50/248). ConclusionTo ensure transfusion safety by reducing OT to a minimum, OT should be used only in emergencies, policies should be put in place to make sure that transfusions can be done during the day easily, and healthcare professionals should be made aware of this issue.

Intravenous versus oral iron for anaemia among pregnant women in Nigeria (IVON): an open-label, randomised controlled trial

Oral iron for anaemia in pregnancy is often not well tolerated, with poor adherence. Iron administered intravenously might address these tolerance and adherence issues. We investigated the effectiveness and safety of intravenous ferric carboxymaltose versus oral ferrous sulphate on anaemia and iron deficiency among pregnant women in Nigeria. We did a multicentre, open-label, parallel, randomised controlled trial of pregnant women (aged 15-49 years) with haemoglobin (Hb) concentrations of less than 10 g/dL at 20-32 weeks' gestation from 11 primary, secondary, or tertiary health facilities in Nigeria (five in Lagos and six in Kano). Exclusion criteria included vaginal bleeding, blood transfusion or major surgery within the past 3 months, symptomatic anaemia, anaemia known to be unrelated to iron deficiency, clinically confirmed malabsorption syndrome, previous hypersensitivity to any form of iron, pre-existing maternal depression or other major psychiatric illness, immune-related diseases, such as systemic lupus erythematosus or rheumatoid arthritis, or severe allergic reactions. Participants were randomly assigned (1:1) by nurses and doctors using a web-based randomisation service to either receive a single dose of intravenous ferric carboxymaltose (20 mg/kg to a maximum of 1000 mg) or oral ferrous sulphate (200 mg; 65 mg elemental iron) three times daily until 6 weeks postpartum. The study was primarily unmasked. Primary outcomes were maternal anaemia (Hb <11 g/dL) at 36 weeks' gestation and preterm birth at before 37 weeks' gestation, with analysis by intention to treat in participants with available data. This study was registered at the ISRCTN registry on Dec 10, 2020 (ISRCTN63484804) and on ClinicalTrials.gov (NCT04976179) on April 7, 2021. Between Aug 10, 2021, and Dec 15, 2022, 13 724 pregnant women were screened for eligibility. 12 668 were excluded due to ineligibility for inclusion, and 1056 provided consent to participate and were randomly assigned to either the intravenous or oral administration groups. 527 were assigned to the intravenous ferric carboxymaltose group and 529 were assigned to the oral ferrous sulphate group. 518 in the intravenous group were assessed at 36 weeks' gestational age and after 518 deliveries, and 511 completed the 6 weeks postpartum visit. 513 in the oral ferrous sulphate group were assessed at 36 weeks' gestational age and after 512 deliveries, and 501 completed the 6 weeks postpartum visit. No significant difference was found in anaemia at 36 weeks (299 [58%] of 517 in the intravenous group vs 305 [61%] of 503 in the oral group; risk ratio 0·95, 95% CI 0·85-1·06; p=0·36), nor in preterm birth (73 [14%] of 518 vs 77 [15%] of 513; 0·94, 0·70-1·26; p=0·66). There were no significant differences in adverse events. The most common adverse events were diarrhoea (in six participants) and vomiting (in three participants) in the oral group and fatigue (in two participants) and headache (in two participants) in the intravenous group. Although the effect on overall anaemia did not differ, intravenous iron reduced the prevalence of iron deficiency to a greater extent than oral iron and was considered to be safe. We recommend that intravenous iron be considered for anaemic pregnant women in Nigeria and similar settings. Bill & Melinda Gates Foundation.

A Case of Thrombotic Thrombocytopenic PurpuraInitially Suspected as Shiga Toxin-Producing Escherichia coli Hemolytic Uremic Syndrome Due to the Preceding Symptoms of Hemolytic Anemia with Vomiting, Hematochezia, and AKI

A Case of Thrombotic Thrombocytopenic PurpuraInitially Suspected as Shiga Toxin-Producing Escherichia coli Hemolytic Uremic Syndrome Due to the Preceding Symptoms of Hemolytic Anemia with Vomiting, Hematochezia, and AKI

O CUIDADO DA ENFERMAGEM AO PORTADOR DA ANEMIA EM UNIDADE DE TERAPIA INTENSIVA.

The study on nursing care for patients with iron-deficiency anemia in the ICU underscores the relevance of this common and potentially serious condition, caused by insufficient iron levels in the body. This deficiency hampers hemoglobin production, resulting in symptoms such as fatigue, weakness, and difficulty concentrating. Factors such as blood loss, dietary iron deficiency, and underlying conditions contribute to the development of iron-deficiency anemia, especially in critically ill patients in the ICU. The research reviewed biochemical data for anemia in the ICU and highlighted the importance of nursing care in this context. Increased oxygen demand due to physiological stress can exacerbate symptoms of iron-deficiency anemia in critically ill patients, leading to severe complications and prolonged hospitalization. The literature review addressed the methodology used to identify best care practices, including searching electronic databases and analyzing institutional protocols. The discussion of results underscored the severity of iron-deficiency anemia in the ICU, emphasizing the need for effective interventions to improve clinical outcomes. The results and discussions highlighted the crucial role of nursing in caring for patients with iron-deficiency anemia in the ICU. From early symptom detection to appropriate treatment administration, the nursing team plays a crucial role in patient recovery. Challenges such as constant monitoring, iron supplementation administration, and blood transfusions were discussed, emphasizing the need for continuous education and specialized training of the healthcare team. Finally, the concluding remarks emphasized the importance of a coordinated and continuous approach in managing iron-deficiency anemia in the ICU. The implementation of evidence-based practices, along with continuous team training, is essential for providing high-quality care and improving outcomes for patients.

ASSOCIATION OF SOCIODEMOGRAPHIC FACTORS AND DIETARY PREFERENCE WITH ANAEMIA AMONG MALES: A CROSS SECTIONAL STUDY

Background: Anaemia is a problem of paramount importance but research about its impact and socio-demographic characteristics in adult men is scanty. The current study aimed to determine the frequency and association of socio-demographic factors and dietary preference with anaemia in male patients. Methods: This cross-sectional study was conducted in Department of Medicine, Ayub Teaching Hospital Abbottabad. A total of 144 patients were enrolled. Patients were interviewed on basis of a questionnaire and examined for symptoms of anaemia. Admitted patients from medicine ward who were aged above 20 years were included in the study. Unconscious patients and those who were unable to communicate were excluded from the study. Data was analyzed using SPSS-22. Results: This study included a total of 144 patients. Respondents were in the age range of 22–90 years with mean age 49.66±16.474 years. A total of 90 (62.5%) patients belonged to rural areas and 54 (37.5%) belonged to urban areas, 50 (34.7%) were unemployed and 94 (65.3%) were employed. Presence of anaemia was found to be significantly associated with concomitant presence of chronic diseases (p&lt;0.05). Conclusion: Moderate anaemia is common in our males, and is significantly associated with presence of chronic diseases. No significant association of anaemia was found with dietary preferences. Pak J Physiol 2024;20(3):56–8, DOI: https://doi.org/10.69656/pjp.v20i3.1754

Anemia in patients with cartilage hair hypoplasia: a narrative review and recommendations.

Cartilage hair hypoplasia (CHH) can lead to the development of anemia as a possible complication of this rare genetic disease. Despite various publications on anemia in CHH patients, a comprehensive review on this topic has not been conducted. This article reviews publications on anemia in CHH patients published from 1981 to 2022. Most authors have reported macrocytic anemia and blood transfusion as a common treatment approach in this patient group. Recommended guidelines for managing anemia in CHH patients include iron chelation therapy for those requiring multiple blood transfusions, regular assessment of anemia symptoms, red blood cell parameters, and immune system function. Future studies should evaluate the erythroid system in a larger cohort of CHH patients, considering key factors such as concurrent illnesses, age, height, and weight.