Type Of Anemia Research Articles

Clinical manifestations of 17 Chinese children with hereditary spherocytosis caused by novel mutations of the ANK1 gene and phenotypic analysis.

Background: Hereditary spherocytosis (HS) is an autosomal dominant (AD) and autosomal recessive (AR) disorder that is mostly caused by mutations of the erythrocyte membrane-related gene ANK1. Methods: Clinical and genetic testing data of 17 HS children with ANK1 gene mutations were retrospectively collected. Clinical manifestations and phenotypic analysis of HS were summarized based on our experience and literature review. Results: A total of 17 mutations of the ANK1 gene were identified from 17 probands (12 sporadic cases and five familial cases), including 15 novel mutations and two previously reported ones. Among the 15 novel variants of ANK1, there were four non-sense mutations, four frameshift mutations, three splicing mutations, three missense mutations and one in-frame deletion of three amino acids. In the present study, HS patients with mutations in membrane binding domains had significantly lower hemoglobin (Hb) levels and higher total bilirubin (T-Bil) levels than those with mutations in regulatory domains. After reviewing and analyzing all available published reports of Chinese HS patients carrying ANK1 mutations in PubMed and Chinese journals, there were no significant differences in Hb, Ret and T-Bil between different mutation types or mutation regions. Conclusion: Mutations of the ANK1 can be inherited or de novo. Clinical manifestations of HS in children caused by ANK1 mutations are similar to those of other types of hemolytic anemia. Our report expands the mutation spectrum of HS, thus providing references for clinical management and genetic counseling of HS.

EFFECT OF ASSOCIATION OF THROMBOCYTOPENIA WITH ANEMIA ON FETO-MATERNAL OUTCOME

Objectives: To find out effect of association of thrombocytopenia with anemia on feto-maternal outcome. Background: Thrombocytopenia is defined as platelet count less than 150,000/mm3. It is a second common hematological disorder in pregnancy, anemia being the most common. The exact mechanism of Anemia and Thrombocytopenia is not well understood. There is scarcity of literature on association between Anemia and Thrombocytopenia. Pubmed mostly revealed case reports and case series with only a few studies related to our topic. It is pertinent to mention here that most of the studies have been conducted on Paediatric age group. Therefore, the present study is planned to evaluate the effect of association of thrombocytopenia with anemia on feto-maternal outcome. Methodology : The study was conducted after taking informed consent from the patients in the Department of Obstetrics and Gynaecology, with the collaboration of Department of Pathology and Department of Pediatrics, JNMCH, AMU, Aligarh (U.P) on 360 pregnant women at 26-32 weeks of gestation. Complete Blood Count (CBC) and Red cell indices were calculated by Automated Haemotology (H3D Premier Diagnova) Analyzer. Type of anemia was determined on the basis of general blood smear and on indices. Appropriate therapy was given and response seen after 4 to 6 weeks. During labour and after delivery, feto-maternal outcome was evaluated. All the qualitative variables were analyzed using Pearson Chi square test while all quantitative variables were analyzed using independent sample test and Kruskal-Wallis one-way ANOVA test. Results: The association of thrombocytopenia with anemia was highest in cases of dimorphic anemia and lowest in cases of megaloblastic anemia while only 15% of control were having thrombocytopenia in the present study. The maternal outcome in terms of preterm labor, PPH, duration of hospital stay after delivery, maternal sepsis, DIC, bleeding from any other site between cases and controls was not significant. Fetal outcome between cases and controls in terms prematurity, birthweight, neonatal infections, NICU admissions, intracranial hemorrhage, still births was not statistically significant. Only the mean 1 minute Apgar score was lower in cases as compared to controls and this was statistically significant. Conclusion : It can be concluded that there is an association that exists between hemoglobin and platelet count. Appropriate therapy corrects anemia and improves platelet count. Timely detection and correction of anemia with thrombocytopenia reduces intrapartum and postpartum complications. In order to reduce maternal and neonatal morbidities, careful surveillance is required of all pregnancies for early detection and treatment of anemia.

P174 Uncontrolled depression and female gender increase the risk of severe fatigue in patients with inflammatory bowel disease under infliximab therapy.

Abstract Background Fatigue is a significant predictor of worst health-related qualify of life in inflammatory bowel disease (IBD) patients. Nevertheless, the role of fatigue in IBD patients under infliximab (IFX) therapy has been poorly investigated. The aim of the study was to evaluate the potential factors associated with fatigue in patients under maintenance treatment with IFX. Methods A prospective observational cohort study was designed. All IBD patients aged 18 and over under maintenance treatment with intravenous (IV) infliximab were consecutively included at the infusion day. Patients completed 3 self administered questionnaires. Fatigue was assessed with the Fatigue Impact Scale (FIS), quality of life with the Inflammatory Bowel Disease Questionnaire-Short From (IBDQ-9) and anxiety and depression using the Hospital Anxiety and Depression scale (HAD). We considered the maximum total FIS as the highest fatigue perception. Disease activity was defined in Crohn’s disease as a Harvey-Bradshaw index >4, and in ulcerative colitis (UC) as a Partial Mayo index >2. Patient demographics and disease characteristics were also collected: age, sex, disease duration, smoking habit, type of IBD, extra-intestinal manifestations, clinical activity, prior surgery, obesity, anemia, treatments (steroids, immunosuppressants, anxiolytics, antidepressants) and presence of anxiety or depression. Multiple linear regression was used to identify the variables associated with the presence of fatigue. Results Ninety patients were consecutively included (49 female, median age 42 years, interquartile range 19). Sixty three patients (70%) had Crohn’s disease (46.8% fistulising and 25.8% stenosing behaviour) and twenty seven ulcerative colitis (30%). Nearly 27% were smokers, 35 (39%) presented anxiety and 18 (21%) depression. Approximately, 8% of the patients and 7% received treatment for anxiety and depression, respectively, but only 2/18 patients with current depression received antidepressants. Combotherapy was present in 41% of the patients and 75.6% were in clinical remission. Mean fatigue was 32.74 ± SD 17.27. The highest scores for fatigue were associated with female gender (B = 10.936; P= 0.009) and the presence of depression (B = 11.114; P = 0.029). Activity disease almost increased significantly the severity of the fatigue(B = 8.995; P= 0.063). The use of antidepressants not increased the risk (B = -4.995; P = 0.555). Patients with fatigue had significantly reduced the quality of life (r = -0.638; p < 0.001) (Figure 1). Conclusion Uncontrolled depression and female gender increased the risk of severe fatigue more than disease activity in patients under maintenance treatment with IFX. Fatigue is related to worst health-related qualify of life.

The effect of different types of anemia on HbA1c levels in non-diabetics

BackgroundDiabetes mellitus is one of the most common diseases worldwide with significant morbidity and mortality. HbA1c remains one of the most important methods for diagnosis and monitoring of the disease. Since HbA1c is a reflection of the glucose attached to red blood cells, factors affecting hemoglobin and red blood cells’ half-life can influence HbA1c measurements.ObjectiveThis study aims to evaluate the effect of different types of anemia including iron deficiency anemia, sickle cell anemia, β -thalassemia trait, and megaloblastic anemia on HbA1c levels in a tertiary hospital over the past 6 years (2016–2022).MethodThis is a retrospective chart review study of 324 patients including those with one of the four types of anemia mentioned above and a control group. The control group were healthy adults with normal HbA1c and hemoglobin, who were not known to have diabetes or anemia. Patients with diabetes or prediabetes based on self-reporting or elevated fasting, random blood sugar, or 2 hours post-prandial blood glucose were excluded.ResultsThe mean HbA1c levels were significantly higher in sickle cell anemia at 5.83% (95% CI = 5.39–6.28) and in iron deficiency anemia at 5.75% (95% CI = 5.68–5.82) when compared to the control group at 5.32% (95% CI = 5.22–5.41). However, the mean HbA1c levels in megaloblastic anemia were 5.38% (95% CI = 5.26–5.5) and 5.45% (95% CI = 5.21–5.69) in beta thalassemia trait, which were not significantly different when compared to the control group. HbA1c significantly decreased from 5.75 to 5.44% after treatment in the iron-deficient group with a p-value of < 0.001. Moreover, lower hemoglobin and higher red cell distribution width correlated with higher HbA1c levels in patients with sickle cell anemia.ConclusionThis study found a significant increase in HbA1c levels in iron deficiency anemia and sickle cell disease in patients not known to have diabetes. However, there was no significant effect in those patients with β-thalassemia trait and megaloblastic anemia. Treatment of iron deficiency anemia significantly decreased the HbA1c level, bringing it back to normal.

The role of perinatal phenotyping in confirming the molecular diagnosis of congenital dyseryhtropoietic anaemia type I (CDA1) – a case report

Congenital dyserythropoietic anaemia type I (CDA1) is an autosomal recessive disorder characterised by macrocytic anaemia and ineffective erythropoiesis. A family with a prenatal presentation of severe hydrops fetalis at 20 weeks gestation were referred for trio whole exome sequencing, which identified a homozygous variant in the CDAN1 gene (NM_138477.2:c.3107C>T, p.(Ser1036Phe)), which was classified as a variant of uncertain significance based on the following ACMG criteria: PS4_supporting, PM2_supporting and PP3.

Digital necrosis secondary to cold agglutinin disease: A rare clinical image

Cold Agglutinin Disease (CAD) is a rare entity of Autoimmune Hemolytic Anemia (AHAI) type immunoglobulin M characterized by destruction of red blood cells at low temperature. It affects one person in a million. Etiological evaluation is essential for managing the cause in addition to symptomatic treatment.

Haemoglobin levels and outcomes of subgroups of patients with pre-operative anaemia based on red cell size: A retrospective cohort study.

Pre-operative anaemia is common and associated with adverse outcomes. We hypothesised that pre-operative anaemia would be evident more than 1 month pre-operatively, and that peri-operative changes in haemoglobin and post-operative outcomes differed between red cell size-based subsets of anaemia. A retrospective single-centre cohort study, including all patients 18 years and older undergoing their first surgery at Landspitali between January 2006 and December 2018 with available measurement of haemoglobin (Hb) within 30 days preceding surgery. Clinical data were compared between patients with subgroups of anaemia classified by mean corpuscular volume (MCV) into microcytic (MCV < 80 fl), normocytic (MCV 80-100 fl), and macrocytic (MCV > 100 fl) anaemia. The development of haemoglobin measurements from a nationwide database was plotted from 1 year pre-operatively to 2 years post-operatively. Of 40,979 patients, 10,505 (25.6%) had pre-operative anaemia, of which 1089 (10.4%) had microcytic anaemia, 9243 (88.0%) had normocytic anaemia, and 173 (1.6%) had macrocytic anaemia. Patients within all subgroups of pre-operative anaemia had a higher degree of comorbidity and frailty burden and a low haemoglobin evident for more than 100 days pre-operatively and similar changes post-operatively. Post-operative prolonged recovery of haemoglobin was slower for macrocytic anaemia than other types of anaemia. All groups of patients with anaemia had a higher incidence of 30-day mortality, acute kidney injury, and rate of readmission compared with patients without anaemia. Pre-operative anaemia is evident long prior to the procedure and its association with worse outcomes is similar regardless of red cell size.

Anemia of chronic diseases: current state of the problem and perspectives

Anemia of chronic diseases is a condition, that accompanies several chronic conditions, that have inflammation as an underlying cause. The article covers current concepts of pathogenesis, evaluation and treatment of this type of anemia. The new perspectives in the development of investigational methods and treatment are discussed. The new methods of iron deficiency assessment in patients with systemic inflammation are discussed separately.

A study of correlation between pre-pregnancy weight, gestational weight gain, erythropoiesis-related micronutrient levels in term pregnant women and the birth weight of the baby

Introduction and Aim: Adequate Nutrients intake is very crucial for the health of pregnant women and the fetus. Inadequate intake will cause maternal anemia, increase the likelihood for the Antepartum and postpartum maternal complications, fetal growth restriction resulting in low birth weight (LBW) babies. Micronutrients which are involved in erythropoiesis may affect the birth weight of the newborn. The objective was to study the correlation between the pre-pregnancy weight, gestational weight gain, erythropoiesis-related micronutrient levels in apparently normal term pregnant women and birth weight of the baby. Materials and Methods: An Institutional ethical clearance was obtained. A total of 168 term pregnant women were selected for the present study. They were apparently normal term pregnant women who were willing to participate and who gave consent were included. Maximum of 86.9% of study subjects belonged to the age group of 21-30 years. The present hospital based cross sectional study was conducted in the department of OBG of tertiary care centres of North Karnataka between December 2019 to February 2020. Sample size was estimated to be 158. Results: In this study, we found that there is a statistically significant positive correlation between the maternal weight in first trimester, maternal weight at term, gestational weight gain, maternal serum ferritin, Serum total Iron binding capacity, Serum Vitamin B12, and Serum folic acid. The association was found between the type of anemia and birth weight of the baby with Odds ratio (95% CI): 2.01(0.71-5.64), p=0.08, though it is not statistically significant. Conclusion: Hence there is an association between pre-pregnancy weight, gestational weight gain and erythropoiesis-related micronutrients and birth weight of the baby. Hence it is very important to provide nutrition education to pregnant women along with iron and folic acid supplementation, other micronutrients which affect the pregnancy outcome.

Analisis Titer dan Subtipe Antibodi pada Inkompatibilitas ABO yang Menyebabkan Hemolytic Disease of Fetus and Newborn

Background: Hemolytic disease of the fetus and newborn (HDFN) is a type of anemia in the fetus or newborn. Clinical features of HDFN such as hepatosplenomegaly, liver failure, ascites, at birth die from heart failure to brain damage. One of the most common causes is incompatibility of blood groups such as ABO. Differences in clinical manifestations that occur in HDFN are caused by differences in antibody titers and IgG subtypes.Objective: The aim of this study was to determine the anti-A and anti-B antibody titers and the types of immunoglobulins that affect HDFN due to ABO incompatibility.Methods: The sample used in this study was blood and umbilical cord blood from 30 pairs of mother-babies who had different blood groups. Titration examination by tube method and IgG subtype by ELISA method were performed on maternal samples.Results: The correlation of total bilirubin levels with maternal Anti-A and Anti-B titers are p= 0.023 and p= 0.001, in addition there are significant increase in OD of Anti-A IgG1 and Anti-B IgG1 againts elevated infant bilirubin levels.Conclusion: IgG titers &gt;8 causing hyperbilirubinemia, but no jaundice and IgG titers &gt;16 causing hyperbilirubinemia to jaundice. The IgG subtype that plays a more role in causing clinical problems is IgG1.

Study of etiological patterns and various clinical presentations of anemia in children aged 6 months to 5 years admitted in a tertiary care hospital

Background: Nutritional anemia (NA) is the commonest cause of anemia in children. Iron deficiency is the most important contributing factor to nutritional anemia. Severe iron deficiency is associated with impaired brain development along with cognitive, behavioural, and psychomotor manifestations, particularly during the first two years. This study aimed to evaluate the clinical and etiological profile of anemia in children aged 6 months to 5 years. Material and methods: Hospital-based observational study conducted on children between 6 months to 5 years of age, admitted to Government General Hospital, Srikakulam and having anemia according to WHO classification. Results: Of the 157 children diagnosed with anemia over 18 months period, iron deficiency anemia is the commonest cause of anemia, seen in 107 children followed by sickle cell anemia seen in 21 children. Out of the sampled children, 154 children recovered, and 3 children succumbed to death. Conclusion: Nutritional anemia, particularly iron deficiency anemia is the most common type of anemia in 6 months to 5 years-old children. Co-morbidities like malnutrition, parasitic infestations, diarrheal diseases, and recurrent respiratory tract infections form a vicious cycle and result in nutritional anemia. Identifying the factors that are leading to iron deficiency anemia and implementing the control measures like early iron supplementation results in reducing morbidity and mortality.

A Cross-Sectional Study of Lipid Profile in Anemic Patients in a Tertiary Care Center

Background: Various studies have reported a correlation (both positive and negative) between the status of anemia and lipid profile. Studies observed that the lipoproteins levels were significantly lower in anemic patients, and this reduction was proportional to the severity of anemia and not related to the type of anemia. Objectives: To study the lipid profile among the anemia patients and the correlation between the severity of the anemia and lipid subfractions. Materials and Methods: This is a cross-sectional study among 85 subjects with anemia in a Tertiary care hospital, who satisfied the eligibility criteria. After detailed history, clinical examination and blood investigations including blood counts, hemoglobin, and lipid profile were done. Results: The mean hemoglobin (g/dL) among the subjects was 7.86 (±2.03) g/dL ranging from 3 to 11 g/dL. Among the 85 subjects, 35 (41.18%) had dimorphic anemia followed by 21 (24.71%) had microcytic hypochromic anemia, 15 (17.65%) had normocytic hypochromic anemia, and 14 subjects (16.47%) had normocytic normochromic anemia. Body mass index was not significantly associated with the type and severity of anemia. Lipid subfractions were not associated with the type of anemia and significantly decreased with an increase in the severity of anemia. Conclusion: The lipid profile parameters in our study were not associated with type of anemia and significantly decreased with an increase in the severity of anemia.

Burden of Anaemia and its Impact on Lymphoma Patients in Southern Rajasthan, India: A Cross-sectional Study

Introduction: The frequency of lymphoma is progressively rising. A key clinical feature of lymphoid malignancies is anaemia. The impact of anaemia goes beyond physical symptoms and can negatively affect functional capacity and Quality of Life (QoL). The presence of anaemia has been identified as a predictive factor for event-free and disease-free survival in patients diagnosed with lymphoma and is regarded as a significant unfavourable predictor for treatment results. Aim: To investigate the prevalence and impact of anaemia in naive lymphoma patients. Materials and Methods: This hospital-based, cross-sectional study was conducted in the Department of Pathology at Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India, from January 2019 to December 2022. A total of 66 patients diagnosed with lymphoid malignancies were included in the study. Various parameters of lymphoma cases were assessed to determine the presence of anaemia and its association with demographic features, disease stage, and haematological indices. Statistical analysis was carried out using Statistical Package for Social Sciences (SPSS) version 20.0 The Pearson's Chi-square test was used to analyse the difference in the prevalence of anaemia in different groups. Results: The mean age of the study patients was 47.35±20.60 years .The present study included 66 patients with lymphoid malignancies and revealed a high incidence of anaemia among them, with 38 (57.58%) cases presenting with anaemia. There was a male predominance, with 52 (78.79%) out of 66 patients male. Out of the total number of patients, 36 (54.55%) were classified as having stage I and stage II disease, while 30 (45.45%) had stage III and stage IV based on age, Ann Arbor staging, extranodal involvement, Lactate Dehydrogenase (LDH) level, and lymphoma prognostic score. Differentiation between anaemic and non anaemic patients was made by statistical analysis. Based on the findings from the complete blood count, the patients were categorised according to the severity and type of anaemia. It was determined that 38 out of 66 patients, accounting for 57.58%, had anaemia. Conclusion: Anaemia was more prevalent in younger patients and females. Microcytic hypochromic anaemia and Anaemia of Chronic Disease (ACD) were the most common types observed. Anaemia was associated with bone marrow infiltration and advanced disease stages. The present study emphasised the importance of early diagnosis and appropriate management of anaemia in lymphoma patients, as it can negatively impact treatment outcomes and reduce QoL.

Types of Anemias and Iron Deficiency Frequency in Hospitalized Patients with Decompensated Heart Failure: Internal Medicine Clinic Experience

Types of Anemias and Iron Deficiency Frequency in Hospitalized Patients with Decompensated Heart Failure: Internal Medicine Clinic Experience

В12-дефицитная анемия в сочетании с активной цитомегаловирусной инфекцией у ребенка одного года

The article presents a clinical case of B12-deficiency anemia in combination with active cytomegalovirus infection in a one-year-old child. This type of anemia is extremely rare in childhood, under certain circumstances, including the enthusiasm for restrictive diets among young patients’ mothers. In the described case, severe megaloblastic macrocytic anemia was combined with generalized cytomegalovirus infection, which aggravated the course and prognosis of the disease. These pathologies led to damage of the central nervous system with a tempo neurological deficit, as well as the development of protein-energy insufficiency. Complex therapy included hemotransfusion of erythrocyte mass, injections of anticytomegalovirus immunoglobulin and cyanocobalamin. The general condition of the child improved, recovery of previously lost skills and significant positive laboratory dynamics were noted after the therapy.

Cirrhosis-induced oxidative stress in erythrocytes: The therapeutic potential of taurine.

Cholestasis/cirrhosis could induce erythrocyte lysis. The incidence of various types of anemia in cirrhosis is approx. 75%. Several studies have mentioned the pivotal role of oxidative stress in this complication. Taurine (TAU) is the human body's most abundant free amino acid. TAU is known as a robust cell membrane stabilizer. Many studies have mentioned that TAU could counteract oxidative stress in various experimental models. The current study was intended to evaluate the effect of TAU on erythrocytes in cirrhotic rats. Bile duct ligation (BDL) surgery was carried out on rats. Then, complete blood count (CBC), hemoglobin (Hgb), hematocrit (HTC), and erythrocytes' G6PD, catalase (CAT), and superoxide dismutase (SOD) activity were measured. Moreover, biomarkers of oxidative stress were assessed, and the erythrocytes' morphological changes were monitored in the cirrhotic mice exposed to TAU (0.25%, 0.5%, and 1% w : v in drinking water). Significant changes in the assessed erythrocyte parameters (G6PD activity, Hgb, HTC, and erythrocyte count) and red blood cells (RBC) morphological alterations were detected on day 42 after BDL surgery. Biomarkers of oxidative stress also did not change at the time points, except on post-BDL days 28 and 42. A significant decrease in blood parameters was evident at post-BDL day 42. All doses of TAU (0.25%, 0.5%, and 1% w : v in drinking water) significantly improved erythrocyte parameters and encountered oxidative stress in the erythrocytes of cirrhotic animals. These data indicate that TAU could be a safe agent to mitigate cirrhosis-induced erythrocyte damage and anemia. Further investigations are necessary to prove this in clinical settings.

The effect of different types of anemia on HbA1c levels in non-diabetics

The effect of different types of anemia on HbA1c levels in non-diabetics

Assessment of anemia among pregnant women at Al-Zahraa teaching hospital

Objectives: To assess anemia among pregnant women, and to find out the relationship between pregnant women anemia and their sociodemographic data. Methodology: A descriptive study was carried out through the present study in order to achieve the early stated objectives. The study was began from May, 2021 to December, 2021. Results: The finding of this study reveals that most of the pregnant women had anemia with type of iron deficiency in second trimester were live in rural areas and did not receive adequate education. Also our study show that there was relationship between anemia and demographic data such as education, socioeconomic status. Conclusion: The present study show that most of pregnant women had anemia with the type of Iron Deficiency Anemia, also they had low educational level and insufficient socioeconomic status and they were live in rural area. Most of pregnant women were in second stage. The present study revealed that there was a relationship between anemia with, gestational age, educational level and socioeconomic status and residency. Recommendations: It is important for pregnant women to eat foods that contain iron and adhere to a balanced diet and take iron supplements during pregnancy and also during breastfeeding.

Congenital cardiac surgery in a patient with cold agglutinins

Cold agglutinin disease is a type of autoimmune haemolytic anaemia caused by autoantibodies that bind to red blood cell antigens at a cold temperature and causes extravascular haemolysis and sometimes thrombosis also. Due to exposure to a lower temperature during open-heart surgery, the activation of haemolysis may occur in the presence of cold agglutinin antibodies. We present the management of a cyanotic child who has undergone open-heart surgery after the detection of high cold agglutinin titres during routine pre-transfusion screening.

Intravenous iron sucrose in postnatal iron deficiency anaemia: A safe option

Introduction: Iron deficiency anaemia is the most common type of reversible anemia encountered during postpartum period and may lead to long-standing iron deficiency. If treated, it facilitates a healthy future for mother and children. Aims and Objectives: To know safety of intravenous iron sucrose in treatment of postpartum iron deficiency anaemia. Materials and Methods: 91 postnatal women with iron deficiency anaemia with haemoglobin between 7-10g/dl were included prospectively at IGGMCH Nagpur. These women were given 200 mg of elemental iron infused over 30 minutes every alternate day until the required dosage is infused. The blood samples of all the patients were collected and analyzed for Hb and other RBC indices before and after therapy. Result: Majority of the patients were multi-para (63.76%) belonging to lower socio-economic groups. All blood parameters were increased significantly when compared from baseline values. Mean raise in Hb, hematocrit, MCV, MCH, MCHC and serum ferritin are 1.3, 2.3, 3.4fL, 2.3pg, 3.5 gm/dl and 53.71mcg/l respectively after 30 days of treatment. Conclusion: Intravenous iron sucrose was very well tolerated and safe for treating postnatal iron deficiency anaemia.