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Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency
Published in Charles Theisler, Adjuvant Medical Care, 2023
Symptoms during a hemolytic episode may include dark urine, fatigue, paleness, rapid heart rate, shortness of breath, and yellowing of the skin (jaundice).1 In patients with glucose-6-phosphate dehydrogenase deficiency, hemolytic anemia is most often triggered by bacterial or viral infections or by certain drugs (antibiotics and medications used to treat malaria). A hemolytic episode can also occur after eating fava beans or inhaling pollen from fava plants (a reaction called favism).1 In the U.S., G6PD deficiency is more common among males (particularly African Americans).
Liver Diseases
Published in George Feuer, Felix A. de la Iglesia, Molecular Biochemistry of Human Disease, 2020
George Feuer, Felix A. de la Iglesia
This condition is usually associated either with production of deficient erythrocytes or with the hemolysis of the normal red cells due to antibodies or other hemolytic substances. The abnormalities leading to hemolytic anemias may be congenital, acquired, or associated with Rh-factor incompatibility. Hemolysis of normal red cells may occur following the transfusion of incompatible blood or the exposure to hemolytic substances such as poisons, sulphonamides, phenylhydrazines, snake venom, bacterial or protozoal toxins, and malaria. The serum of patients with excessive hemolysis often shows a mild to moderate unconjugated hyperbilirubinemia as the result of bilirubin overproduction. This mechanism, however, rarely causes severe jaundice unless the liver function is also impaired. Hemoglobinuria and excessive excretion of fecal urobilin and stercobilin, however, may occur (Figure 23). An overload of hemoglobin alone is generally insufficient to cause jaundice, and it may be necessary to have the preexistence of some degree of liver damage. Hepatic damage may be due to fatty infiltration associated with anemia or can be the result of direct toxic damage.
Dermatitis herpetiformis
Published in Lionel Fry, Atlas of Bullous Diseases, 2020
Hemolysis is one of the commonest side-effects and will occur to some extent in most patients. The degree of hemolysis varies between patients; in some it may be severe, with a sharp fall in hemoglobin concentration, and this will necessitate discontinuing dapsone. Hemolysis occurs early after starting the drug, and thus it is important to see the patient within 2 weeks and repeat the full blood count and also do a reticulocyte count. If severe hemolysis does not occur at the beginning of treatment, the length of time between follow-up appointments can be gradually lengthened, and at each visit the hematological parameters should be ascertained. Even patients established on dapsone should be seen at least every 6 months. If patients, or their ancestors, come from the Middle East it is important to establish that these patients are not glucose-6-phosphate dehydrogenase deficient. If they are, then dapsone should not be used. Deficiency of this enzyme will lead to severe hemolysis.
Ultrastructural analysis of nucleated erythrocyte in patients with autoimmune hemolytic anemia (AIHA)
Published in Ultrastructural Pathology, 2023
Jing Liu, Shuxu Dong, Yongxin Ru
AIHA caused by wAIHA, that is, polyclonal immunoglobulin (Ig) G that binds to RBC membrane proteins at an optimal temperature of 37°C, is the most prevalent subtype. It is characterized by extravascular hemolysis in spleen,1 occasionally coexisting with complement (C) activation.5 Both paroxysmal cold hemoglobinuria (PCH, DAT-positive for anti-IgG) and cold agglutinin syndrome (CAS, DAT-positive for anti-IgM) are categorized as cAIHA as they caused by subclasses of Igs (mostly of the IgM isotype) that target erythrocytes at 4°C.6 On the other hand, the diagnostic criteria for mixed AIHA include the presence of warm IgG and high-titer cold agglutinins.7 The atypical AIHA is an independent form defined as a negative DAT, but positive for IgM and IgA-driven wAIHA.1 The properties of the corresponding Abs were summarized by Barcellini et al .3 Correct identification of the antibody is important for accurate diagnosis of the disorder.
Protective effect of myricetin, apigenin, and hesperidin pretreatments on cyclophosphamide-induced immunosuppression
Published in Immunopharmacology and Immunotoxicology, 2021
Mehmet Berköz, Serap Yalın, Ferbal Özkan-Yılmaz, Arzu Özlüer-Hunt, Mirosław Krośniak, Renata Francik, Oruç Yunusoğlu, Abdullah Adıyaman, Hava Gezici, Ayhan Yiğit, Seda Ünal, Davut Volkan, Metin Yıldırım
MTT (3-(4, 5-dimethylthiazol-2-yl)-2, 5-di-phenyltetrazolium bromide) assay was used to analyze splenocyte proliferation [18]. After the experimental period the spleen was aseptically removed from the sacrificed rats and splenic single-cell suspensions were prepared as per the procedure mentioned in the section quantitative hemolysis assay. The cells were seeded at a density of 5 × 106 cells/well into the 96-well plate and incubated for 48 h at 37 °C in 5% CO2 condition. After incubation, 20 µL of MTT (5 mg/mL in PBS) solution was added to each well and cultured for a further 4 h. Finally, the formazan particles were dissolved by adding 100 µL of dimethyl sulfoxide (DMSO) to each well and the absorbance was measured in an enzyme-linked immunosorbent assay (ELISA) plate reader (VersaMax, Molecular Devices, Sunnyvale, CA) at 570 nm. The results are expressed as percentage of proliferation (%) compared to that of the control cells.
Study of haemolysis interference limit on serum potassium assay on Roche® Cobas 8000 and evaluation of corrected potassium
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2021
Claudio Ilardo, Amandine Lancien, Joël Barthes
Haemolysis is the destruction of red blood cells (erythrocytes) in the blood. Haemolysis can interfere with laboratory determinations. These interferences are due to the release in serum or plasma of constituents present in red blood cells. Haemolysis of samples is a problem that complicates the analysis and interpretation of potassium (K) results. K is one of the analytes most frequently measured in laboratories. The mean frequency of hemolyzed samples received in clinical laboratories can be as high as 3%, accounting to or over 60%–70% of unsuitable specimens [1]. Following the publication of Martinez-Morillo and Alvarez [2], the Roche® quality control centre conducted a new evaluation of the risk of overestimation of serum potassium results related to haemolysis and decided to adjust the H-index limit from 90 to 20 [3].