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Haematological Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
After maturation in the bone marrow, young red cells (reticulocytes) pass into the bloodstream. The reticulocyte count (normally approximately 1% of the total red cells) represents new red cell production and is a useful measure of how effective the bone marrow is at producing new cells (for the normal range, see Table 15.1). In disease states such as haemolytic anaemia, a very high reticulocyte count would be expected as the bone marrow tries to compensate for the cells being lost. After about 120 days in the circulation, the cell is recycled by macrophages in the spleen. Premature destruction of red cells is called haemolysis.
Long-Term Glucose Infusions in the Treatment of Fetal Growth Retardation
Published in Asim Kurjak, John M. Beazley, Fetal Growth Retardation: Diagnosis and Treatment, 2020
The titre was significantly greater (p <0.01) in the untreated SFD newborns than in the treated ones (Figure 16) who had practically the same value as the control group. Similar results were found upon analyzing the reticulocyte count. The lower value in the treated SFD newborns can be considered as a sign of compensation of the chronic hypoxia.
Unexplained Fever In Hematologic Disorders Section 1. Benign Hematologic Disorders
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
A distinct form of severe anemia, usually normocytic or mildly macrocytic, is aplastic anemia,51 due to bone marrow failure. The peripheral blood usually shows anemia associated with leukopenia and thrombocytopenia (pancytopenia). The reticulocyte count is low. The bone marrow biopsy will reveal absent or reduced cellularity. The serum iron is elevated. The clinical manifestations vary with the severity of the pancytopenia. Bleeding and infection are the most common complications. Infection is usually associated with fever, but local signs of inflammation may be absent. The differential diagnosis is important because pancytopenia may occur in a variety of disorders, potentially evolving with fever, including lymphoma, pre-leukemia, metastatic carcinoma to the marrow, granulomatous diseases, parenchymal liver diseases with hypersplenism, and lipidoses. Two other diseases, usually febrile, SLE and tuberculosis due to atypical mycobacteria, may be associated with pan-yctopenia; some viral diseases, especially hepatitis and infectious mononucleosis, have also been implicated. The main causes of aplastic anemia are ionizing irradiation and chemical agents. The latter include chloramphenicol, phenylbutazone, hydantoin, sulfa drugs, phe-nothiazines, quinacrune, colchicine, sulfonylureas, gold compounds, benzene, insecticides, organic arsenicals, antineoplastic, and immunosuppressive drugs.
Fist Detection of Hb Suqian[β42(CD1) Phe→Leu, HBB:c.129T > A] in Han Chinese
Published in Hemoglobin, 2023
Wenjuan Wang, Zixuan Ding, Airui Jiang, Suning Chen, Huanju Han
The proband was a female who was 62 years old. She came to our hospital because of chronic anemia and jaundice. The hematological parameters were obtained on a hematology analyzer(Sysmex Corporation, Kobe, Japan) as follows: red blood cell (RBC) count 3.55 × 1012/L (reference range 3.50–5.50 × 1012/L), Hb 10.0 g/dL (reference range 11.5–15.0 g/dL), mean corpuscular volume (MCV) 94.9 fL (reference range 82.0–100.0 fL), mean corpuscular Hb (MCH) 28.0 pg (reference range 27.0–33.5 pg), and reticulocyte count 9.5% (reference range 0.5%–1.5%). Bilirubin, haptoglobin(HP) and lactate dehydrogenase (LDH) were determined by an automatic analyzer (Hitachi Ltd., Tokyo, Japan) and the results revealed hemolysis occurred [HP < 3.0 mg/dL; total bilirubin (TBIL) 60.44 μmol/L; indirect bilirubin (IBIL) 45.14 μmol/L; LDH 480.8 U/L].
Cobalamin and folic acid deficiencies presenting with features of a thrombotic microangiopathy: a case series
Published in Acta Clinica Belgica, 2022
Britt Ceuleers, Sofie Stappers, Jan Lemmens, Lynn Rutsaert
Our initial physical examination revealed a very pale, tachypneic but euvolemic woman appearing older than her stated age. There were no abnormal neurological or gastrointestinal findings. Vital signs were as follows: oxygen saturation 98%, heart rate 133/min, a blood pressure of 154/81 mmHg and a temperature of 37.3°C. A complete blood count (Table 1) revealed a severe macrocytic anemia with thrombocytopenia. Reticulocyte count was normal. An additional hemolytic workup showed elevated LDH, decreased haptoglobin, hyperkalemia, indirect hyperbilirubinemia and a negative Direct Coombs test. Laboratory findings also showed normal kidney function (creatinine 1.02 mg/dl), hypovitaminosis B12 (<148 ng/L) with hyperhomocysteinemia and normal folic acid levels (9.4 µg/L). By means of an arterial blood gas analysis, we established a high anion gap metabolic acidosis with partial respiratory compensation, assumedly as a consequence of high lactate levels in the blood. A peripheral blood smear revealed schistocytes.
Transcranial Doppler Velocities among Sickle Cell Disease Patients in Steady State
Published in Hemoglobin, 2020
Khaled Salama, Rasha Rady, Rania H. Hashem, Mona El-Ghamrawy
Data were collected by interviewing the patients and through review of the medical records. Venous sampling was done for complete blood count (CBC); results were obtained with an automated counter (XS 800 I; Sysmex Corporation, Kobe, Japan), reticulocyte count was measured by staining reticulocytes by supra vital stain, a stain that has high affinity to ribosomal proteins. The preparation used was 1 mL of sample mixed with 1 ml of the stain (1:1) for 20 min., then a fresh film was prepared. The reticulocyte count was expressed in relation to 1000 counted erythrocytes (i.e. %). Serum ferritin was measured by enzyme-linked immunosorbent assay (ELISA) techniques using AxSYM™ (Abbott Laboratories, Abbott Park, IL, USA). Chemistry panel included serum bilirubin for total bilirubin, alanine transaminase (ALT), aspartate aminotransferase (AST) and serum lactate dehydrogenase (LDH) were measured using a Beckman Coulter counter (Miami, FL, USA). Serum was physically separated from contact with cells as soon as possible, with a maximum time limit of 2 hours from the time of collection.