Haematology
Michael McGhee in A Guide to Laboratory Investigations, 2019
There are a number of haematological conditions that must be referred to a consultant. The mean corpuscular volume may be normal in anaemia of chronic disease, uraemia, acute blood loss, myeloproliferative disorders and bone marrow infiltration, or where vitamin B 12 or folate deficiency are combined with iron deficiency or thalassaemia. Anti-cardiolipin immunoglobulin G is provided as an antibody against the beta-2 glycoprotein coagulation system. A significantly raised level is indicative of an increased risk of thrombosis, and is often found in autoimmune disease and in patients with recurrent miscarriages (more than three), and is thought to be due to placental thrombosis. Infection with the Epstein-Barr virus (human herpes type 4 virus) has been implicated in a wide spectrum of clinical diseases, ranging from glandular fever to lymphoma. Antiphospholipid syndrome may be suspected when a patient has suffered from venous thrombosis, or thrombophlebitis, arterial thrombosis or recurrent miscarriage and has antiphospholipid antibodies.
Anaemia
Sherif Gonem, Ian Pavord in Diagnosis in Acute Medicine, 2017
Microcytic anaemias are usually due to iron deficiency or one of the sideroblastic anaemias. Sideroblastic anaemia refers to a group of disorders in which haem formation is defective, resulting in the formation of iron deposits in a ring around the nucleus of developing red blood cells. Increased loss of red blood cells occurs due to haemorrhage or haemolysis. Acute haemorrhage is usually associated with a normal mean corpuscular volume, unless there is a chronic component giving rise to concomitant iron-deficiency anaemia. Occasionally, the reticulocytosis that occurs in response to acute haemorrhage may produce a mild macrocytosis. Symptoms of anaemia include fatigue, shortness of breath and pallor. Chest pain, palpitation or syncope suggests that the anaemia is severely compromising oxygen delivery and thus requires more urgent treatment. Anticoagulation should be reversed unless it is essential and, depending on the source of haemorrhage, a gastroenterologist, general surgeon, vascular surgeon or gynaecologist should be urgently consulted.
Peripheral nervous system
Matthew Tate, Johnathan Cooper-Knock, Zoe Hunter, Elizabeth Wood in Neurology and Clinical Neuroanatomy on the Move, 2015
Question 28 A 37-year-old man with a long history of changeable bowel habit and abdominal pain presents with a 5-month history of worsening tingling and burning pain in his hands and feet. On examination, he has no weakness or wasting of the distal limb muscles, and Romberg’s sign is negative, although he has impairment of vibration sense and proprioception in a glove-and-stocking distribution. Investigations reveal a macrocytic anaemia (mean corpuscular volume [MCV] 102).
Elevated levels of CRP and IL-8 are related to reduce survival time: 1-year follow-up measurements of different analytes in frail elderly nursing home residents
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2019
Maria Edvardsson, Märtha Sund-Levander, Anna Milberg, Jan Ernerudh, Ewa Grodzinsky
There are only few studies with specific focus on predictors of survival in nursing home residents (NHRs). The aim was to study whether 1-year changes in complete blood count (including hemoglobin, red blood cells, erythrocyte volume fraction, mean corpuscular volume, mean corpuscular hemoglobin concentration, white blood cells count and platelet count), C-reactive protein and interleukin-1β (IL-1β), IL-1Ra, IL-6, IL-8 and IL-10, are associated with 8-year survival in elderly NHRs, aged ≥ 80 years. Complete blood count, C-reactive protein and interleukins were measured at baseline, after 6 and 12 months from 167 NHRs aged 80–101 years, mean age 88 ± 4.5 years, 75% of whom were women. Dates of death were collected from the National Death Register 8 years after baseline. Levels of hemoglobin, red blood cells and mean corpuscular hemoglobin concentration were lower after 1-year, but higher for mean corpuscular volume and IL-1β, compared to baseline or 6 month follow-up. In the Cox regression model with a time-dependent covariate, raised levels of C-reactive protein and IL-8 were associated with reduced survival time. Elevated levels of C-reactive protein and IL-8 during 1-year follow-up were related to reduce lengths of survival in elderly NHRs.
Description of the Phenotypes of 63 Heterozygous, Homozygous and Compound Heterozygous Patients Carrying the Hb Groene Hart [
Published in Hemoglobin, 2014
Philippe Joly, Philippe Lacan, Caroline Garcia, Alain Francina
We here report the phenotypes and genotypes of 63 patients of North African origin, carriers of Hb Groene Hart [Hb GH, α119(H2)Pro → Ser; HBA1: c.358C>T], an α+-thalassemia (α+-thal) hemoglobin (Hb) variant. Fifty patients were heterozygous, five were homozygous and eight also carried the common −α3.7 (rightward) deletion in compound heterozygosity. The expression of the αGH-globin chain is increased in the following order: heterozygous, compound heterozygous and homozygous. Parallel significant changes of mean corpuscular Hb (MCH) and mean corpuscular volume (MCV) were also observed. Our large cohort of Hb GH carriers could have been obtained by the systematic realization of globin chain separation by reversed phase liquid chromatography (RP-LC) in our routine Hb testing.
Relationship between obesity and iron deficiency anemia: is there a role of hepcidin?
Published in Hematology, 2018
Ertan sal, Idil Yenicesu, Nurullah Celik, Hatice Pasaoglu, Bulent Celik, Ozge Tugce Pasaoglu, Zühre Kaya, Ulker Kocak, Orhun Camurdan, Aysun Bideci, Peyami Cinaz
Objectives: Iron deficiency is common in obese children although the underlying mechanism is unclear. The aim of this study was to investigate the associations between iron parameters, leptin, hepcidin and adiponectin levels in obese children. Methods: A total of 237 children, ranging in age from 5 to 18 years, 180 with primary obesity and 57 healthy children and adolescents, were enrolled. Complete blood count, serum iron levels, iron-binding capacity, ferritin levels, leptin, hepcidin and adiponectin levels were studied. Results: White blood cell and platelet count, iron-binding capacity, high-sensitive C-reactive protein, leptin and hepcidin values in the obese group were higher than those of the control group (p
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