The Role of the Bone Marrow Examination in the Diagnosis of Immune Thrombocytopenic Purpura: Case Series and Literature Review

Background. Idiopathic thrombocytopenic purpura (ITP) is a bleeding disorder in which the immune system destroys native platelets. In this condition an autoantibody is generated against a platelet antigen. ITP affects women more often than men and is more common in children than adults. Objective. To assess the effect of Helicobacter pylori eradication therapy (HPET) on platelet count in Helicobacter pylori associated chronic immune thrombocytopenic purpura (chronic ITP) in adult. Materials and Methods. It is an interventional prospective study conducted at Liaquat University of Medical and Health Sciences, Jamshoro, from 2014 to 2015. A set of 85 patients diagnosed with chronic ITP were included in the study via convenient sampling. Patients with platelets count < 100 × 109/L for >3 months were selected. They were posed to first-line investigations which comprised complete blood count (CBC) and peripheral blood smear examination followed by second-line tests including bone marrow examination and Helicobacter pylori stool specific antigen (HpSA-EIA). Standard H. pylori eradication therapy was offered and the patients were assessed at regular intervals for 6 months. Results. Of the 85 study patients, 32 (37.6%) were male and 53 (62.3%) were female. Mean ages of H. pylori positive and negative subjects were 43.89 ± 7.06 and 44.75 ± 7.91 years, respectively. Bone marrow examination confirmed the diagnosis and excluded other related BM disorders. H. pylori stool antigen (HpSA) was detected in 34 (40%) patients and hence regarded as H. pylori positive; the rest were negative. Treatment with eradication therapy significantly improved the mean platelet counts from 48.56±21.7 × 109/l to 94.2±26.8 × 109/l. Conclusion. We concluded that the anti-H. pylori eradication therapy improves blood platelet counts in chronic immune thrombocytopenia.

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Bone Marrow Clot Section a Useful Tool for Diagnosis of Haematological Diseases- A Case Series

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/49056:15028 ◽

2021 ◽

Author(s):

Parul Garg ◽

Harjot Kaur ◽

Ishwer Tayal ◽

Aradhana Singh Hada

Keyword(s):

Bone Marrow ◽

Diagnostic Tool ◽

Core Biopsy ◽

Case Series ◽

Bone Marrow Aspiration ◽

Bone Marrow Examination ◽

Biopsy Material ◽

Haematological Disorders ◽

Neoplastic Disorders

Bone marrow examination is required for diagnosis of various haematological disorders. It includes both neoplastic and non-neoplastic disorders. Usually, bone marrow examination includes Bone Marrow Aspiration (BMA), bone marrow biopsy and bone marrow imprints. Bone marrow clot sections can also be an adjuvant of bone marrow examination. The bone marrow clot sections are prepared from the left-over blood after aspirate smears have been prepared. An adequate bone marrow clot section can be valuable for diagnosis of various diseases, especially in cases in which the aspirate and core biopsy material are inadequate or non contributory or it can be an adjuvant procedure. Little has been published about usefulness of bone marrow clot section. Studies are going on to evaluate the role of bone marrow clot section as an adjuvant or a diagnostic tool. This study includes a series of three cases in which bone marrow clot section was diagnostic.

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THE ROLE OF MULTIPARAMETRIC FLOW CYTOMETRY IN DETECTING AND CHARACTERIZING GAMMA‐DELTA T‐CELL ENTITIES IN PERIPHERAL BLOOD. SINGLE‐CENTER CASE SERIES AND LITERATURE REVIEW

Hematological Oncology ◽

10.1002/hon.5_2881 ◽

2021 ◽

Vol 39 (S2) ◽

Author(s):

F Martín Moro ◽

I Martín Rubio ◽

R Alonso ◽

C López ◽

J Marquet ◽

...

Keyword(s):

Flow Cytometry ◽

T Cell ◽

Literature Review ◽

Peripheral Blood ◽

Case Series ◽

Single Center ◽

Gamma Delta ◽

Multiparametric Flow Cytometry ◽

Gamma Delta T Cell

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TO DETERMINE THE FREQUENCY OF VISCERAL LEISHMANIASIS IN PERIPHERAL CYTOPENIC PATIENT IN PATHOLOGY DEPARTMENT HAYATABAD MEDICAL COMPLEX.

Journal of Saidu Medical College, Swat ◽

10.52206/jsmc.2014.4.2.560-566 ◽

1969 ◽

Vol 4 (2) ◽

pp. 560-566

Author(s):

ZARD ALI KHAN ◽

MOHAMMAD SAJJAD ◽

IMRAN UD DIN ◽

MUKAMIL SHAH ◽

SHAH JEHAN

Keyword(s):

Bone Marrow ◽

Visceral Leishmaniasis ◽

Case Series ◽

Bone Marrow Aspiration ◽

Bone Marrow Examination ◽

Total Leukocyte Count ◽

Full Blood Count ◽

Female Ratio ◽

Pathology Department ◽

Case Series Study

BACKGROUND: Visceral Leishmaniasis is a chronic disease and was first described in 1903, byLIESHMAN and DONOVAN. The disease is common in tropical and sub tropical areas of the worldwith various hematological manifestations. It is characterized by fever, visceromegaly, weight loss,pancytopenia and hypergammaglobulenemia. The disease is silent killer, invariably killing almost alluntreated patients, but curable with hematological improvement within 4-6 weeks of treatment.OBJECTIVE: To determine the frequency of Visceral Leishmaniasis in patints with cytopenias .MATERIAL AND METHODS: A descriptive study conducted in Pathology department, HayatabadMedical Complex, Hayatabad from September 1, 2012 to August 31, 2013. This study comprises of 126patients, subjected to complete blood counts. Diagnosis were confirmed by finding Amastigote( L/Dbody) from bonemarrow aspirate. All the patients who were referred to pathology Department of thehospital for bone marrow examination, with the results of peripheral blood using automatedHaematology analyzer, Sysmex KX 21 showing cytopenia were included in the study. Consent wastaken from the patient for bone-marrow aspiration procedure. After consent detailed history, physicalexamination was done.Laboratory investigations i.e. full blood count, which includes hemoglobin estimation, white blood cell,red blood, and platelet count.Bone marrow cytology (Giemsa stain) was recorded on the designed profroma.Posterior superior iliac spine (PSIS) was used as the site for aspiration in adults and children over 2years of ageRESULT: Descriptive case series study of 126 patients of peripheral cytopenia. In which 77 (61.1%)patients were males and 49 (38.9%) were female with male to female ratio of 1.57: 1 It was also foundin this study that visceral leishmaniasis was present in 29 (23%) of cases and the male: female were 1.6:1. Result of the automated hematology analyzer of peripheral cytopenic patients in visceralleishmaniasis show that all of the patients were having total leukocyte count less than 4000/cmm(100%). The hemoglobin level wass less than lOgm/dl in 26 cases (87.7%) and more than lOgm/dl inthree cases (10.3%). In case of platelets count, 27 cases (93.1%) were having platelets count less than150000/cmm.CONCLUSION: Incidence of visceral leishmaniasis is highier in children age group 1-10 years, alsomales are more prone than females. Leukopenia is recorded in all (100%) of the cases, followed bythrombocytopenia (93.1%) and anemia (Hb <10gm %) 87.7% cases.KEY WORD: Visceral Leishmaniasis, Kala Azar, Amastigote (L/D body)

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Clinical and Morphological Profile of Immune Thrombocytopenic Purpura in Children - A Five Year Study in a Paediatric Tertiary Health Care Centre of South India

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2020/560 ◽

2020 ◽

Vol 7 (46) ◽

pp. 2724-2729

Author(s):

Ashida M. Krishnan ◽

Deepthi Raj M.L ◽

Priya V.S ◽

Arya R.S

Keyword(s):

Health Care ◽

Bone Marrow ◽

Immune Thrombocytopenic Purpura ◽

Peripheral Blood ◽

South India ◽

P Value ◽

Severe Thrombocytopenia ◽

Care Centre ◽

Health Care Centre ◽

Thrombocytopenic Purpura

BACKGROUND Immune Thrombocytopenic Purpura (ITP) is one of the most commonly encountered disease in paediatric practice. Thorough clinical and morphological study of peripheral blood and bone marrow is required for confirming ITP. Clinicomorphological aspects of paediatric ITP is a less studied topic especially in developing countries like India. The objective was to study the clinical and morphological profile of paediatric cases of ITP. METHODS This is a 5-year record based retrospective study conducted in a paediatric tertiary health care centre in Kerala, South India. Data of all paediatric cases diagnosed as ITP including clinical presentation, clinical findings, blood counts, peripheral blood morphology, bone marrow morphology, and treatment response was collected and entered in SPSS software version 16.0 and analysed. For assessing correlation, chi-square test was used. RESULTS The age of children ranged from 3 months to 15 years. H/o viral fever was noted in 53 % cases. Cases which had moderate and severe thrombocytopenia were 74 % and 21 % respectively. Isolated thrombocytopenia was the most common peripheral blood picture observed with few cases showing coexisting eosinophilia and anaemia. All cases showed megakaryocyte proliferation in marrow with 9 % cases showing coexisting iron deficiency anaemia. Majority of cases showed rapid response to steroid / IVIG therapy and the response had no correlation with grade of thrombocytopenia (p value < 0.05). CONCLUSIONS Paediatric cases of ITP usually present following viral infections or vaccination, with worrisome bleeding episodes, petechiae, ecchymosis or purpura. KEYWORDS ITP, Paediatrics, Platelet Count, Thrombocytopenia, Vaccination

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