scholarly journals Reticulocyte size in nutritional anemias

Blood ◽  
1976 ◽  
Vol 48 (5) ◽  
pp. 669-677 ◽  
Author(s):  
DR Clarkson ◽  
EM Moore
Keyword(s):  
Iron Deficiency ◽  
Vitamin B12 ◽  
Mean Corpuscular Volume ◽  
Vitamin B12 Deficiency ◽  
Deficiency Anemia ◽  
Initial Development ◽  
Abrupt Decrease ◽  
Iron Saturation ◽  
Iron Deficient ◽  
B12 Deficiency

Abstract Alterations in reticulocyte size occur 2–3 days after the onset of iron deficient or megaloblastic erythropoiesis and precede, by several weeks, changes in mean corpuscular volume (MCV). Iron-deficiency anemia induced in a normal subject by repeated phlebotomies was characterized by the initial development of larger than normal reticulocytes followed by an abrupt decrease in reticulocyte size. Microreticulocytes appeared 3 days after the fall in per cent iron saturation and antedated the decrease in MCV to below normal by 6 wk. Mean reticulocyte size was disproportionately smaller than normal in patients presenting with iron deficiency. In contrast, reticulocyte size increased abruptly in a patient (and rats) 2–3 days after administration of methotrexate. Mean reticulocyte size was disproportionately larger than normal in patients presenting with folate or vitamin B12 deficiency. Specific replacement therapy with iron, folate, or vitamin B12 was quickly followed by normalization of reticulocyte size.

scholarly journals Reticulocyte size in nutritional anemias

Blood ◽  
1976 ◽  
Vol 48 (5) ◽  
pp. 669-677
Author(s):  
DR Clarkson ◽  
EM Moore
Keyword(s):  
Iron Deficiency ◽  
Vitamin B12 ◽  
Mean Corpuscular Volume ◽  
Vitamin B12 Deficiency ◽  
Deficiency Anemia ◽  
Initial Development ◽  
Abrupt Decrease ◽  
Iron Saturation ◽  
Iron Deficient ◽  
B12 Deficiency

Alterations in reticulocyte size occur 2–3 days after the onset of iron deficient or megaloblastic erythropoiesis and precede, by several weeks, changes in mean corpuscular volume (MCV). Iron-deficiency anemia induced in a normal subject by repeated phlebotomies was characterized by the initial development of larger than normal reticulocytes followed by an abrupt decrease in reticulocyte size. Microreticulocytes appeared 3 days after the fall in per cent iron saturation and antedated the decrease in MCV to below normal by 6 wk. Mean reticulocyte size was disproportionately smaller than normal in patients presenting with iron deficiency. In contrast, reticulocyte size increased abruptly in a patient (and rats) 2–3 days after administration of methotrexate. Mean reticulocyte size was disproportionately larger than normal in patients presenting with folate or vitamin B12 deficiency. Specific replacement therapy with iron, folate, or vitamin B12 was quickly followed by normalization of reticulocyte size.

scholarly journals Iron deficiency anemia and megaloblastic anemia in obese patients

2017 ◽  
Vol 55 (1) ◽  
pp. 3-7 ◽  
Author(s):  
Mahmoud Arshad ◽  
Sara Jaberian ◽  
Abdolreza Pazouki ◽  
Sajedeh Riazi ◽  
Maryam Aghababa Rangraz ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Morbid Obesity ◽  
Iron Deficiency ◽  
Vitamin B12 ◽  
Iron Deficiency Anemia ◽  
Megaloblastic Anemia ◽  
Vitamin B12 Deficiency ◽  
Deficiency Anemia ◽  
Obese Patients ◽  
B12 Deficiency

Abstract Background. The association between obesity and different types of anemia remained uncertain. The present study aimed to assess the relation between obesity parameters and the occurrence of iron deficiency anemia and also megaloblastic anemia among Iranian population. Methods and Materials. This cross-sectional study was performed on 1252 patients with morbid obesity that randomly selected from all patients referred to Clinic of obesity at Rasoul-e-Akram Hospital in 2014. The morbid obesity was defined according to the guideline as body mass index (BMI) equal to or higher than 40 kg/m2. Various laboratory parameters including serum levels of hemoglobin, iron, ferritin, folic acid, and vitamin B12 were assessed using the standard laboratory techniques. Results. BMI was adversely associated with serum vitamin B12, but not associated with other hematologic parameters. The overall prevalence of iron deficiency anemia was 9.8%. The prevalence of iron deficiency anemia was independent to patients’ age and also to body mass index. The prevalence of vitamin B12 deficiency was totally 20.9%. According to the multivariable logistic regression model, no association was revealed between BMI and the occurrence of iron deficiency anemia adjusting gender and age. A similar regression model showed that higher BMI could predict occurrence of vitamin B12 deficiency in morbid obese patients. Conclusion. Although iron deficiency is a common finding among obese patients, vitamin B12 deficiency is more frequent so about one-fifth of these patients suffer vitamin B12 deficiency. In fact, the exacerbation of obesity can result in exacerbation of vitamin B12 deficiency.

scholarly journals Multifactorial Etiology of Anemia in Celiac Disease and Effect of Gluten-Free Diet: A Comprehensive Review

Nutrients ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 2557 ◽  
Author(s):  
Martín-Masot ◽  
Nestares ◽  
Diaz-Castro ◽  
López-Aliaga ◽  
Alférez ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Iron Deficiency ◽  
Vitamin B12 ◽  
Clinical Manifestations ◽  
Vitamin B12 Deficiency ◽  
Deficiency Anemia ◽  
Intestinal Biopsy ◽  
B12 Deficiency ◽  
Endomysial Antibodies ◽  
Inflammatory Bowel

Celiac disease (CD) is a multisystemic disorder with different clinical expressions, from malabsorption with diarrhea, anemia, and nutritional compromise to extraintestinal manifestations. Anemia might be the only clinical expression of the disease, and iron deficiency anemia is considered one of the most frequent extraintestinal clinical manifestations of CD. Therefore, CD should be suspected in the presence of anemia without a known etiology. Assessment of tissue anti-transglutaminase and anti-endomysial antibodies are indicated in these cases and, if positive, digestive endoscopy and intestinal biopsy should be performed. Anemia in CD has a multifactorial pathogenesis and, although it is frequently a consequence of iron deficiency, it can be caused by deficiencies of folate or vitamin B12, or by blood loss or by its association with inflammatory bowel disease (IBD) or other associated diseases. The association between CD and IBD should be considered during anemia treatment in patients with IBD, because the similarity of symptoms could delay the diagnosis. Vitamin B12 deficiency is common in CD and may be responsible for anemia and peripheral myeloneuropathy. Folate deficiency is a well-known cause of anemia in adults, but there is little information in children with CD; it is still unknown if anemia is a symptom of the most typical CD in adult patients either by predisposition due to the fact of age or because biochemical and clinical manifestations take longer to appear.

scholarly journals IRON DEFICIENCY AND THALASSAEMIA

2018 ◽  
Vol 25 (12) ◽  
pp. 1863-1868
Author(s):  
Asma Shaikh ◽  
Nadeem Nusrat ◽  
Muhammad Akbar Agha ◽  
Asma Shabbir
Keyword(s):  
Iron Deficiency ◽  
Vitamin B12 ◽  
Mean Corpuscular Volume ◽  
Complete Blood Count ◽  
Vitamin B12 Deficiency ◽  
Reference Laboratory ◽  
Corpuscular Volume ◽  
Beta Thalassaemia ◽  
Thalassaemia Trait ◽  
B12 Deficiency

Objectives: To study the importance of normal or low mean corpuscular volume in vitamin B12 deficiency due to co-existence of iron deficiency or beta thalassaemia trait masking a rise in mean corpuscular volume. Study Design: Observational non-probability cross sectional study. Setting: DDRRL. Period: January 2014 to September 2014. Methods: 105 vitamin B12 deficient cases (vitamin B12 less than 200ng/l) who presented with normal or low mean corpuscular volume (MCV less than 95 fl) on complete blood count (CBC) were determined from Dow diagnostic research and reference laboratory (DDRRL). Serum ferritin, red blood cell folate (RBC Folate) level and Hemoglobin electrophoresis for beta thalassaemiatrait were analysed in these patients. Results: Total of 105 vitamin B12 deficient patients who fulfilled the inclusion criteria were enrolled in this study from which 39 (37.14%) were male and 66 (62.85%) were females. Amongst them 36.19% had microcytosis with the mean age of 37±16.2 years while 63.8% were normocytic with mean age of 41.58±15.65 years. In microcytic group, iron deficiency, beta thalassaemia trait, combined deficiency of B12, iron and beta thalassaemia trait and RBC folate deficient were 52.6%,34.21%, 7.8% and 2.63% respectively. In normocytic group, iron deficiency, beta thalassaemia trait and RBC Folate deficient were 13.4%, 00% and 11.9% respectively. Conclusion: There is a significant coexistent frequency of iron deficiency and beta thalassaemia trait in vitamin B12 deficiency with normal or low MCV especially in females of 20-40 years of age. There should be a high index of suspicion for B12 deficiency when investigating anaemia with normal or altered red cell indices.

scholarly journals Prevalence of Iron, Vitamin B12 deficiency and inflammatory anaemia in treatment naive individual consecutive cancer patients: A cross sectional study.

2020 ◽  
Author(s):  
Avinash Pandey ◽  
Shivkant Singh ◽  
Raj Aryan ◽  
Krishna Murari
Keyword(s):  
Iron Deficiency ◽  
Vitamin B12 ◽  
Cancer Patients ◽  
Serum Ferritin ◽  
Transferrin Saturation ◽  
Vitamin B12 Deficiency ◽  
Cross Sectional ◽  
Iron Deficient ◽  
Treatment Naïve ◽  
B12 Deficiency

Background: In treatment naive Indian cancer patients, prevalence of iron, B12 deficiency and inflammatory anaemia in poorly known. Aims and Objectives : To evaluate prevalence of anaemia and iron, B12 deficiency along with inflammation in treatment naive individual consecutive cancer patients. Material and Methods: All patients registered from 1st July 2019 till 31st December 2019 in Medical Oncology Outpatient Department were offered to undergo Iron profile, Serum B12 levels and Serum ferritin along with routine haematological investigations. Anaemia was defined as Haemoglobin < 11gm/dL. Transferrin saturation <20%, Serum Ferritin >300 microgram/litre and Vitamin B12 level <200 picogram/millilitre were 'cut-offs' used to define iron deficiency, inflammation and Vitamin B12 deficiency respectively. Data was analysed using descriptive statistics, frequency distribution, crosstabs and Bar Diagram in SPSS version 17.0. Pearsons Chi square test and Odds ratio was used to measure the strength of association with variables. Results: 311/441 (70.5%) were found eligible. Median age was 52 + 15.9 (Range 18-84 ) years with 144/331(46%) females. The prevalence of anaemia was 61% + 2.7 (95% CI 55-66%). Mean Haemoglobin was 9.86 + 2.08 (range 3-16) gram/decilitre. 21/311(7%) had severe anaemia (Haemoglobin < 6.9 gm/dl). 135/311 (71%), 61/189 (32%) and 89/189 (47%) anaemic patients had iron deficiency, inflammation and B12 deficiency respectively. More than 70% of Gastrointestinal (50/69), Gynaecological(17/24) and Lung Cancer(18/22) patients had underling Iron deficiency. Conclusion: Two-third of cancer patients are iron deficient. B12 deficiency and inflammation are present in half and one-third patients respectively.

Two Cases of Vitamin B12 Deficiency Anemia Combined with Iron Deficiency Anemia

2003 ◽  
Vol 20 (2) ◽  
pp. 206
Author(s):  
Eun Hae Kim ◽  
Hee Soon Cho ◽  
Chae Hoon Lee ◽  
Kyung Dong Kim ◽  
Myung Soo Hyun
Keyword(s):  
Iron Deficiency ◽  
Vitamin B12 ◽  
Iron Deficiency Anemia ◽  
Vitamin B12 Deficiency ◽  
Deficiency Anemia ◽  
B12 Deficiency

scholarly journals Gastrointestinal Absorption, Plasma Transport, Surface Distribution, and Urinary and Fecal Excretion of Radioactive Vitamin B12 in Iron Deficiency

Blood ◽  
1965 ◽  
Vol 25 (3) ◽  
pp. 335-344 ◽  
Author(s):  
J. D. COOK ◽  
L. S. VALBERG
Keyword(s):  
Iron Deficiency ◽  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
Intravenous Dose ◽  
Plasma Transport ◽  
Fecal Excretion ◽  
Surface Distribution ◽  
Iron Deficient ◽  
B12 Deficiency ◽  
Gastric Biopsies

Abstract No evidence of vitamin B12 deficiency or of any mechanism which might lead to vitamin B12 deficiency, such as defective absorption or increased urinary or fecal excretion of the vitamin, has been found in iron-deficient subjects in whom gastric acid secretion and gastric biopsies were normal. It is concluded that when vitamin B12 deficiency occurs in iron-deficient subjects it is the result of gastric atrophy. An unexplained finding was delayed disappearance of an intravenous dose of Co58-B12 from the plasma in iron-deficient subjects.

Does Cell Size Matter?: Utilizing Mean Cell Volume in Hospitalized Patients As a Screen to Determine Common Causes of Anemia Including Iron Deficiency Anemia, Vitamin B12 and Folate Deficiency

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 2338-2338 ◽  
Author(s):  
Manika Gupta ◽  
Kathleen Copley ◽  
Michael Keeney ◽  
Ian Chin-Yee
Keyword(s):  
Iron Deficiency ◽  
Vitamin B12 ◽  
Cell Volume ◽  
Iron Deficiency Anemia ◽  
Vitamin B12 Deficiency ◽  
Folate Deficiency ◽  
Deficiency Anemia ◽  
Mean Cell Volume ◽  
Common Causes ◽  
B12 Deficiency

Abstract Background: The approach to anemia is traditionally based on the Mean Cell Volume. Based on this approach anemia is subdivided into microcytic, normocytic and macrocytic causes. This approach may not accurately discern common causes of anemia in hospitalized patients. Previous studies suggest the MCV may not be a sensitive measurement to differentiate iron deficiency anemia (IDA) and megaloblastic anemia due to vitamin B12 or folate deficiency. Methods: In a retrospective, single-centre study at London Health Sciences Center, all adult patients (age 18 years or older) with confirmed IDA, vitamin B12 and folate deficiency and their associated MCV and RDW values at LHSC over a one year period were reviewed. IDA was defined as hemoglobin less than 115 g/l and ferritin less than 30 (M) and 10 (F). Vitamin B12 deficiency was defined as a value of less than 145. Results: 1119 patients were identified with confirmed IDA, B12 or Folate deficiency. 894 patients had IDA of which 564 patients had low MCV (sensitivity 63.1%) and 797 patients had low MCV or high RDW (sensitivity 89.1%). Of the 96 patients with vitamin B12 deficiency anemia, 12 patients had high MCV (sensitivity 12.5%) and 70 patients had high MCV or high RDW (72.9%). Only one of 2244 patients who had RBC folate measured had an actual folate deficiency. Conclusion: Our results confirm that a normal MCV does not exclude IDA or vitamin B12 deficiency. Clinicians need to be aware of the low sensitivity of the MCV as a screen. The sensitivity of MCV for IDA or vitamin B12 deficiency is improved with indices such as RDW. Folate deficiency is rare in North America and should not be routinely ordered for assessment of nutritional anemia. Disclosures No relevant conflicts of interest to declare.

scholarly journals A Study of Erythropoiesis by Combined Morphologic, Quantitative Cytochemical and Autoradiographic Methods

Blood ◽  
1968 ◽  
Vol 31 (3) ◽  
pp. 304-313 ◽  
Author(s):  
S. N. WICKRAMASINGHE ◽  
E. H. COOPER ◽  
D. G. CHALMERS
Keyword(s):  
Cell Cycle ◽  
Bone Marrow ◽  
Iron Deficiency ◽  
Vitamin B12 ◽  
Iron Deficiency Anemia ◽  
Vitamin B12 Deficiency ◽  
Deficiency Anemia ◽  
Normal Bone Marrow ◽  
Normal Bone ◽  
B12 Deficiency

Abstract The relationship between the morphology of human erythropoietic cells and their position in interphase has been studied. In normal bone marrow, pro-normoblasts, basophilic normoblasts and early polychromatic normoblasts were present in all stages of interphase. It has been shown that a significant increase in nuclear size occurs as a cell moves through its cell cycle, in both normal and megaloblastic erythropoiesis. The relative distribution of the basophilic erythropoietic cells and the dividing polychromatic cells, in the various stages of interphase, has been determined in normal bone marrow, vitamin B12 deficiency and iron deficiency anemia. In vitamin B12 deficiency, associated with moderate or severe anemia, there was an increased proportion of cells in G2, and there were several cells with DNA contents that were between the 2c and 4c values, which were not in DNA synthesis as judged by 3H-TdR labeling. These abnormalities were most pronounced in the dividing polychromatic cell group. Similar abnormalities were not present in iron deficiency anemia, indicating that these disturbances were not produced by the presence of anemia per se. The possible relationship between these changes in the cell cycle and the ineffective erythropoiesis seen in anemia due to vitamin B12 deficiency has been discussed.

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