scholarly journals Simultaneous measurement of reticulocyte and red blood cell indices in healthy subjects and patients with microcytic and macrocytic anemia

Blood ◽  
1995 ◽  
Vol 85 (3) ◽  
pp. 818-823 ◽  
Author(s):  
G d'Onofrio ◽  
R Chirillo ◽  
G Zini ◽  
G Caenaro ◽  
M Tommasi ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Marrow Transplantation ◽  
Healthy Subjects ◽  
Megaloblastic Anemia ◽  
Macrocytic Anemia ◽  
Hemoglobin Concentration ◽  
Beta Thalassemia ◽  
Hemoglobin Content

Using the new Bayer H*3 hematology analyzer (Leverkusen, Germany), we have determined red blood cell and reticulocyte indices in 64 healthy subjects, in patients with microcytosis due to iron deficiency (58 patients) and heterozygous beta-thalassemia (40 patients), and in patients with macrocytosis (28 patients). We found in all cases that reticulocytes were larger than mature red cells by 24% to 35%, with a hemoglobin concentration 16% to 25% lower and a similar hemoglobin content. The correlation between red cell and reticulocyte indices was strikingly tight (r = .928 for volume, r = .929 for hemoglobin concentration, r = .972 for hemoglobin content) in all four groups, regardless of red blood cell size. The ratio of reticulocyte to red blood cell mean corpuscolar volume (MCV ratio) was constantly above 1. Inversion of the MCV ratio was observed only in four patients. It was always abrupt and transitory and was associated with erythropoietic changes leading to the production of red blood cells of a different volume (treatment of megaloblastic anemia, functional iron deficiency, bone marrow transplantation). In two cases of marrow transplantation, reticulocyte volume fell during the aplastic phase after conditioning chemotherapy and then rapidly increased up to values higher than before; this production of macroreticulocytes was the earliest sign of engraftment.

scholarly journals Red Blood Cell Transfusion and the Use of Intravenous Iron in Iron Deficient Patients Presenting to the Emergency Department

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 1-2
Author(s):  
Arvand Barghi ◽  
Robert Balshaw ◽  
Emily Rimmer ◽  
Murdoch Leeies ◽  
Allan Garland ◽  
...  
Keyword(s):  
Emergency Department ◽  
Logistic Regression ◽  
Iron Deficiency ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Hemoglobin Concentration ◽  
Factors Associated ◽  
Iv Iron ◽  
Iron Parameters ◽  
Rbc Transfusion

Background: Red blood cell (RBC) transfusions are often used to treat patients with iron deficiency who present to the emergency department (ED) with symptomatic anemia. Intravenous (IV) iron is the preferred treatment in this setting, as it has been shown to increase hemoglobin concentration rapidly and durably. We aim to determine the incidence of iron deficiency anemia (IDA) and the management of these patients in the ED setting. Objectives: To evaluate the incidence of IDA, the frequency of RBC transfusion and iron supplementation, and factors associated with RBC transfusion. Study Design: Retrospective cohort study of all adult patients presenting to the St Boniface Hospital (Winnipeg, CAN) ED from January 2014 to January 2019. Methods: We used electronic data from the Emergency Department Information System (EDIS) and Laboratory Information Services (LIS) databases to identify patients presenting with IDA, defined as anemia (hemoglobin <120 g/L) with either a transferrin saturation less than 20% or ferritin less than 30 umol/L, or mean corpuscular volume (MCV) of < 75 fL. A ferritin greater than 100 umol was used to exclude IDA, regardless of MCV. We extracted patient demographics, diagnoses, markers of iron storage, RBC transfusion and use of IV iron. Multivariate logistic regression analysis was used to evaluate factors associated with RBC transfusion. Results: Of 39222 patients, 17945 (45%) were anemic. Of the anemic patients, iron parameters were ordered in 1848 (10.3%) patients, and IDA was present in 910 (5.1 %). In the IDA population, 95 patients (10.4 %) received 1 RBC unit, and 197 patients (21.6 %) received 2 or more units. Oral iron and IV iron were prescribed for 64 (7 %) and 14 (1.5 %) patients, respectively. Our logistic regression model demonstrated that hemoglobin concentration was the main determinant of whether patients received RBC transfusion. Other variables including patient age, cardiac symptoms, heart rate, blood pressure, and CTAS score were not associated with increased likelihood of receiving RBC transfusion. Conclusion: Iron parameters were infrequently ordered in the evaluation of anemia in the ED, with limited use of oral and IV iron. The decision to transfuse RBCs was primarily influenced by hemoglobin concentration, but not other surrogates of hemodynamic instability. An interventional study to improve education and access to oral and IV iron is planned to reduce unnecessary RBC transfusions and their associated risks in patients with IDA. Disclosures No relevant conflicts of interest to declare.

scholarly journals A Retrospective Assessment of Prevention and Treatment of Iron Deficiency Amongst Patients Requiring Peripartum Transfusion

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 1264-1264
Author(s):  
Heather Vandermeulen ◽  
Yulia Lin ◽  
Anne McLeod ◽  
Jon Barrett ◽  
Michelle Sholzberg ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Red Blood Cell Transfusion ◽  
Beta Thalassemia ◽  
Alpha Thalassemia ◽  
Iron Deficient ◽  
Thalassemia Minor ◽  
Thalassemia Trait ◽  
In Pregnancy

Abstract Background: Iron deficiency is common and affects nearly 18% of pregnant women in the United States. This is attributable to both poor baseline stores in young women and the high iron requirements of pregnancy; a singleton pregnancy results in a net loss of 630 mg of iron. Both maternal and fetal outcomes are impacted by iron deficiency. There are higher rates of maternal postpartum depression, fetal growth restriction, prematurity and developmental delay when mothers are iron deficient in pregnancy. It is also important to avoid transfusions in women of child bearing age, due to the risks of alloimmunization and hemolytic disease of the newborn. Since iron deficiency is the most common cause of anemia in pregnant women, we sought to assess the prevalence of iron deficiency in women receiving peripartum red blood cell transfusions. Materials and Methods: This study is a retrospective quality review of all cases of peripartum transfusion at an academic centre caring for high risk pregnancies from January 2013 to July 2018. All women admitted to the Labor and Delivery ward who received a red blood cell transfusion were identified through electronic blood bank database. We also identified the next age-matched woman to deliver who was not transfused. Charts were reviewed for risk factors for iron deficiency, evidence of prior iron deficiency, iron supplementation during pregnancy and fetal outcomes such as birth weight, gestational age at delivery, NICU admission and fetal mortality. A detailed transfusion history was recorded for women who received peripartum transfusions, including peritransfusion hemoglobins and indication for transfusion. Results: To date, 120 cases of peripartum red blood cell transfusion have been reviewed. Of these, 19 patients were excluded due to chronic anemia unrelated to iron deficiency or pregnancy (e.g., chronic renal failure). Age matched controls have been identified and are pending review. Preliminary data suggests that the majority of red cell transfusions given in the peripartum period are to women experiencing antepartum (26%) and/or postpartum (63%) hemorrhage. Thirty seven percent of women who were transfused had documented anemia in pregnancy and 51% of women were iron deficient in pregnancy (ferritin <30 ng/mL). Twenty one percent of women in the transfused group were noted to have pre-existing iron deficiency before conceiving. In the transfused cohort, six patients were identified as having alpha thalassemia trait (3 cases) or beta thalassemia minor (3 cases). Discussion: We present the preliminary results of a retrospective review of cases of peripartum red cell transfusion at an academic centre. Although a significant portion of transfusions were unavoidable and attributable to hemorrhage, it may be possible to decrease the number of units these women require. Over half of women who were transfused had documented iron deficiency in pregnancy. This raises the question of how many units of red blood cells could have been saved by appropriately treating these patients' iron deficiency. It is also clear in the literature that iron deficiency is associated with multiple poor fetal and maternal outcomes; we have identified an opportunity to improve the care of these women and their babies. We plan to feed this information back to the Obstetrical caregivers at our centre and to help educate providers about the recognition and treatment of iron deficiency in pregnancy. The high rate of transfusion amongst patients with alpha thalassemia trait and beta thalassemia minor warrants further investigation, but may highlight a knowledge gap around transfusion triggers for these patients. Disclosures No relevant conflicts of interest to declare.

Proposal of a score combining red blood cell indices for early differentiation of beta‐thalassemia minor from iron deficiency anemia

Hematology ◽  
2011 ◽  
Vol 16 (2) ◽  
pp. 123-127 ◽  
Author(s):  
Alexandre Janel ◽  
Laurence Roszyk ◽  
Chantal Rapatel ◽  
Gabrielle Mareynat ◽  
Marc G Berger ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Blood Cell ◽  
Iron Deficiency Anemia ◽  
Red Blood Cell ◽  
Deficiency Anemia ◽  
Beta Thalassemia ◽  
Early Differentiation ◽  
Thalassemia Minor ◽  
Red Blood Cell Indices

Use of the Gel Test to Detect Mixed Red Blood Cell Populations in Bone Marrow Transplantation Patients

Vox Sanguinis ◽  
1993 ◽  
Vol 65 (2) ◽  
pp. 161-162 ◽  
Author(s):  
M. C. Zago-Novaretti ◽  
F. L. Dulley ◽  
P. E. Dorlhiac-Lacer ◽  
D. A. F. Chamone
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Marrow Transplantation ◽  
Cell Populations

Prevalence of Red Blood Cell Alloimmunization Among Beta-Thalassemia and Sickle Cell Anemia Patients: a Study from Saudi Arabia

2021 ◽  
Vol 67 (10/2021) ◽  
Author(s):  
Raed Felimban ◽  
Ahmed Alsharyufi ◽  
Jasem Aljehani ◽  
Ahmed Sahlool ◽  
Hamead Aljabri ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Blood Cell ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Red Blood Cell ◽  
Beta Thalassemia

scholarly journals Preliminary Study on the Clinical and Genetic Characteristics of Hereditary Spherocytosis in 15 Chinese Children

2021 ◽  
Vol 12 ◽  
Author(s):  
Chongjun Wu ◽  
Ting Xiong ◽  
Zhongjin Xu ◽  
Chunlei Zhan ◽  
Feng Chen ◽  
...  
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Clinical Characteristics ◽  
Hemoglobin Concentration ◽  
Chinese Children ◽  
Test Results ◽  
Test Analysis ◽  
Genetic Characteristics ◽  
Significant Difference ◽  
Gene Test

ObjectiveTo investigate the clinical and genetic characteristics of hereditary spherocythemia (HS) in Chinese children, and to analyze the potential genotypic/phenotypic associations.MethodsThe clinical data and gene test results of children with HS were collected. All patients were diagnosed by gene test results, and the laboratory results were obtained before splenectomy. The data of red blood cell (RBC), hemoglobin (HB), mean red blood cell volume (MCV), mean red blood cell hemoglobin (MCH), mean red blood cell hemoglobin concentration (MCHC), and hematocrit (HCT) were statistically analyzed according to different mutation genes. Statistical methods for comparison between groups Mann–Whitney test analysis, two-terminal p &lt; 0.05 was considered significant difference.ResultsA total of 15 children were enrolled in our hospital, and 14 variants were found (nine variants have not been reported before), including 10 ANK1 mutations (seven ANK1 truncated mutations) and five SPTB mutations. Patients with ANK1 mutations had more severe anemia than those with SPTB mutations (significantly lower RBC, HB, MCHC, and HCT).ConclusionThis is one of the few studies on the genetic and clinical characteristics of children with HS in China. This study identified the unique genetic and clinical characteristics of Chinese children with HS and analyzed the pathogenic genotype–phenotypic association. The results confirmed that the anemia degree of HS patients caused by ANK1 was more serious than that of patients with SPTB deficiency. However, further study of the correlation between genotype and phenotype requires a larger sample size.

Sign in / Sign up

Export Citation Format

Share Document