scholarly journals Study of Spectrum of anemia in various age groups

2021 ◽  
Vol 6 (3) ◽  
pp. 197-202
Author(s):  
Varsha Pandey
Keyword(s):  
Hemolytic Anemia ◽  
Age Groups ◽  
Macrocytic Anemia ◽  
Hypochromic Anemia ◽  
Severe Anemia ◽  
Mild Anemia ◽  
Normocytic Normochromic Anemia ◽  
Moderate Anemia ◽  
Study Population ◽  
Normochromic Anemia

: Anemia is major health problem world-wide especially in developing countries. Globally 1.62 billion persons are affected. It has grave consequences on human health. The present study evaluates the severity and morphology of anemia in various age groups in rural population. : 1): To study degree and severity of anemia in study population; 2): To study distribution of anemia in various age groups; 3): To study morphological spectrum of anemia in study population. s: The study includes 792 patients having low concentration of hemoglobin for their age & sex. The other hematological parameters and morphology were analyzed. : In our study, females constituted 72.6% (575/792) of study population and male constituted 27.4% (217/792) of population. Pediatric patients (up to 15 years of age) constituted 10% of study population. Out of 792 anemic patients, 439 (55.4%) were having moderate anemia, 228 (28.7%) were having mild anemia & 125 (15.78%) were having severe anemia. Out of 792 anemic patients, 384 (48.4%) were having microcytic hypochromic anemia, 296 (37.37%) were having normocytic normochromic anemia, 84 (10.6%) were having macrocytic anemia and 3.5% were having hemolytic anemia. Out of 792 anemic patients, 439 (55.4%) were having moderate anemia, 228 (28.7%) were having mild anemia & 125 (15.78%) were having severe anemia. In our study anemia was more common in females as compared to males constituting majority of study population which is in concordance with other studies also. Moderate anemia was more common in study population as well as in various sub-groups being in concordance with other studies too. Morphologically microcytic hypochromic anemia was the most common type of anemia especially in adult females. Pregnant females were found to have normocytic normochromic anemia predominantly. Most of the cases of hemolytic anemia was found in children <15years. Similarly macrocytic anemia was found more commonly in adult males. Anemia is the most hematological abnormality found in daily practice, though found in all age groups but quite higher in females. The main objective for diagnosing anemia is to make clinician aware so that they can take measures to prevent and control anemia.

scholarly journals Gambaran Anemia pada Lanjut Usia di Panti Sosial Tresna Werdha Abiyoso Yogyakarta Tahun 2013

2014 ◽  
Vol 1 (1) ◽  
pp. 23
Author(s):  
Hieronymus Rayi Prasetya ◽  
Sistiyono Sistiyono ◽  
Maria Elisabeth Enjel Naur
Keyword(s):  
Nursing Home ◽  
Descriptive Analysis ◽  
Hypochromic Anemia ◽  
The Elderly ◽  
The Body ◽  
Old Patients ◽  
Mild Anemia ◽  
Normocytic Normochromic Anemia ◽  
Moderate Anemia ◽  
Normochromic Anemia

Background: Anemia is a main health problem of elderly. The aging process causes many psychological changes in nearly all body systems of elderly that causes many kinds of processes of nutrient absorptions in the body disturbed. There is an opinion says that generally elderly has lower hemoglobin levels compared to the younger people. Other research showed that elderly often suffered from calorie and protein malnutrition and micronutrient. It happened because the HCL and pepsin secretion was reduced. Consequently, the absorption of Vitamin B12 and iron decreased that causes Anemia. Method: It was a descriptive analysis with laboratory tests. The sample of this research was 60 year-old and older patients in TresnaWerdhaAbiyoso Nursing Home Yogyakarta. There were 96 patients. The data of research results were analyzed descriptively and presented in the forms of tables and graphs. Results: Of the 96 old patients, there were 31 patients suffered from anemia that consisted of 27 patients with mild anemia and 10 patients with moderate anemia. Based on the morphology of erythrocytes in elderly, there were two kinds of anemia. They were normocytic-normochromic anemia with 84 patients and microcytic-hypochromic anemia with 12 patients. Conclusion: The description of anemia in elderly who stayed in TresnaWerdhaAbiyoso Nursing Home Yogyakarta showed that 32.29% of the elderly suffered from anemia. 72.97% suffered from mild anemia. 27.03% suffered from moderate anemia. The anemia classifications based on morphology in elderly in Tresna Werdha Abiyoso Nursing Home Yogyakarta were 87.5% normocytic-normochromic anemia and 12.5% microcytic-hypochromic anemia.

Fetal breathing, sleep state, and cardiovascular responses to graded anemia in sheep

1987 ◽  
Vol 63 (4) ◽  
pp. 1463-1468 ◽  
Author(s):  
B. J. Koos ◽  
H. Sameshima ◽  
G. G. Power
Keyword(s):  
Eye Movements ◽  
Cardiovascular Responses ◽  
Severe Anemia ◽  
Sleep State ◽  
Fetal Sheep ◽  
Rapid Eye Movements ◽  
Mild Anemia ◽  
Arterial Blood ◽  
Moderate Anemia ◽  
Pressure Changes

Graded anemia was produced for 2 h in 10 unanesthetized fetal sheep by infusing plasma in exchange for fetal blood. This reduced the mean fetal hematocrits during the 1st h of anemia to 19.7 +/- 0.5% [control (C) = 28.2 +/- 1.1%] for mild anemia, 17.4 +/- 0.9% (C = 30.0 +/- 1.1%) for moderate anemia, and 15.1 +/- 1.0% (C = 29.2 +/- 1.3%) for severe anemia. The respective mean arterial O2 contents (CaO2) were 4.46 +/- 0.20, 3.89 +/- 0.24, and 3.22 +/- 0.19 ml/dl. Mean arterial PO2 was reduced significantly (by 2 Torr) only during moderate anemia, and mean arterial pH was decreased only during severe anemia. No significant changes occurred in arterial PCO2. Fetal tachycardia occurred during anemia. Mean arterial pressure was reduced by 2–3 mmHg during mild anemia; however, no significant blood pressure changes were observed for moderate or severe anemia. The incidence of rapid-eye movements and breathing activity was not affected by mild anemia, but the incidence of both was reduced significantly during moderate and severe anemia. It is concluded that 1) a reduction in CaO2 of greater than 2.48 +/- 0.22 ml/dl by hemodilution inhibits rapid-eye movements and breathing activity, and 2) the PO2 signal for inhibition does not come from arterial blood but from lower PO2 in tissue.

scholarly journals Association and correlation of thyroid dysfunction with anemia types in pregnant women of northern Andhra Pradesh, India

2021 ◽  
Vol 10 (4) ◽  
pp. 1671
Author(s):  
Prabhavathi V. ◽  
Prasad D. K. V. ◽  
Sravani K.
Keyword(s):  
Pregnant Women ◽  
Andhra Pradesh ◽  
Thyroid Dysfunction ◽  
Hypochromic Anemia ◽  
Normocytic Normochromic Anemia ◽  
Significant Difference ◽  
History Of ◽  
Normochromic Anemia ◽  
Hb Concentration ◽  
Rbc Count

Background: Thyroid dysfunction is a common disorder in pregnancy along with anemia. But no study has evaluated the association between them. To estimate the prevalence of thyroid dysfunction and its association with anemia types in pregnant women during 1st trimester.Methods: Three hundred and eighty pregnant women with <12 weeks of gestational age were selected for the study with no history of thyroid dysfunction and anemia. All the pregnant women were classified into A, euthyroid and B, thyroid dysfunction groups. The B group was again subdivided into hypothyroid, subclinical hypothyroid (SCH), hyperthyroid according to nature of dysfunction. 5 ml of blood sample was collected from all subjects to analyse thyroid hormones and erythrocyte indices.Results: Out of 380 subjects, euthyroid was found to be 77.9%, and rest 22.1% were with thyroid dysfunction. Out of 84 thyroid dysfunction, hypothyroid was found to be 7.9%, SCH 13.9% and hyperthyroid was 0.3%. Out of 296 euthyroid women, anemia was identified in 97 pregnant women (32.8%) whereas in thyroid dysfunction women it was 43 women out of 84 (51.2%) which is a statistically significant. Significantly higher frequency of microcytic hypochromic anemia and normocytic normochromic anemia types were also found in thyroid dysfunction groups compared to euthyroid group (p<0.05). However, no significance between the thyroid dysfunction groups, Statistically significant difference was observed in the Hb concentration, RBC count, MCV, MCH and PCV between euthyroid and different thyroid dysfunction conditions (p<0.05). A statistically significant positive correlation was found between fT4 and erythrocyte indices.Conclusions: As fT4 and TSH correlated with erythrocyte indices, it is advisable to screen for thyroid dysfunction and vice versa so as to prevent the complications associated with anemia and thyroid dysfunction.

scholarly journals ANEMIA DAN DEFISIENSI BESI PADA SISWA SLTP NEGERI I CURUG, TANGERANG

2018 ◽  
Vol 15 (1) ◽  
pp. 5
Author(s):  
Fify Henrika ◽  
T. Silangit ◽  
Riadi Wirawan
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Junior High School ◽  
Phase 1 ◽  
Hypochromic Anemia ◽  
Female Adolescents ◽  
Deficiency Anemia ◽  
Normocytic Normochromic Anemia ◽  
Normochromic Anemia ◽  
Latent Iron Deficiency

A research was conducted to 69 female students from a junior high school (SLtP) Negeri I Curug, tangerang aged 12–14 yearsto obtain percentages of anemia and iron deficiency in female adolescents. Anemia was found on 10.2% of the students, with 4.3%of normocytic normochromic anemia and 5.8% of microcytic hypochromic anemia. Microcytic hypochromic erythrocytes was foundon 21.7% of the subjects which consist of 2.9% iron deficiency anemia, 1.4% phase 2 iron deficiency (latent) with possibility ofhemoglobinopathy, and 2.9% phase 1 iron deficiency (pre-latent) with possibility of hemoglobinopathy. Anemia without iron deficiencywith possibility of chronic diseases and/or hemoglobinopathy was 2.9%, and without anemia nor iron deficiency but with possibility ofhemoglobinopathy was 11.6%. Iron deficiency was found among 26.1% of subjects which consist of 11.6% pre-latent iron deficiency,8.7% latent iron deficiency, and 5.8% iron deficiency anemia with 2.9% and 2.9% were normocytic normochromic anemia andmicrocytic hypochromic anemia, respectively.

scholarly journals Anemia in Diabetes – An Added Dilemma

2021 ◽  
Vol 2 (3) ◽  
pp. 139-141
Author(s):  
Syed Ahmed Arshad ◽  
Jamal Ara
Keyword(s):  
Adult Population ◽  
Age Groups ◽  
Sampling Technique ◽  
Diabetic Patients ◽  
Age Group ◽  
Cross Sectional ◽  
Mild Anemia ◽  
Gender And Age ◽  
Moderate Anemia ◽  
The Mean

Aim: To study the frequency of anemia in diabetes of an adult population. Methodology: This cross-sectional observational study included 277 adult patients, above the age of 18 years, who were diagnosed as having diabetes by clinical and laboratory basis and were considerably controlled on their prescribed management. The study was conducted in Creek General Hospital Karachi from October to December 2020 by random based sampling technique. After a written consent answers were noted according to the questionnaire and the relevant data was tabulated and analyzed. Patients with complications or with other chronic illness, except hypertension, were excluded. The data was evaluated for the frequency of anemia in diabetics, categorizing the severity of anemia into mild, moderate, and severe. Universal variables like gender and age were assessed. Results: Among the 277 patients in the study, there were 121(43.7%) males and 156 (56.3%) females. There were 17 (6%) in the young age group, 162 (58.5%) in the middle age group and 98 (35.4%) elders. The mean hemoglobin was 11.1 gm/dl. Out of 277 there were 222 (80%) who fell in the category of anemia. There were 90 out of 121 (74%) males who were anemic and 132 out of 156 (84%) females who were anemic. The most frequent category of anemia was moderate anemia (48%) followed by mild category (46%). Mild anemia was more frequent in males while moderate anemia was more prevalent in females. Anemia was higher in percentage in the younger group (88%). Mild to moderate anemia was more prevalent than severe in all age groups. 81% of hypertensive, diabetic patients was anemic. 78% smokers had anemia. There was visible increase in frequency of anemia as the duration of diabetes increased. Conclusion: Anemia is highly prevalent in diabetics.

The Prevalence of Anemia In the Elderly: a Hospital-Based Analysis In a Middle-European Country

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 5143-5143
Author(s):  
Reinhard Stauder ◽  
Günter Schruckmayer ◽  
Ines Sam ◽  
Georg Kemmler ◽  
Gunther Gastl
Keyword(s):  
Pearson Correlation ◽  
Age Groups ◽  
Macrocytic Anemia ◽  
The Elderly ◽  
Advanced Age ◽  
Normocytic Anemia ◽  
Elderly Persons ◽  
Outpatient Basis ◽  
Severe Anemia ◽  
Lowered Serum

Abstract Abstract 5143 Anemia represents a relevant challenge among the elderly as anemia is associated with decreased functional capacities and an increased morbidity and mortality rate. Aim of this study was to provide demographic data in a representative Middle-European population and secondly to define the subtype and cause of anemia to form the basis for treatment algorithms. Laboratory values from 19758 patients older than 64 years treated at the Medical University Innsbruck, Austria from 1.10.2004 -29.9.2005 were analyzed. The cohort consisted of 10917 women and 8841 men. The median age was 75 yrs in women and 72 yrs in men (p <0.001). 10737 (54.3%) patients were treated on an outpatient basis, whereas 9.021 (45.7%) were inpatients. Women revealed in general lower hemoglobin (Hb) values than men (median 13.4 vs 14.3 g/dl; p<0.001). This phenomenon was not age-dependent as assessed by age-matched regression-analyses. Based on the WHO-criteria for the definition of anemia (Hb < 12 in female and < 13 g/dl in male), 19.3% of women and 23.4% of men suffered from anemia. The incidence of anemia was significantly correlated with advanced age as shown by correlation analysis (Hb vs age; r=0.21; p<0.001). In the age groups 75–79, 80–84, 85–89, older than 90yrs, women were anemic in 20, 25, 29 and 33%, whereas men were anemic in 25, 34, 40 and 47% of cases, respectively. Severe anemia (Hb <10 g/dl) was observed in 17.3 % of anemic cases and was more frequently in women (440 out of 2106 cases) than in men (282 out of 2017) (p<0.001). Severe anemia was more often detected in elderly persons: 2.13, 3.52, 3.98, 5.08, 7.83 and 8.24% in women, and 2.79, 2.38, 3.26, 4.93, 3.99 and 7.73% in men in the age groups 70–74, 75–79, 80–84, 85–89 and 90+yrs, respectively. Based on the mean corpuscular volume (MCV) of red blood cells, anemia was defined as microcytic in 3.7%, normocytic in 78% and macrocytic in 18.4% of cases. Microcytic and normocytic anemia were more frequent in women (58.2% and 52.5% of cases), whereas macrocytic anemia revealed a male preponderance of 58%. An iron deficiency, as defined by lowered serum ferritin levels, was observed in 73% and in 63.4% of cases (male/female) in microcytic anemia. In macrocytic anemia lowered serum vitamin B-12 levels were detected in 1.36 % and decreased levels of folic acid in 7.5% of cases. In normocytic anemia C-reactive protein (CRP) was elevated in 64.7% and serum creatinine in 36.6% of cases. A decreased glomerular filtration rate (GFR), as defined by the MDRD1 analysis, was detected in 11.5% of men and in 18.4% of women (p<0.001). Importantly, a decline in GFR was associated with decreased Hb-levels (Pearson correlation r=0.117; p<0.01). These data clearly demonstrate that late-life anemia is frequent in patients admitted to the hospital as well as in outpatients. Anemia increases dramatically with advanced age reaching a prevalence of nearly 50% in elderly men. A recognizable cause of anemia for which a specific treatment is available is found in a small but relevant proportion of patients. In the majority of elderly the pathogenesis of anemia is complex and comprises a mixture of different subtypes including the anemia of chronic inflammation and of renal insufficiency. Disclosures: Stauder: Celgene: Research Funding.

scholarly journals A study on occurrence of anemia in primigravida women attending antenatal ward of BPKIHS

2017 ◽  
Vol 13 (3) ◽  
pp. 37-40
Author(s):  
Upendra Yadav ◽  
B Lal Das
Keyword(s):  
Protein Energy Malnutrition ◽  
Descriptive Statistics ◽  
Normal Delivery ◽  
Healthy Baby ◽  
Mild Anemia ◽  
Protein Energy ◽  
Nutritional Problem ◽  
Increased Risk ◽  
Moderate Anemia ◽  
Study Population

Background: Anemia is identified as a very common nutritional problem in developing countries. Prevalence of micro nutrient malnutrition in respect of iron, iodine and vitamin A is more wide spread then protein energy malnutrition. Pregnancy is a serious burden to the women with the disease for the anemia and places them at increased risk of mortality.Objective: To determine the Hb% level of Primigravida women. To classify status of anemia on the basis of level of Hb%. To find out the association between Hb level and selected background factors. To find out the association between the Hb% level and week of gestation and nutritional pattern.Method: A descriptive and exploring Study design was carried out on 300 primigravid women admitted in BPKIHS, Dharan antenatal ward and every alternate admitted case was selected for the study. The instrument was structured questionnaires with close ended, observation check list and observational sheet. Descriptive statistics and inferential statistics were used for data analysis.Result: Overall occurrence of anemia was found to be 42% among the study population. Mild anemia and moderate anemia were found to be 17% and 25% respectively. Greater proportions of 13-19 yr. women were found to be anemic compares to those > 20 years of age. Greater proportions of anemic women were from the nonsedentary groups than the sedentary. Both mild and moderate anemia were more among Primigravid women with >40 gestational week.Conclusion: Understanding the extent and severity of anemia among pregnant women is essential to the development and implementation of effective anemia control for the normal delivery and healthy baby in Nepal. Health Renaissance 2015;13 (3): 

scholarly journals Wide Spectrum of Molecular and Clinical Heterogeneity in HbH Disease in North Indian Patients

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1358-1358 ◽  
Author(s):  
Reena Das ◽  
Chris Fisher ◽  
Jasbir Kaur ◽  
Ayyub Helena ◽  
Amita Trehan ◽  
...  
Keyword(s):  
North India ◽  
Severe Anemia ◽  
Phenotype Correlation ◽  
Early Presentation ◽  
The Third ◽  
Mild Anemia ◽  
Moderate Anemia ◽  
Thalassemia Trait ◽  
Double Heterozygosity ◽  
Hbh Disease

Abstract Background: Deletional a+-thalassemia comprising of -a3.7 and -a4.2 deletions is commonly encountered in the Indian sub-continent but HbH disease, resulting from the co-inheritance of a+-thalassemia trait and ao-thalassemia trait, is uncommon with just a few cases reported. Few recent reports on the molecular characterization of patients with HbH disease from India has been published which includes both deletional a-thalassemia and non-deletional a-thalassemia. This report highlights the clinical and molecular heterogeneity of HbH disease from north India. Materials and Methods: We encountered 34 patients with HbH disease in 28 families from north India over 15 years and performed the molecular analysis to determine the frequency of both deletional and non-deletional alpha gene defects. Patients as well as parents and affected siblings were also studied for automated complete blood cell counts, reticulocyte counts and HbH inclusions using 1% brilliant cresyl blue. Cation exchange HPLC (Bio-Rad Laboratories, Hercules, CA, USA) and hemoglobin electrophoresis at pH 8.6 were performed. Genomic DNA from peripheral blood leucocytes was extracted by the phenol-chloroform method. A multiplex Gap-PCR was carried out as an initial screen which tested for deletions a3.7, a4.2, aSEA, aMED and aSA. Southern Blot for alpha and zeta probes with Bam H1 digest was performed on 20 subjects. PCR followed by sequencing for both a1 and a2 genes were done. The a–GlobinXS MLPA kit (MRC Holland) with 35 probes was used to screen for the extent of deletions. Results: Homozygous Hb Sallanches (a2 codon 104 G>A; Cys →Tyr) in 6 cases in 5 families was found. Homozygous polyadenylation signal mutation of a2(-AA) AATAAA →AATA—was detected in 3 cases. One patient each showed double heterozygosity for -a3.7/aHb Sallanches a, a76 +Ta/aHb Sallanches a. PolyAa/ aHb Sun Prairie a, aPolyAa/ a76 +Ta, and -a3.7/aHb Seal Rocka and aSeal Rock a/--. Three patients were double heterozygous for -a3.7/--SA. Fifteen patients from 12 families had a0 deletion of varying lengths in combination with -a3.7 based on the MLPA analysis. The extent of deletions was variable ranging from a0 starts upstream of z gene & extends downstream of a1, deletion of probes 1-18, deletion of probes 1-22 and deletion of probes 8-18.The genotype phenotype correlation illustrating the clinical heterogeneity of HbH disease is detailed in Table 1. Discussion: This is the largest series of cases of HbH disease encountered in Indians. Since HbH disease is uncommon in India, the clinical recognition of the diagnosis is limited to few centres and molecular characterization is incomplete. Our study shows considerable heterogeneity both at the molecular level as well as the clinical presentation. Alpha2 gene sequencing revealed a novel mutation with addition of +T at codon 76 leading to a frameshift mutation .MLPA will be useful in characterizing the approximate location of the breakpoints and designing simple GAP PCR assays to identify the deletion. Increased awareness amongst the clinicians as well as more diagnostic laboratories will help to identify more patients with HbH disease. Table 1: Genotype and phenotype correlation of cases with HbH Number of cases Clinical Severity Homozygous Hb Sallanches 6 cases (5 families) Severe anemia with early presentation Homozygous aPolyAa/ aPolyAa 3 cases Moderate anemia with presentation in the second decade Double heterozygous -a3.7/aHb Sallanches a 1 case Moderate anemia Double heterozygous a76 +Ta/aHb Sallanches a 1 case Moderate anemia with presentation in the third decade Double heterozygous aPolyAa/ aHb Sun Prairie a 1 case Moderate anemia with early presentation Double heterozygous aPolyAa/ a76 +Ta 1 case Moderate anemia with early presentation Homozygous a2 Codon 19 (-G) 1 case Severe anemia with early presentation Double heterozygous for -a3.7/--SA 3 cases Moderate anemia with presentation in the third decade Double heterozygous for aSeal Rock a/-- 1 case Severe anemia with early presentation Double heterozygous for -a3.7/aSeal Rock a 1 case Mild presentation at family screening in forth decade with mild anemia Double heterozygosity for -a3.7/-- 15 cases (13 families) Larger deletions showed early presentation with severe anemia and shorter deletions showed mild anemia Disclosures No relevant conflicts of interest to declare.

Causes and Severity of Anemia in Hereditary Hemorrhagic Telangiectasia

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 3776-3776 ◽  
Author(s):  
Kristy Pahl ◽  
Arkopal Choudhury ◽  
Raj S. Kasthuri
Keyword(s):  
Hereditary Hemorrhagic Telangiectasia ◽  
Initial Evaluation ◽  
Deficiency Anemia ◽  
Severe Anemia ◽  
Gi Bleeding ◽  
Visceral Organ ◽  
Center Of Excellence ◽  
Mild Anemia ◽  
Recurrent Epistaxis ◽  
Moderate Anemia

Abstract Introduction: Hereditary hemorrhagic telangiectasia (HHT) is characterized by the abnormal development of blood vessels leading to the formation of mucocutaneous telangiectasias and arteriovenous malformations (AVMs) in visceral organs. Anemia is a frequent complication of HHT secondary to blood loss from recurrent epistaxis, gastrointestinal bleeding, or both. The purpose of this study was to determine presence and severity of anemia at initial evaluation for HHT, and identify predictors of anemia. Methods: We conducted a retrospective chart review of HHT patients evaluated at the University of North Carolina HHT Center of Excellence from 2008-2015. Data abstracted from the medical record included diagnosis of anemia, hemoglobin, source of bleeding, HHT genotype, epistaxis severity score (ESS), presence of visceral organ AVMs, history of treatment of AVMs, iron therapy, and need for blood transfusions. All data were collected from the patient's first visit to the HHT center. Source of bleeding was recorded as epistaxis, GI bleeding, or both. Epistaxis severity was determined by the ESS, with a higher score indicating more severe bleeding. GI bleeding had to be confirmed by patient history, presence of bleeding telangiectasias on endoscopy, or ongoing symptoms (bright red or dark stools). Presence of anemia required verification with complete blood count results. Anemia severity was defined as mild if hemoglobin ≥ 10, moderate if 8-10, and severe if <8 g/dl. Screening for visceral organ AVMs was conducted as per the international guidelines for management of HHT. All patients were screened for pulmonary (pAVM) and brain (bAVM) AVMs, and screening for GI and liver (lAVM) AVMs was pursued only in symptomatic patients. Cramer's V and chi squared goodness of fit test determined if overall source or severity was linked to gender, genotype, and AVM location. A test of multinomial proportions determined statistical significance between individual gender, genotype, and AVM location with source and severity. Results: A total of 168 patients were included, of which 84 had documented anemia. In patients with anemia, the majority were female (72%), Caucasian (79%), and had ALK-1 genotype (50%). Mild anemia was most common (52%), followed by moderate (37%), and severe anemia (11%). Neither gender nor genotype was significantly associated with anemia severity. In patients with mild anemia, pAVMs were the most common visceral organ affected (45%), while GI telangiectasias were most common in the severe anemia group (67%). In moderate anemia, there was an equal proportion of GI and pAVM involvement (44%). Overall the presence of AVMs was linked to anemia severity (p-value: 0.0006), but there was no association between individual AVM site and anemia severity. The majority of patients with mild anemia were or had been on oral iron (76%), while patients with moderate (75%) and severe anemia (100%) had or were currently on IV iron replacement. Epistaxis was the most common cause of anemia in the mild and moderate groups (75% and 59% respectively), while both GI bleeding and epistaxis were present in the majority of patients with severe anemia (44%). The mean ESS in patients with mild anemia was 5.18 compared to 6.93 in those with moderate anemia. The ALK-1 genotype was a significant predictor of anemia related to epistaxis. LAVMs also significantly increased the risk for anemia from recurrent epistaxis while GI telangiectasias were associated with anemia from both GI bleeding and epistaxis. Conclusion:Iron deficiency anemia can be associated with significant morbidity. This is the first study to analyze the causes and severity of anemia in HHT patients at the time of initial evaluation to an HHT Center of Excellence. A high prevalence of anemia was found in this HHT population, with 50% of patients having documented anemia. We found that patients with ALK-1 mutations and liver AVMs are more likely to have epistaxis as the source of their anemia. Further, we demonstrate that patients with severe anemia more frequently present with GI AVMs. Understanding disease related predictors of anemia could help identify patients that are at highest risk and thereby facilitate aggressive screening in high-risk groups. Our findings are timely given the increasing awareness of HHT within the hematology community. Disclosures No relevant conflicts of interest to declare.

scholarly journals Beneficial effects of empagliflozin on hematocrit levels in a patient with severe anemia

2021 ◽  
Author(s):  
Jan Budzianowski ◽  
Janusz Rzeźniczak ◽  
Jarosław Hiczkiewicz ◽  
Dominika Kasprzak ◽  
Anna Winnicka-Zielińska ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Severe Anemia ◽  
St Segment Elevation ◽  
Beneficial Effects ◽  
Extensive Evaluation ◽  
Sodium Glucose Cotransporter ◽  
St Segment ◽  
Normocytic Normochromic Anemia ◽  
Patients With Diabetes ◽  
Normochromic Anemia

Abstract Introduction Sodium-glucose cotransporter (SGLT2) inhibitors may additionally benefit patients with diabetes by improving their erythropoiesis followed by the elevation of hemoglobin and hematocrit levels. Reason for the report In the case described, severe normocytic normochromic anemia was resolved when empagliflozin had been introduced to the therapy. Case summary A 78-year-old male patient was admitted to our hospital with a non-ST-segment elevation myocardial infarction. His past medical history included diabetes, right coronary artery angioplasty, myocardial infarction and paroxysmal atrial fibrillation which required anticoagulant treatment. When examined, severe normocytic normochromic anemia was also diagnosed. About two years prior to his admission, the patient began suffering from persistent anemia despite the modification of his anticoagulant therapy with warfarin, rivaroxaban and dabigatran. An extensive evaluation failed to provide an explanation for his anemia. Outcome Eventually, only the introduction of empagliflozin successfully increased the values of hemoglobin and hematocrit. Therefore, it transpires that SGLT2 enhances erythropoietin (EPO) secretion which subsequently raises hematocrit levels in patients with severe anemia. Graphic abstract

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