scholarly journals Magnesium Hydroxide as Curative Strategy against Lactic Acidosis in Goat

2020 ◽  
Author(s):  
A. A. Khaskheli ◽  
M. Q. Koondhar ◽  
A. A. Jariko
Keyword(s):  
Lactic Acidosis ◽  
Magnesium Hydroxide ◽  
Clinical Signs ◽  
Economic Loss ◽  
Normal Diet ◽  
Indirect Bilirubin ◽  
Ruminal Ph ◽  
Group A ◽  
Serum Biochemical ◽  
Group B

Lactic acidosis is a metabolic disorder caused by feeding errors. It represents a significant economic loss due to direct as well as indirect effects. In present study a total of twenty four goats were focused in order to observe the efficacy of Magnesium hydroxide against induced lactic acidosis. Goats were divided into two groups viz., A and B. Goats in group A were induced lactic acidosis by offering over feeding of grains, while group B was kept as control and normal diet was provided to the goats. After appearance of clinical signs, goat in group A were treated with Magnesium hydroxide at the dose rate of 1g/Kg body weight on the interval of 24, 48 and 72 hours. Results indicated body temperature, ruminal pH, blood pH, respiration rate and heart rate attained normal level after the treatment with Magnesium hydroxide. Serum biochemical examinations of liver function after induction of lactic acidosis revealed that glucose level (190.14±36.49mg/dl), total bilirubin (0.75±0.04mg/dl), direct bilirubin (0.27±0.03mg/dl), indirect bilirubin (0.40±0.03mg/dl), alanine aminotransferase (36.42±3.04 U/L) and alkaline phosphatase (420±3.65 U/L) were significantly (P less than 0.05) increased. Magnesium Hydroxide helped in improving the normal physiological parameters but did not improved the rumen and intestinal motility. The hematological examination after the induction of lactic acidosis revealed hemo-concentration and increased Hb% (15.02±1.30) which significantly (P less than 0.05) became normal within 72hrs after Magnesium hydroxide therapy. Present study concludes that the Magnesium hydroxide is very helpful in minimizing the complications of lactic acidosis in goat, thus may be used as therapy of choice.

Survival of classic swine fever virus in hams made from the meat of pigs vaccinated with the PAV-250 strain and unvaccinated pigs

2019 ◽  
Vol 10 (3) ◽  
pp. 536-551
Author(s):  
Heidi Amezcua Hempel ◽  
María Salud Rubio Lozano ◽  
Eliseo Manuel Hernández Baumgarten ◽  
Pablo Correa Girón † ◽  
Oscar Torres Ángeles ◽  
...  
Keyword(s):  
Reference Strain ◽  
Clinical Signs ◽  
Classical Swine Fever ◽  
Fever Virus ◽  
Direct Immunofluorescence ◽  
Biometric Analysis ◽  
Treatment Groups ◽  
Group A ◽  
Group B ◽  
Group D

The study was to determine the presence of Classical Swine Fever virus (CSFv), in the meat of vaccinated pigs with the PAV-250 strain and then challenged using the same strain. Five treatment groups were established (each with four pigs). Group A: Pigs thatwere fed with processed hams from negative animals; Group B: Pigs that were fed with processed hams from commercial pigs inoculated with the ALD (reference strain) (titre of 104.0/ml); Group C: Pigs fed with processed hams from pigs infected with the virulent ALD strain (titre of 102.5/ml); Group D: Pigs fed with processed hams from pigs vaccinated with the PAV-250 strain and challenged with the ALD strain (titre of 101.1/ml); and Group E: Pigs fed with processed hams from pigs vaccinated with two doses of the PAV-250 strain and challenged with the ALD strain (negative). Blood samples were taken at d 1, 5, 10, 15 and 20 for biometric analysis. Groups B, C and D manifested clinical signs of CSFv: 40 °C temperature, anorexia, paralysis, vomiting, diarrhea, tremor, hirsute hair and cyanosis. Pigs were slaughtered and necropsies performed to identify lesions in tissues. Results of direct immunofluorescence testing of tissues were positive and the virus was recovered. Under these study conditions, it was found that CSFv resisted the cooking method at 68 °C for 40 min in hams from unvaccinated pigs, and that the virus was able to transmit the disease to healthy unvaccinated pigs, whereas the hams from the vaccinated animals did not transmit the virus.

scholarly journals Comparison of Three Rapid Commercial Canine Parvovirus Antigen Detection Tests with Electron Microscopy and Polymerase Chain Reaction

2009 ◽  
Vol 21 (3) ◽  
pp. 344-345 ◽  
Author(s):  
Silke Schmitz ◽  
Christina Coenen ◽  
König Matthias ◽  
Thiel Heinz-Jürgen ◽  
Reto Neiger
Keyword(s):  
Electron Microscopy ◽  
Polymerase Chain Reaction ◽  
Chronic Diarrhea ◽  
Gastrointestinal Disease ◽  
Clinical Signs ◽  
Canine Parvovirus ◽  
Chain Reaction ◽  
Group A ◽  
Polymerase Chain ◽  
Group B

Different antibody-based tests for rapid detection of Canine parvovirus antigens in feces are commercially available, allowing quick diagnosis in a clinical setting. However, the diagnostic accuracy of these tests compared with standard methods has not been evaluated so far. In the current study, 3 commercial tests were compared with immune-electron microscopy (IEM) and polymerase chain reaction (PCR). Dogs were divided into 3 groups: group A, samples from dogs with acute hemorrhagic diarrhea ( n = 50); group B, dogs with chronic diarrhea ( n = 10); and group C, dogs with no evidence of gastrointestinal disease ( n = 40). Specificity of all 3 commercial tests versus PCR and IEM was good to excellent (92.2–100%). Sensitivity, in contrast, was poor: 15.8–26.3% versus PCR and 50–60% versus IEM. In group A, 10 dogs were positive by IEM and 24 dogs were positive by PCR. Positive PCR results were also obtained from animals in control groups (group B, 1 dog; group C, 5 dogs). No dog in group B or C was positive by IEM. In conclusion, the rapid tests are useful to diagnose canine parvoviral enteritis, but they do not rule out parvovirus infection in an animal with typical clinical signs. In addition, a small percentage of healthy dogs and dogs with chronic diarrhea showed positive PCR results; this may be due to asymptomatic/persistent infection or intestinal passage of virus. The significance of this finding remains unclear.

Histopathologic lesions in conventional pigs experimentally infected with Haemophilus parasuis serovar 5

2015 ◽  
Vol 43 (02) ◽  
pp. 91-96 ◽  
Author(s):  
R.-L. Austin-Busse ◽  
A. Ladinig ◽  
G. Balka ◽  
S. Zoels ◽  
M. Ritzmann ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Control Group ◽  
Post Inoculation ◽  
Haemophilus Parasuis ◽  
Tissue Samples ◽  
Group A ◽  
Pathologic Lesions ◽  
Group B ◽  
Kidney Lesions ◽  
Challenge Group

Summary Objective: In the present study various tissues of pigs were investigated for the presence of histopathologic lesions after an experimental infection with Haemophilus (H.) parasuis serovar 5. Material and methods: Conventional pigs (n = 36) were divided into a control group B (n = 9) and a challenge group A (n = 27), which was infected intratracheally. Pigs that did not die prior to study termination were euthanized on day 14 post inoculation. Postmortem samples of the lung, heart, liver, kidney, spleen, left tarsal joint capsule and brain were collected. Results: All but one pig with detectable histopathologic lesions (n = 11) showed typical macroscopic changes. Histopatho logic examination of all tissue samples identified pyelitis (n = 10), synovitis (n = 7) and meningitis (n = 7) and all those animals were euthanized prior to study termination. No histopathologic lesions were found in pigs of the control group. The correlations between pyelitis and meningitis, pyelitis and synovitis and synovitis and meningitis were significant (p < 0.001). No significant correlation could be observed between the histopathologic and the clinical examination of the joints. The investigation of samples from the joints by PCR was not significantly correlated with the observed synovitis. The clinical observation of neurologic signs was significantly correlated with meningitis (p = 0.03). A significant correlation (p < 0.001) could be detected between meningitis and the detection of H. parasuis by PCR in brain samples. Conclusions: H. parasuis constantly causes clinical signs and pathologic lesions as soon as it infects the brain while it can infect the joints without causing histopathologic lesions. Pigs with histopathologic lesions do not always show typical clinical signs. Only few studies described the finding of kidney lesions in pigs with Glässer’s disease and this is the first study to describe a pyelitis in pigs experimentally infected with H. parasuis. The observed pyelitis mainly occurred in acute cases.

scholarly journals The efficacy of paclitaxel drug-eluting balloon angioplasty versus standard balloon angioplasty in stenosis of native hemodialysis arteriovenous fistulas

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
P Cisneros Clavijo ◽  
M Donato ◽  
J Ajila ◽  
K Garzon ◽  
F Escobar ◽  
...  
Keyword(s):  
Vascular Access ◽  
Balloon Angioplasty ◽  
Clinical Signs ◽  
Target Lesion ◽  
High Rate ◽  
Central Type ◽  
Group A ◽  
Drug Eluting ◽  
Drug Eluting Balloon ◽  
Group B

Abstract Background End stage renal disease is on increasing trend and haemodialysis is the main dialysis modality among these patients. Thus, a functioning dialysis vascular access is critical to the delivery of life-saving haemodialysis treatment to these patients. Conventional angioplasty is the first line of treatment; with a 50% of permeability rate (6 months). For this reason, new alternatives are necessary to maintain the access permeability.Hypothesis: Paclitaxel coated balloon is superior to conventional plain balloon angioplasty with decreased re-stenosis of target lesion, improved access circuit and target lesion patency, and decreased number of interventions needed to maintain patency. Methods A total of 39 patients were randomized to receive a paclitaxel-coated balloon (n=15) or plain angioplasty balloon (n=24) after satisfactory angioplasty with a high-pressure balloon. The inclusion criteria were clinical signs of vascular dysfunction confirmed by Doppler Ultrasound and/or angiography. The primary endpoint was target lesion patency defined as time elapsed between the completion of effective and the appearance of restenosis at 3, 6 and 12 months after angioplasty. Secondary endpoints included the relationship between the location of the stenosis, previous angioplasty, demographic variables and survival. Results We recruited 39 patients with dysfunctional vascular accesses; 24 were assigned to the conventional balloon angioplasty group and 15 drug-eluting balloon angioplasty (paclitaxel). With demographic characteristics in Table I. In group A, all were autologous acces. Group B 16% (4) of the accesses were prosthetic and 84% (20) autologous. In relation to the type and length of stenosis, group A was more frequent at the level and longer, whereas in group B it predominated in the central type and less than 20 mm.In our study, we also observed a high rate of total occlusions, frequently in central vessels in group B, while in group A, where peripheral vessels were predominant, total occlusion was less frequent. Table II. We had no complications in either group, and dialysis was immediate at the end of the procedure. Group A did not present restenosis. Table III. Table III shows DEB group (15p) with 100% of permeability according to follow-up and only one (1/15) of patients died due to myocardial infarction and cerebrovascular accident and this patient kept lasted 9 months without restenosis In Table IV. Group B had 2 (8%) patients with restenosis so it was necessary to reoperate using a drug eluting balloon and until now there is no restenosis. From this group we do not have mortality. One patient 1 (24%) had a recovered infarction. Conclusions Paclitaxel-coated balloon angioplasty resulted in superior survival of dysfunctional peripheral vascular access at 12 meses. Both arms show equivalent complications and similar mortality FUNDunding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): Enrique Garcés Hospital

scholarly journals A mini review on the Lactic Acidosis in goats and its remedial approaches

2020 ◽  
Vol 5 (2) ◽  
pp. 98-103
Author(s):  
Asad Ali Khaskheli ◽  
Muhammad Ibrahim Khaskheli ◽  
Allah Jurio Khaskheli ◽  
Arshad Ali Khaskheli
Keyword(s):  
Alkaline Phosphatase ◽  
Lactic Acidosis ◽  
Sodium Bicarbonate ◽  
Glucose Level ◽  
Magnesium Hydroxide ◽  
Total Bilirubin ◽  
Direct Bilirubin ◽  
Cassia Fistula ◽  
Indirect Bilirubin ◽  
Rumen Ph

The current study was performed in order to investigate the threat of lactic acidosis in goats worldwide and explore the curative strategies. In this regards a detailed review was performed, however obtained facts were found to be much interesting and valuable. It was indicated by researchers that lactic acidosis is the most common problem in goats throughout the worlds. It represents significant economic loss due to direct and indirect effects. It was further stated that goats with lactic acidosis show decreased body temperature up to 98.1±0.89 °F, rumen and intestinal movement 0.23±0.48/m, rumen pH 4.8±0.07, blood pH 7.1±0.08, increased respiration rate 56.14±7.15/m and heart rate, 136.28±4.71/m. Affected goats also show signs of dyspnea, anorexia, inactivity, incoordination and recumbancy. The glucose level remains 190.14±36.49 mg/dl, total bilirubin 0.75±0.04 mg/dl, direct bilirubin 0.27±0.03mg/dl, indirect bilirubin 0.40±0.03 mg/dl, alanine aminotransferase ALT 36.42±3.04 U/l and alkaline phosphatase 420±3.65 U/l. Furthermore, Glucose level, total bilirubin, direct bilirubin, indirect bilirubin, ALT (SGPT) and alkaline phosphatase increase with treatment of Cassia Fistula, serum biochemical changes rapidly return to normal compared to treatment with Sodium bicarbonate or Magnesium hydroxide. The ruminal juices changes are also significantly improved with the treatment. The changes in the ingesta color, odor and consistency and rumen pH return to normal with the use of Cassia Fistula, Sodium bicarbonate and Magnesium hydroxide. In conclusion, Cassia fistula, Sodium bicarbonate and Magnesium hydroxide could be used as valuable strategies against lactic acidosis in goats. These therapies have been proved to be effective for treating the acidosis in goats. 

Effect of protein rich diet on experimental pathology of necrotic enteritis in broilers

2014 ◽  
Vol 11 (1) ◽  
pp. 21-29 ◽  
Author(s):  
MJ Ferdoush ◽  
MM Rashid ◽  
M Dipti ◽  
P Roy ◽  
PM Das ◽  
...  
Keyword(s):  
Fish Meal ◽  
Anaerobic Bacteria ◽  
Clinical Signs ◽  
Intestinal Content ◽  
Necrotic Enteritis ◽  
Predisposing Factor ◽  
Experimental Pathology ◽  
Group A ◽  
Group B ◽  
Protein Rich

This study was designed to know the effect of protein rich diet (50% fish meal) on the experimental pathology of necrotic enteritis in broilers. The Clostridium (Cl.) perfringens was obtained from the Department of Pathology, Bangladesh Agricultural University. Reconfirmation and recharacterization of Cl. perfringens were performed by culture, microscopic examination, staining and biochemical tests. The experimental pathologic studies were performed with supplementation of protein rich diet and challenged with Cl. perfringens in broilers. The dose of the inoculum for experimental infection with Cl. perfringens was 1x108 CFU/2.5ml. Fifteen birds of 21 days old were divided into 3 (A, B and C) groups each containing 5 birds. Birds of group A were fed with 50% fish meal at a rate of 500gm /kg of feed from day 21 to day 34 and challenged from day 28 to day 32 with 1x108 CFU/2.5ml. Birds of group B were fed with normal feed and challenged on day 28 for consecutive five days. Group C was kept as control with commercial normal pellet without Cl. perfringens. Birds of all groups were observed up to 34 days of age for clinical signs. Eighty percent (4/5) of the birds of group A developed moderate clinical signs like diarrhoea, ruffled feather and less feed intake whereas 40% (2/5) birds of group B developed same clinical signs like group A but in mild form. There was no mortality in any groups. All the birds were sacrificed at Day 35. Severe necrosis and hemorrhage in intestine, enlarged liver and hemorrhage in the base of heart were noted in the birds of group A. On an average 2-5 bacteria were found in impression smear of intestines in higher magnification (100x), and anaerobic bacteria counted from intestinal content was 1.51x107CFU/ml. In histopathology, necrosis and reactive cells were found in liver, heart, lung and sloughing off intestinal epithelium was also found in intestines. On the other hand similar lesions like group A were observed in the birds of group B but in moderate form and no bacteria was found in impression smears of intestines. Anaerobic bacteria counted from intestinal content of this group was 1.1x107CFU/ml. In histopathology necrosis, reactive cells were found but less than group A. The birds of group C were normal in all parameters. However, anaerobic bacteria count from the intestinal content was 0.8x107CFU/ml. From this study, it may be concluded that protein rich diet is a predisposing factor for necrotic enteritis in broilers. DOI: http://dx.doi.org/10.3329/bjvm.v11i1.17729 Bangl. J. Vet. Med. (2013). 11 (1): 21-29

scholarly journals Rapid on-site diagnosis of canine giardiosis: time versus performance

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Isaia Symeonidou ◽  
Athanasios Ι. Gelasakis ◽  
Androulla N. Miliotou ◽  
Athanasios Angelou ◽  
Konstantinos V. Arsenopoulos ◽  
...  
Keyword(s):  
Gold Standard ◽  
Zinc Sulfate ◽  
Clinical Signs ◽  
Negative Likelihood Ratio ◽  
Microplate Assay ◽  
Immunochromatographic Strip ◽  
Group A ◽  
Immunochromatographic Strip Test ◽  
Group B ◽  
Strip Test

Abstract Background Infections by protozoans of the genus Giardia are a common cause of diarrhea in dogs. Canine giardiosis constitutes a disease with a zoonotic potential; however, it is often underestimated due to its challenging diagnosis. The objective of the study was to assess the diagnostic performance of an immunochromatographic strip test (SpeedTMGiardia, Virbac, France) comparing it with microscopy (zinc sulfate flotation) by utilizing the combination of an enzyme immunoassay (ProSpecTTMGiardia EZ Microplate Assay, Oxoid Ltd., UK) and the PCR as the gold standard. A positive result in both ELISA and PCR was set as the gold standard. Methods Initially, fecal samples from dogs with clinical signs compatible with giardiosis were tested with the SpeedTMGiardia test and separated into two groups of 50 samples each: group A (positive) and group B (negative). Thereafter, all samples were examined by zinc sulfate centrifugal flotation technique and assayed by the ProSpecTTMGiardia Microplate Assay and PCR. The performance of the SpeedTMGiardia and zinc sulfate centrifugal flotation tests were calculated estimating sensitivity, specificity, and positive and negative likelihood ratio; the chi-square and McNemar tests were used for the comparison of the two methods. Results Giardia cysts were not detected by microscopy in 16 out of the 50 samples (32%) of group A and in none of group B samples. Eight out of 50 samples in group B (16%) were tested positive both with the ProSpecTTMGiardia Microplate Assay and PCR. Fecal examination with the SpeedTMGiardia test was more sensitive (86.2%) than the parasitological method (58.6%, P < 0.001) while the specificity of both methods was 100%. Conclusions The SpeedTMGiardia test is an easy-to-perform diagnostic method for the detection of Giardia spp., which can increase laboratory efficiency by reducing time and cost and decrease underdiagnosis of Giardia spp. infections. This immunochromatographic strip test may be routinely exploited when a rapid and reliable diagnosis is required, other diagnostic techniques are unavailable and microscopy expertise is inefficient. In negative dogs with compatible clinical signs of giardiosis, it is recommended either to repeat the exam or proceed with further ELISA and PCR testing.

scholarly journals A Comparative Study on Efficacy of Polymyxin B, Neomycin and Polymyxin B, Neomycin, Hydrocortisone in the Treatment of Otitis Externa at Nepal Medical College and Teaching Hospital, Kathmandu

2017 ◽  
Vol 2 (2) ◽  
pp. 162-167
Author(s):  
Mayuri Gupta ◽  
S Aryal
Keyword(s):  
Teaching Hospital ◽  
Otitis Externa ◽  
Clinical Signs ◽  
Polymyxin B ◽  
Medical College ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Cure Rates

IntroductionAcute otitis externa (AOE) is a common but preventable ear condition. Tenderness with movement of the tragus or pinna is a classic feature of otitis Externa. Polymyxin B, neomycin, hydrocortisone preparations are the choice for first-line therapy when the tympanic membrane is intact. This study atiempted to compare the efficacy of polymyxin B, neomycin and polymyxin B, neomycin, hydrocortisone in the treatment of otitis Externa.ObjectiveTo compare the efficacy of polymyxin B, neomycin and polymyxin B, neomycin, hydrocortisone in the treatment of otitis Externa.MethodologyTo evaluate the efficacy of polymyxin B, neomycin and polymyxin B, neomycin, hydrocortisone in the treatment of otitis Externa, a hospital based, randomized, prospective study was conducted in Nepal Medical College and Teaching Hospital (NMCTH), Atiarkhel, Kathmandu from August 2012 to May 2014. 70 outpatients suffering from otitis Externa who met the inclusion and exclusion criteria were included. Patients were randomized into group A and group B with lotiery system. Odd number patients were included in group A and even number patients in group B. Group A patients received pack soaked with ribbon gauge in polymyxin B, neomycin ointment and Group B patients received pack soaked with ribbon gauge in polymyxin B, neomycin, hydrocortisone ointment. The patients were called for follow up after 48 hours and 96 hours to assess the improvement on the basis of tragal and circumduction tenderness either present or absent (present 1 or absent 2). A decrease in the clinical signs and symptoms (i.e. tragal and circumduc_on tenderness) was noted. Absence of pain was considered as clinically cured.ResultsIn comparison to polymyxin B, neomycin group, hydrocortisone group exhibited statistically significant effectiveness after 48 hours of treatment (p<0.05), but in cure rates after 96 hours, no statistical significant difference was observed between two groups (p>0.05).ConclusionPolymyxin B, neomycin, hydrocortisone group showed higher and faster cure rates than polymyxin B, neomycin group in the treatment of otitis Externa at 48 hours follow up. Birat Journal of Health SciencesVol.2/No.1/Issue 2/ Jan - April 2017, Page: 162-167 

scholarly journals A comparative study of early postoperative feeding versus conventional feeding for patients undergoing caesarean section

2019 ◽  
Vol 8 (12) ◽  
pp. 5002
Author(s):  
Neeraja S. ◽  
Naritha Reddy ◽  
Naima Fathima
Keyword(s):  
Cesarean Section ◽  
Comparative Study ◽  
Caesarean Delivery ◽  
Normal Diet ◽  
Early Feeding ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Postoperative Feeding

Background: Early alimentation after caesarean delivery probably has limited clinical significance in terms of improved energy and protein intake. Decreasing the post-operative ileus is possible with early feeding. Objective of this study was to study efficacy of early postoperative feeding versus conventional feeding for patients undergoing caesarean section.Methods: Present study was hospital based comparative study carried out among 200 women who fulfilled the selection criteria. The cases were divided into 2 groups of 100 each by suitable random sampling technique. Group A included 100 cases who were given early feeding within 6 hours of caesarean delivery. Group B included 100 control who were given the feeding after 24 hours of caesarean delivery.Results: The mean duration of postoperative hospital stay in Group A and Group B was 4.59±0.65 and 4.81±0.81 days respectively (p <0.05). The mean time to return of bowel sounds in Group A and Group B was 2.79±1.36 and 3.55±1.49 hours respectively (p <0.01). 2(2%) cases in group A had postoperative ileus symptoms, whereas 3 (3%) cases in Group B had the same. Statistically significant difference (p <0.05) was seen in terms of vomiting 1% versus 17%, nausea 5% versus 16%, abdominal distention 2% versus 7%, diarrhea 4% versus 90% in the early feeding versus conventional feeding groups.Conclusions: It can be concluded from present study that fast return to the normal diet is possible with early feeding among women undergoing cesarean section compared to the conventional feeding among women undergoing cesarean section.

Small Populations of PNH-Type Cells in Aplastic Anemia Patients Are Derived from PIG-A Mutant Stem Cell Clones without Proliferative Advantage.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 974-974 ◽  
Author(s):  
Kanako Mochizuki ◽  
Chiharu Sugimori ◽  
Xingmin Feng ◽  
Xuzhang Lu ◽  
Gudrun H. Reed ◽  
...  
Keyword(s):  
Stem Cell ◽  
Clinical Signs ◽  
Gene Mutations ◽  
Small Populations ◽  
Initial Examination ◽  
Hematopoietic Stem ◽  
Exon 2 ◽  
Cell Clones ◽  
Group A ◽  
Group B

Abstract Several studies revealed that a small number of glycosylphosphatidylinositol anchored protein-deficient cells are detectable in peripheral blood of healthy individuals but these PNH-type cells do not persist for a long time because they are originated from committed progenitor cells rather than primitive stem cells with PIG-A gene mutations. We have studied more than 700 patients with AA for the presence of CD55-CD59- granulocytes and red blood cells using highly sensitive flow cytometry and detected 0.003% or more PNH-type cells in about 50% of patients. In patients whose proportions of PNH-type are very low, the appearance of PNH-type cells may also be transient because they are not derived from true PIG-A mutant stem cell clones. In an attempt to characterize hematopoietic clones from which small populations of PNH-type cells are originated, we studied changes in the proportion of PNH-type granulocytes, clinical findings, and PIG-A mutations over 3–7 years on 52 AA patients (18 males and 33 females). The initial examination revealed less than 0.1% (0–0.075%) PNH-type granulocytes in 21 patients (Group A) and more than 0.1% (0.101–36%) PNH-type granulocytes in 31 patients (Group B). In three (14%) patients of Group A, PNH-type granulocytes became undetectable 2.9, 1.3 and 1.6 years after the initial examination. 0.007 % granulocytes became detectable 2.5 years after the first examination which produced a negative result in one patient. Among the other 17 (81%) patients of Group A, proportions of PNH-type granulocytes remained stable at 0.03–0.41% over 3–6 years. By contrast, 5 (16%) patients of Group B showed an apparent increase in the proportion of PNH-type cells (from 1.46%, 1.63%, 3.31%, 23%, and 36% to 79%, 21%, 83%, 55%, and 78%, respectively) 2 to 4 years after the initial examination. Four of the five developed clinical signs of hemolysis. The proportion of PNH-type cells in Group B patients remained stable in 33 (63%) patients and declined in 12 (23%) patients. When we sorted a small (0.04%) population of PNH-type granulocytes from a patients of Group A and analyzed PIG-A gene, only one point mutation at position 479, C to T was revealed in the exon 2. The finding that the proportion of PNH-type cells remained stable over 3 years in most Group A patients suggests that very low proportions of PNH-type cells are derived from primitive hematopoietic stem cell clones with PIG-A mutation. Among AA patients displaying small populations of PNH-type cells, only those whose proportion of PNH-type cells are more than 1% may be at a high risk of developing hemolytic PNH.

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