scholarly journals Study to evaluate the role of serum LDH in the diagnosis of Megaloblastic anemia by treatment response at a tertiary care center in the northeastern part of India

2019 ◽  
Vol 10 (4) ◽  
pp. 2927-2935
Author(s):  
Saurabh Chopra ◽  
Lalit Prashant Meena ◽  
Jaya Chakravarty ◽  
Madhukar Rai
Keyword(s):  
Bone Marrow ◽  
Folic Acid ◽  
Vitamin B12 ◽  
Treatment Response ◽  
Reticulocyte Count ◽  
Megaloblastic Anemia ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center

Megaloblastic anemia and Myelodysplastic syndrome are generally considered mutually exclusive diagnosis and at times becomes difficult to diagnose on the first encounter even after performing bone marrow examination. Aim of this study is to evaluate the role of LDH in the diagnosis of Megaloblastic anemia by treatment response at a tertiary care center in the northeastern part of India. Patients with age more than 12 years, Hemoglobin of patients less than 10 gm/dl, MCV ≥ 100 fl, Reticulocyte count <2.5 were included in the study. Based on serum LDH level patients were divided into two groups. Group A with serum LDH level ≥ 1200 U/L and Group B with serum LDH level of less than 1200 U/L. All these patients of serum LDH ≥1200 U/L were given a treatment trial of injectable Vitamin B12 containing 1000 μg of Vitamin B12 for 14 days. The response to treatment was monitored by an increment in reticulocyte count at day 5 and day 14. Bone marrow aspiration was done in all patients who had serum LDH less than 1200 mg/dl. Seventy-nine consecutive patients, who presented with anemia (Hb<10 g/dl) and macrocytosis (MCV > 100 fl) were included in the study. Median LDH values were higher in the patients who responded ( vitamin B12 deficient megaloblastic anemia ) as compared to non-responders. 93.5% of patients with megaloblastic anemia had Vitamin B12 deficiency, and in comparison, the folic acid deficiency was present among just 6.5 percent patients. Serum Vitamin B 12 and Folic acid level should not be used as a sole criterion for the diagnosis of Megaloblastic anemia and other parameters such as MCV, LDH, and characteristic blood picture, should all be taken into consideration before planning an appropriate treatment strategy.

scholarly journals Evaluation of pancytopenia on bone marrow aspiration- study at a tertiary care center in Kashmir valley, India

2018 ◽  
Vol 5 (4) ◽  
pp. 946
Author(s):  
Subuh Parvez Khan ◽  
Sajad Geelani ◽  
Fiza Parvez Khan ◽  
Noorjahan Ali ◽  
Shazieya Akhter ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Megaloblastic Anemia ◽  
Care Center ◽  
Tertiary Care ◽  
Disease Process ◽  
Bone Marrow Aspiration ◽  
Deficiency Anemia ◽  
Total Leucocyte Count ◽  
Tertiary Care Center ◽  
Kashmir Valley

Background: Pancytopenia refers to combination of anaemia, leukopenia and thrombocytopenia. It may be a manifestation of a wide variety of disorders, which primarily or secondarily affect the bone marrow. However, aetiology of pancytopenia varies from one geographical region to another. Bone marrow aspiration plays an important role in identifying the cause of pancytopenia. This study was carried to identify the causes of pancytopenia and to find out the bone marrow morphology in cases of pancytopenia.Methods: This study was conducted in the department of haematology in a tertiary care center in Kashmir valley for a period of 3 years. Inclusion criteria: cases with hemoglobin less than 10 gm/dl, total leucocyte count of less than 4000/mm3 and platelet count less than 100,000/mm3 were included in the study.Exclusion criteria: Patients receiving chemotherapy/radiotherapy were excluded from the study. Bone marrow aspiration (BMA) was performed from posterior iliac crest of the patients. Bone marrow aspiration smears were stained with Leishman stain for microscopy.Results: A total of 334 cases were studied during a period of 3 years. Age of patients ranged from 1 year to 85 years with mean of 43.59 years.180 cases were male, and 154 cases were female with male:female ratio of 1.2 :1. The commonest cause of pancytopenia was megaloblastic anemia seen in 103 cases (30.8%) followed by dual deficiency anemia seen in 69 cases (20.7%).37 cases (11%) were of acute leukaemia. Aplastic anemia was seen in 35 cases(10.5%). Other causes of pancytopenia were myelodysplastic syndrome, multiple myeloma, iron deficiency anemia and hypersplenism.Conclusions: Bone marrow aspiration in patients of pancytopenia helps in the identification of the underlying cause in most of the cases. BMA is helpful for understanding the disease process; and in planning further investigations and management of cytopenia patients. 

CLINICAL AND EPIDEMIOLOGICAL PROFILE OF CHILDREN WITH MEGALOBLASTIC ANEMIA AT A TERTIARY CARE HOSPITAL IN WESTERN INDIA: A CROSS SECTIONAL STUDY

2021 ◽  
pp. 35-38
Author(s):  
Anjali Sharma ◽  
Anand Deshpande ◽  
Chhavi Sauparna ◽  
Zeeshan Ahmed
Keyword(s):  
Bone Marrow ◽  
Folic Acid ◽  
Vitamin B12 ◽  
Megaloblastic Anemia ◽  
Tertiary Care ◽  
Neurological Manifestation ◽  
Vitamin B ◽  
Western India ◽  
Care Hospital ◽  
Vitamin B 12

Background: In India most cases of Megaloblastic anemia are caused by nutritional deciency of vitamin B12 and Folic acid. Initial workup include Complete Blood Count(CBC), Peripheral blood smear(PBS) ,Vitamin B12 asssay, folic acid assay and Bone marrow if required. Therefore, this study is planned to study the clinical and laboratory prole of children with Megaloblastic anemia and to study the clinical outcome of children with Megaloblastic anemia Methods: The study was a prospective observational study conducted among 60 children with megaloblastic anemia, aged 1- 12 years. Demographic data, clinical symptoms and signs, laboratory ndings, serum B12 and Folic acid ,Bone marrow report and stool routine microscopy report were collected. Chi square test was applied. Results: Among the 60 children 40% were female sand 60% were males. The age of the study population ranged from a minimum of 1 month to a maximum of 12 years with a mean(SD) of 8.08 (± 5.45).Majority of children (41.6%) were in age group of 6 months- 1 year. Most common symptoms fever and most common sign is pallor. More than fty percent cases presented with severe anemia. Many cases reported late, leading to delay in diagnosis leads to poor outcome. Developmental delay (neurological manifestation) is strongly associated with vitamin B 12 deciency as compared to folic acid deciency. (p value <0.05) Conclusions: There is a slight female preponderance seen in megaloblastic anemia, probably due to reduced attention to girl children in the study group. neurological manifestation is strongly associated with vitamin B 12 deciency as compared to folic acid deciency.

scholarly journals Bone marrow evaluation of patients having pancytopenia at tertiary care center, M. Y. hospital, Indore, India: one-year study

2019 ◽  
Vol 7 (4) ◽  
pp. 1257
Author(s):  
Meena Mittal ◽  
C.V. Kulkarni ◽  
Khushboo Likhar
Keyword(s):  
Bone Marrow ◽  
Aplastic Anemia ◽  
Megaloblastic Anemia ◽  
Care Center ◽  
Tertiary Care ◽  
Bone Marrow Aspiration ◽  
Tertiary Care Center ◽  
Erythroid Hyperplasia ◽  
One Year ◽  
Complications And Mortality

Background: Pancytopenia is reduction of all three formed elements of blood below the normal reference range leading to anemia, leucopenia, thrombocytopenia. Bone marrow aspiration is extremely helpful in evaluating the cause of pancytopenia by cellularity and cytology in order to prevent grave complications and mortality as the underlying pathology determines the management and prognosis of the patients. Aim of research study was to evaluate the patients having pancytopenia at tertiary care center, M.Y.H. Hospital, Indore, India.Methods: The present study was carried out over a period of one year from 2017 to 2018, in the Department of Pathology, M. Y. Hospital, Indore. During this period, a total of 109 bone marrow smears were examined. Out of these, 42 cases had the clinical presentation of pancytopenia. A detailed study was done regarding clinical examination and hematological and radiological investigations.Results: In this study 42 cases of pancytopenia were examined over a period of one year. The commonest cause of pancytopenia was megaloblastic anemia (33.34%) followed by aplastic anemia (19.05%). Others includes myelodysplastic syndrome (MDS), acute leukemia, erythroid hyperplasia and plasmacytosis.Conclusions: Bone marrow aspiration can diagnose majority of the cases of pancytopenia. Megaloblastic anemia and aplastic anemia are the commonest causes of pancytopenia.

Intrathecal Methotrexate–Induced Megaloblastic Anemia in Patients With Acute Leukemia

1999 ◽  
Vol 123 (9) ◽  
pp. 774-777 ◽  
Author(s):  
Sabah Sallah ◽  
L. Robert Hanrahan ◽  
Debra L. Phillips
Keyword(s):  
Bone Marrow ◽  
Folic Acid ◽  
Acute Leukemia ◽  
Megaloblastic Anemia ◽  
Care Center ◽  
Tertiary Care ◽  
Intrathecal Methotrexate ◽  
Therapeutic Trial ◽  
Design Data ◽  
Cytotoxic Treatment

Abstract Objective.—To evaluate the occurrence of megaloblastic anemia induced by the infusion of therapeutic or prophylactic methotrexate in patients with acute leukemia. Design.—Data on 3 patients with acute leukemia receiving intrathecal methotrexate were prospectively analyzed. Setting.—Large tertiary-care center. Results.—All 3 patients with acute leukemia developed megaloblastic anemia confirmed by examination of the bone marrow aspirate and biopsy. Two of the 3 patients had low folic acid levels, while all patients had normal serum B12 levels. All patients responded favorably to a therapeutic trial of folic acid. The median time for recovery of the hematologic parameters in these patients was 7 days. Conclusions.—Intrathecally administered methotrexate may result in megaloblastic changes in the bone marrow of leukemic patients. The morphologic clues suggestive of folate deficiency in patients with acute leukemia may be masked by coexisting factors, such as the effects of cytotoxic treatment, prior transfusions, or persistent changes from the leukemic clone itself. Caution should be exercised to avoid attributing these changes to the neoplastic process, since the prognosis and treatment for the conditions involved are totally different. Repeat examination of the bone marrow, obtaining folic acid and vitamin B12 levels, and a therapeutic trial of folic acid may help identify and reverse these changes.

Defining the role of the pediatric critical care nurse practitioner in a tertiary care center

2000 ◽  
Vol 28 (7) ◽  
pp. 2626-2630 ◽  
Author(s):  
Shari L. Derengowski ◽  
Sharon Y. Irving ◽  
Pamela V. Koogle ◽  
Robert M. Englander
Keyword(s):  
Critical Care ◽  
Nurse Practitioner ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Pediatric Critical Care ◽  
Care Nurse ◽  
Critical Care Nurse

Role of Office-Based Vaginoscopy in a Tertiary Care Center

2021 ◽  
Author(s):  
Rahul S. Patel ◽  
Alana L. Christie ◽  
Philippe E. Zimmern
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center

Spectrum of diseases diagnosed on bone marrow examination of 285 infants in a single tertiary care center

Hematology ◽  
2014 ◽  
Vol 20 (3) ◽  
pp. 175-181 ◽  
Author(s):  
Sreejesh Sreedharanunni ◽  
Man Updesh Singh Sachdeva ◽  
Narender Kumar ◽  
Prashant Sharma ◽  
Shano Naseem ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Care Center ◽  
Tertiary Care ◽  
Bone Marrow Examination ◽  
Tertiary Care Center

scholarly journals Congenital Familial Megaloblastic Anemia

Blood ◽  
1971 ◽  
Vol 37 (6) ◽  
pp. 615-623 ◽  
Author(s):  
BEATRICE C. LAMPKIN ◽  
ALLAN PYESMANY ◽  
CAROL B. HYMAN ◽  
DENMAN HAMMOND
Keyword(s):  
Bone Marrow ◽  
Folic Acid ◽  
Dna Synthesis ◽  
Vitamin B12 ◽  
Megaloblastic Anemia ◽  
Vitamin Deficiency ◽  
Preliminary Step ◽  
Orotic Aciduria

Abstract Two sisters with a previously unreported megaloblastic anemia unassociated with a deficiency of either folic acid or vitamin B12 are described. Deficiencies of these vitamins were ruled out by standard studies. All other previously reported forms of megaloblastic anemia not secondary to a vitamin deficiency, such as orotic aciduria, were also excluded by appropriate studies. Optimal hemoglobin responses were obtained after the administration of large amounts of both vitamin B12 and folic acid. Because of this hemoglobin response, the conversion of deoxyuridine-5-monophosphate to deoxythymidine-5-monophosphate in vitro was examined in bone marrow samples from both patients using a modification of a method described by Killmann.18 This preliminary step in DNA synthesis was found to be normal. The results of this test and the optimal hemoglobin response after administration of both vitamins suggest that both folic acid and vitamin B12 may be necessary at some other preliminary step in DNA synthesis.

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