scholarly journals Cell Blood Count Alterations and Patterns of Anaemia in Autoimmune Atrophic Gastritis at Diagnosis: A Multicentre Study

2019 ◽  
Vol 8 (11) ◽  
pp. 1992 ◽  
Author(s):  
Marco Vincenzo Lenti ◽  
Edith Lahner ◽  
Gaetano Bergamaschi ◽  
Emanuela Miceli ◽  
Laura Conti ◽  
...  

Background: Autoimmune atrophic gastritis (AAG) leads to iron and/or vitamin B12 malabsorption, with subsequent haematological alterations which could represent the sole clinical manifestation. We aimed to assess patterns of anaemia and micronutrient deficiencies in patients with AAG at the time of diagnosis. Methods: Observational, multicentre, cross-sectional study including consecutive adult patients diagnosed with AAG within the last ten years. Cell blood count, red cell distribution width, serum vitamin B12, and ferritin were collected. Multivariate analysis for predictive factors of anaemia was computed. Results: 654 AAG patients (mean age 59.2 ± 13.8 years, female (F): male (M) ratio = 2.3:1) were included. Anaemia was present in 316 patients (48.3%; mean age 60.1 ± 15.8 years, F:M ratio = 2.3:1). Pernicious anaemia (132/316 cases, 41.7%) was more common in males (27.1% versus 12.4%; p = 0.001) and in older patients (63.0 ± 14.6 versus 58.9 ± 14.9 years; p = 0.014), while iron deficiency anaemia (112/316 cases, 35.4%) was more common in females (16.9% versus 10.0%; p = 0.039) and in younger patients (56.8 ± 16.6 versus 60.2 ± 14.6 years; p = 0.043). The prevalence of iron deficiency was equally distributed between anaemic and non-anaemic patients (p = 0.9). Anisocytosis (odds ratio: 10.65, 95% confidence interval: 6.13–18.50, p < 0.0001) was independently associated with anaemia. Conclusions: Anaemia is a common manifestation in AAG patients, mostly due to micronutrient deficiencies. Scant haematologic alterations and micronutrient deficiencies may precede overt anaemia.

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Ana Palacios ◽  
Kristen Hurley ◽  
Silvia De Ponce ◽  
Victor Alfonso ◽  
Nicholas Tilton ◽  
...  

Abstract Objectives Anemia is a major public health problem among young children. In addition to iron deficiency, other micronutrient deficiencies have been associated with anemia. The purpose of this study was to identify biomarkers associated with anemia in children <5 years from rural Guatemala. Methods A total of 182 infants (6–24 m) and 207 preschoolers (36–60 m) were recruited from community surveillance to participate in a randomized controlled trial of nutrition and child development. Methods included measured weight, length/height and venous blood draws. Inclusion criteria were length/height-for-age z-score <-1.0 and Hb >7.0 g/dL. Cross-sectional analyses using generalized linear mixed models of baseline data examined associations between anemia (Hb <11.0 g/dL) and micronutrient deficiencies, adjusting for maternal, child and sociodemographic variables. Iron deficiency was defined as low ferritin based on inflammation status, and/or high soluble transferrin receptor, ≥1.97 mg/L. Deficiencies for other parameters were designated as: zinc <65 µg/dL; vitamin B12 < 200 pg/mL; and plasma folate <3 ng/mL or erythrocyte folate <100 ng/mL. Results Prevalence of anemia was 56% in infants and 12% in preschoolers. Among anemic infants/preschoolers, rates of iron, zinc, folate and vitamin B12 deficiencies were 83/75%; 63/18%; 3/4%; and 9/0%, respectively. For infants, the odds of anemia were higher when children were zinc deficient [OR = 3.59;95%CI (1.64–7.85)], after adjusting for community cluster, sex, age, maternal education and household size. No biomarkers were associated with anemia in preschoolers. Conclusions Iron and zinc are common micronutrient deficiencies in children from low- and middle-income countries. These findings suggest that micronutrient deficiencies coexist among children in Guatemala, and that zinc should be considered as part of the prevention strategies to reduce anemia. In preschoolers, no biomarkers were associated with anemia, suggesting that other biological and psychosocial factors could be influencing anemia in this age group. Funding Sources The Mathile Institute for the Advancement of Human Nutrition, Sackler Institute for Nutrition Science of the New York Academy of Sciences.


2020 ◽  
Vol 15 (2) ◽  
pp. 243-245
Author(s):  
Md Anisur Rahman ◽  
Most Umme Habiba Begum ◽  
Md Abdur Razzak ◽  
Jesmin Khandker

Pernicious anaemia often poses diagnostic and therapeutic challenges to the clinician. Herein, we representing a 55 years old lady who presented with anaemia along with its classical symptoms and features of peripheral neuropathy due to Pernicious anaemia associated with Psoriasis and Arthropathy without any association of other autoimmune disorder. She had all objective evidences of autoimmune atrophic gastritis in gastric fundic biopsy and positive anti-intrinsic factor antibody. Treatment with injection vitamin B12 improved the condition rapidly. JAFMC Bangladesh. Vol 15, No 2 (December) 2019: 243-245


2021 ◽  
Vol 12 (7) ◽  
pp. 42-46
Author(s):  
Rajendra Kumar Dhayal ◽  
Shree Krishan Vishnoi ◽  
Rakesh Jora ◽  
Sandeep Choudhary

Background: Vitamin B12 deficiency is common in children but under diagnosed disorder. Helicobacter pylori infection plays an important role in the development of atrophic gastritis and related malabsorption. There may be a relationship between H.Pylori infection and vitamin B12 deficiency. Aims and Objective: To find out prevalence of Helicobacter pylori infection by endoscopic and histopathological findings, in children aged 2-18 years, with vitamin B12 deficiency. Materials and Methods: Seventy-eight patients with deficient serum vitamin B12 levels were evaluated. Upper GI Endoscopy was performed in all cases and gastric biopsies were obtained for histopathological examination and evidence of H. pylori infection. Results: Tissue biopsy revealed chronic atrophic gastritis in 09 patients and chronic antral gastritis in 52 patients. H. pylori infection by histology was positive in 45(57.70%) patients. We found significant correlation between atrophic gastritis and H. pylori infection, as well as between H. pylori infection and B12 deficiency. Conclusion: H.pylori has an effect on gastric mucosa, which affects the absorption of vitamin B12. Thus individuals with B12 deficiency should be subjected for diagnostic evaluation of H.pylori infection so that appropriate therapy can be initiated.


Author(s):  
Tuphan Kanti Dolai ◽  
Somnath Mondal ◽  
Manisha Jain ◽  
Prakas Kumar Mandal

Background: Tribal population in West Bengal constitutes a significant proportion (5.1%) and the vulnerable group because of lower socio-economic status, poor literacy rate and malnutrition. The present study was conducted to evaluate hemoglobin level and prevalence of anemia among the tribal children from the western districts of West Bengal, India.Methods: A cross-sectional study was conducted on school going (class I to class VIII) tribal children (≥5 to <13years) during March 2019 to February 2020. A complete blood count was done by automated blood cell counter and anemia was classified as per WHO criteria.  They were also tested for markers of common nutritional anemias (serum ferritin, serum vitamin B12 and serum folate). Data entry and analysis was done on SPSS version 15. A p-value of <0.05 was considered statistically significant.Results: Total 1, 010 tribal children were included with male:female=1:1.35. Among these, 46.34% (n=468) children had anemia. Among all anemic children 47.65% (n=223), 51.93% (n=243/468) and 0.42% (n=2) respectively had mild, moderate and severe anemia. There was a high prevalence (81.68%) of microcytic red blood cells in the total cohort; among anemic children, 53.94% have microcytosis while no macrocytosis was revealed. Among all grade anemias, iron, folate and vitamin B12 deficiency were found in 44.65% (n=209/468), 13.24% (n=62/468) and 25% (n=117/468) respectively.Conclusions: The prevalence of anemia among tribal children of West Bengal is a matter of concern. The high prevalence of microcytic indices in non-anemic population highlights the dire need for screening for the causes of anemia in this population. 


Nutrients ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 2815 ◽  
Author(s):  
Ann-Kathrin Lederer ◽  
Luciana Hannibal ◽  
Manuel Hettich ◽  
Sidney Behringer ◽  
Ute Spiekerkoetter ◽  
...  

Vegans are at an increased risk for certain micronutrient deficiencies, foremost of vitamin B12. Little is known about the short-term effects of dietary change to plant-based nutrition on vitamin B12 metabolism. Systemic biomarkers of vitamin B12 status, namely, serum vitamin B12 and holotranscobalamin, may respond quickly to a reduced intake of vitamin B12. To test this hypothesis, 53 healthy omnivore subjects were randomized to a controlled unsupplemented vegan diet (VD, n = 26) or meat-rich diet (MD, n = 27) for 4 weeks. Vitamin B12 status was examined by measurement of serum vitamin B12, holotranscobalamin (holo-TC), methylmalonic acid (MMA) and total plasma homocysteine (tHcy). Holo-TC decreased significantly in the VD compared to the MD group after four weeks of intervention, whereas metabolites MMA and tHcy were unaffected. Body weight remained stable in both groups. VD intervention led to a significant reduction of cholesterol intake, and adequate profiles of nutrient and micronutrient status. Lower intake of vitamin B12 was observed in VD, which was mirrored by a lower concentration of serum vitamin B12 and reduced holo-TC after 4 weeks. Plasma holo-TC may be a fast-responding biomarker to monitor adequate supply of vitamin B12 in plant-based individuals.


1999 ◽  
Vol 13 (10) ◽  
pp. 1343-1346 ◽  
Author(s):  
Schenk ◽  
Kuipers ◽  
Klinkenberg-Knol ◽  
Bloemena ◽  
Sandell ◽  
...  

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 3351-3351
Author(s):  
Maria E. Montoya ◽  
Peter R. Van Delden ◽  
M. Tarek Elghetany ◽  
J. David Bessman

Abstract Detection of iron deficiency remains poorly understood and costly due to inappropriate screening. Low ferritin is a definitive diagnosis of iron deficiency, but screening with ferritin is not allowed. Therefore surrogates in the blood count have been used to justify obtaining the serum ferritin. The purpose of this research was to analyze the role of Hemoglobin (Hgb), Mean Corpuscular Volume (MCV), and RBC Distribution Width (RDW) as surrogates in screening for iron deficiency. All 2,563 patients with serum ferritin levels gathered over 12 months were reviewed. The relative utility of Hgb, MCV, and RDW in screening for low ferritin levels was shown through multiple Receiver Operator Characteristic (ROC) curves. 264 patients had a ferritin less than 10 ng/ml and 210 between 11 to 20 ng/ml. Results indicate that when viewed independently MCV correlates most closely to low ferritin as seen in Figure 1. RDW and Hgb in both males and females demonstrate a weaker association though remains of value. Table1 lists the values at which the three screening tools were 95% and 100% sensitive for detecting ferritin levels of 10 ng/ml and below. In contrast the data indicate that for ferritin levels from 11 to 20 ng/ml all three screening variables have poor sensitivity and specificity. This is demonstrated clearly in Figure 2. The data suggest that the most severe iron deficiency (ferritin under 10 ng/ml) can be well predicted by abnormalities in the blood count; however less severe iron deficiency (ferritin 10 to 20 ng/ml) cannot be anticipated from the blood count. The blood count does not appear to be a practical alternative to ferritin for screening for iron deficiency. Table 1: Sreening Variable Sensitivities* 100% Sensitivity 95% Sensitivity *values for ferritin less than 11 ng/ml MCV >98.2 >90.0 RDW <12.2 <13.1 Hgb Males >15.0 >13.7 Hgb Females >14.2 >12.6 Figure 1 Figure 1. Figure 2 Figure 2.


2020 ◽  
Author(s):  
Avinash Pandey ◽  
Shivkant Singh ◽  
Raj Aryan ◽  
Krishna Murari

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.


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