scholarly journals Red cell parameters, HbA2 levels, and the best discrimination index in beta thalassaemia trait in Sri Lanka

2021 ◽  
Vol 52 (1) ◽  
pp. 13
Author(s):  
K. H. B. P. Fernandopulle ◽  
H. M. J. P. Herath ◽  
L. D. Udawatta ◽  
P. M. N. K. Senarathna

Background: Beta thalassaemia is an inherited disease that is a cause of continuous burden on the affected families and the society. The objective of the study was to evaluate the efficacy of Naked Eye Single Tube Red Cell Osmotic Fragility Test (NESTROFT) for the detection of beta thalassaemia trait when used for the screening in Pakistani population. Methods: All participants requesting a complete blood count were included in the study. Informed consent was obtained. Naked Eye Single Tube Red Cell Osmotic Fragility Test was performed with freshly prepared 0.36% buffered saline. Turbidity in the tubes was an indication for individuals to be positive for beta thalassaemia trait. Hemoglobin electrophoresis was performed on all positive cases to confirm the sensitivity and the reliability of the screening test. Chi-Square test was used to test for any significant correlation between the different hematological parameters and other variables. Results: A total of 812 patients were included in the study from January 2017 to June 2017. The mean age of participants was 35.5 + 13.6 years. There were 351 (43.2%) male and 461 (56.7%) female participants. A 100% Naked Eye Single Tube Red Cell Osmotic Fragility Test sensitivity was obtained with 65 (8%) positive cases having HbA2 levels of more than 3.2% indicating their true positivity whereas, all 747 (92%) negative cases having HbA2 levels of less than 3.2% indicating their true negativity. Conclusion: NESTROFT was found and a rapid screening test for the identification of carriers of beta thalassaemia trait in our population.


Author(s):  
Ankita Sain ◽  
Arvind Bhake ◽  
Anil Agrawal ◽  
Sophia Thomas

Introduction: Numerous red cell indices are in practice for surveillance of Microcytic Hypochromic (MCHC) anaemia in determination of their aetiology to the Iron Deficiency Anaemia (IDA) and Beta Thalassaemia Trait (BTT). The studies have revealed that there exists the discrepancies for Sensitivity (SN) and Specificity (SP) for any single index conclusive to classify them to the categories of IDA and BTT. A comparative review is needed as to know which index is suitable to discriminate between above two major entities under MCHC anaemia, which can be put to the practice in resource poor laboratories. Aim: A systematic review was planned for diagnostic reliability of red cell indices that segregates IDA from BTT in a morphological classification of MCHC anaemia. Materials and Methods: A systematic literature search was conducted in a database that yielded 36 studies dealing with one or more of the five included indices (Mentzer index, Bessman index, Green and King index, Srivastava index and Sirdah index) in the present analysis. The data for SN and SP of these indices were collected and compared from their performance at discrimination between IDA and BTT and Youden index was calculated to compare the performance of individual index. Results: Of these five indices, the comparative statistics has shown Green and King index works well at the SN of 79.37% and SP of 82.54% as compared to the rest of the indices. The second closest index that is practicable at discriminating IDA from BTT is Mentzer index. Conclusion: None of the indices can be completely relied upon to achieve a conclusive segregation. However, Green and King and Mentzer indices can be used for screening the suspected population to identify patients which may need the specialised tests to confirm the diagnosis to bring this population under proper treatment either for IDA or BTT.


2021 ◽  
Vol 66 (2) ◽  
pp. 96
Author(s):  
Samantha Senavirathna ◽  
Lakmali Ranasinghe ◽  
Yashobha Thilakarathne

2020 ◽  
Vol 5 (1) ◽  
pp. 16-25
Author(s):  
Lixiang Chen ◽  
Jie Wang ◽  
Jing Liu ◽  
Hua Wang ◽  
Christopher D. Hillyer ◽  
...  

Abstract Liver, spleen, and bone marrow are 3 key erythropoietic tissues in mammals. In the mouse, the liver is the predominant site of erythropoiesis during fetal development, the spleen responds to stress erythropoiesis, and the bone marrow is involved in maintaining homeostatic erythropoiesis in adults. However, the dynamic changes and respective contributions of the erythropoietic activity of these tissues from birth to adulthood are incompletely defined. Using C57BL/6 mice, we systematically examined the age-dependent changes in liver, spleen, and bone marrow erythropoiesis following birth. In addition to bone marrow, the liver and spleen of newborn mice sustain an active erythropoietic activity that is gradually lost during first few weeks of life. While the erythropoietic activity of the liver is lost 1 week after birth, that of the spleen is maintained for 7 weeks until the erythropoietic activity of the bone marrow is sufficient to sustain steady-state adult erythropoiesis. Measurement of the red cell parameters demonstrates that these postnatal dynamic changes are reflected by varying indices of circulating red cells. While the red cell numbers, hemoglobin concentration, and hematocrit progressively increase after birth and reach steady-state levels by week 7, reticulocyte counts decrease during this time period. Mean cell volume and mean cell hemoglobin progressively decrease and reach steady state by week 3. Our findings provide comprehensive insights into developmental changes of murine erythropoiesis postnatally and have significant implications for the appropriate interpretation of findings from the variety of murine models used in the study of normal and disordered erythropoiesis.


Author(s):  
De las Nieves López MA ◽  
◽  
Robles Mateos C ◽  
Soria Cano JJ ◽  
Barón Fernandez O ◽  
...  

Background and Methods: Gliflozins are widely prescribed drugs in patients with type 2 diabetes. We pursue to explain abnormal increments in red cell parameters observed in this population, by means of a longitudinal study in 149 patients with a gliflozins exposure period of 12±6 months. Red cell parameters, HbA1c and other variables were recorded. Results: HbA1c fraction decreased (-0.5±1.3, 95% CI: -0.7 to -0.3, p<0.001), while mean hemoglobin (0.5±0.9, 95% CI: 0.3 to 0.6, P<0.001) and hematocrit (1.6±2.6, 95% CI: 1.2 to 2.0, P<0.001) increased. Mean (SD) hematocrit increased 2.7±1.9 in 112 patients, and decreased -1.7±1.5 in 37 (p<0.001 for subgroup differences). The larger increments in PCV were proportional to higher plasma fraction at baseline (p=0.009). Conclusion: Red cell parameters after gliflozins exposure tend to increase and may reach abnormally high thresholds in some patients with type 2 diabetes.


Author(s):  
Prakas Kumar Mandal ◽  
Tuphan Kanti Dolai ◽  
Soma Mandal ◽  
Tamanash Mondal ◽  
Suman Kumar Maji

Background: Detection of traits/carriers plays an important role in preventing the birth of a thalassemic child. West Bengal, one of the eastern states in India is the home to a bulk of socially challenged population including scheduled castes and scheduled tribes among others. The present study aimed to detect the prevalence of different hemoglobinopathies in a socially challenged district of West Bengal.Methods: In this retrospective cross sectional study thalassemia detection camps were organized at the community level over a period of four years. Venous blood samples were subjected to complete hemogram and high performance liquid chromatography (HPLC). In few difficult cases samples were sent to the reference laboratory for molecular characterization. The prevalence of heterozygous, homozygous or compound heterozygous states of different thalassemias and hemoglobinopathies across various respondent groups (e.g. children, premarital, postmarital and antenatal) and existing caste categories (scheduled tribes, scheduled caste and general) were analyzed.Results: We analyzed a total of 114,606 HPLC reports; 18681 (16.30%), 15438 (13.47%) and 80487 (70.23%) cases belonged to scheduled tribes, scheduled castes and general category respectively. Out of 114,606 cases, 11,001 (9.6%) had revealed abnormal hemoglobins; beta thalassaemia trait was the most common (6.63%; n=7602) across all subgroup analysis. Among others, HbE trait, sickle cell trait and HbD trait were detected in 1788 (1.56%), 1362 (1.18%) and 126 (0.11%) cases respectively.Conclusions: Beta thalassaemia trait and HbE trait are the common haemoglobin variants in this rural district of West Bengal. The prevalence of sickle gene revealed in the present study is much less than previous studies in the locality.


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