scholarly journals Mothball ingestion as a manifestation of pica, leading to paradichlorobenzene CNS toxicity

2020 ◽  
Vol 20 (2) ◽  
pp. 932-935
Author(s):  
Joon Yau Leong ◽  
Margarita Gianniosis ◽  
Saman Zafar ◽  
Yan Zhang
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Fragile X ◽  
Hypochromic Anemia ◽  
High Index ◽  
Deficiency Anemia ◽  
Neurological Assessment ◽  
Cerebellar Peduncles ◽  
Ataxia Syndrome ◽  
High Index Of Suspicion

Background: Pica is a poorly understood psychiatric disorder that presents with the ingestion of non-nutritious substances for unclear reasons. A high index of suspicion for unusual toxin exposure aids in the diagnosis of pica patients presenting with unexplained neurodegenerative features. Methods: We present a 47-year-old female with worsening gait over the past year. Prior to this, she was fully independent with activities of daily living, but is now mostly housebound due to frequent falls. Past medical history is significant for menorrhagia, iron deficiency anemia and pica. CBC and iron studies revealed iron deficiency with microcytic hypochromic anemia. MRI brain demonstrated symmetrical T2 hyperintensities within the middle cerebellar peduncles. Results: Differential diagnoses for her clinical deficits and imaging, including Spinocerebellar Ataxia, Multiple System At- rophy and Fragile X Tremor-Ataxia Syndrome, were excluded based on neurological assessment, family history and genetic PCR testing. Collateral history revealed a regular habit of mothball ingestion and serum paradichlorobenzene levels were elevated to 15mcg/mL. The patient was treated with iron replacement therapy and her symptoms gradually improved over several months. Conclusion: Iron deficiency anemia is commonly associated with pica, which can lead to toxin ingestion. A high index of suspicion for toxin ingestion in pica patients can immensely aid in the diagnosis. Mothball abuse secondary to pica may affect the CNS and can present with nonspecific neurodegenerative changes. To our knowledge, there have been no reported cases in the literature with paradichlorobenzene neurotoxicity predominantly affecting the middle cerebellar peduncles. Keywords: Mothball; paradichlorobenzene; PDCB; toxicity; pica; middle cerebellar peduncles.

scholarly journals Not every hypochromic anemia is an iron deficiency anemia. Case study

2021 ◽  
Vol 2 (8) ◽  
pp. 42-46
Author(s):  
Leonid I. Dvoretsky ◽  
◽  
Alii Yu. Asanov ◽  
Kira S. Papko ◽  
Margarita P. Tuaeva ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Iron Deficiency ◽  
Treatment Failure ◽  
Female Patient ◽  
Iron Deficiency Anemia ◽  
Hypochromic Anemia ◽  
Deficiency Anemia ◽  
Thalassemia Minor ◽  
Long Time

Case study of female patient with hypochromic anemia, who has been treated with iron preparations for iron deficiency anemia for a long time, is reported. A hemoglobin electrophoresis test has been performed due to treatment failure, and β-thalassemia (thalassemia minor) has been diagnosed. The data on β-thalassemia and approaches to differential diagnosis of hypochromic anemias are summarized.

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 Indices in differentiating iron deficiency anemia from thalassemia trait- a comparative study

2021 ◽  
Vol 12 (10) ◽  
pp. 81-86
Author(s):  
Sufia Ahmad ◽  
Noorin Zaidi ◽  
Syed Riaz Mehdi ◽  
Sumaiya Irfan ◽  
Sharique Ahmad
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Hypochromic Anemia ◽  
Bone Marrow Examination ◽  
Deficiency Anemia ◽  
Beta Thalassemia ◽  
Blood Samples ◽  
Biochemical Assays ◽  
Different Types ◽  
Thalassemia Trait

Background: Iron deficiency anemia (IDA) and beta thalassemia trait (BTT) are the two most common and important causes of microcytic hypochromic anemia in India. It is very difficult to differentiate between the two. Many different types of techniques have been proposed for the same. While some are invasive like bone marrow examination others are not available at all centers, like electrophoresis. Hence different indices come into play. Aims and Objective: This study was undertaken to compare the efficacy of Shine and Lal index and Mentzer index in differentiating between IDA and BTT. Materials and Methods: A total of 407 anemia cases were studied over a period of 18 months and their blood samples were subject to different hematological and biochemical assays to diagnose the type of anemia. Results: Based on these tests 92.1% cases were found to be of IDA whereas 3.7% cases were found to be of BTT. Then both the indices were applied in the above mentioned cases. Conclusion: While Shine and Lal index was found to have better sensitivity, Mentzer index was found to have better specificity.

scholarly journals “PREVALENCE OF BETA-THALASSEMIA TRAIT IN PREGNANT WOMEN ATTENDING ANTENATAL CLINIC”

2021 ◽  
pp. 45-47
Author(s):  
Uma Jain ◽  
Preeti Gupta ◽  
Shaily Sengar
Keyword(s):  
Iron Deficiency ◽  
Pregnant Women ◽  
Iron Deficiency Anemia ◽  
Gestational Age ◽  
High Performance ◽  
Hypochromic Anemia ◽  
Antenatal Clinic ◽  
Deficiency Anemia ◽  
Beta Thalassemia ◽  
Thalassemia Trait

INTRODUCTION- Iron deficiency anemia and thalassemia syndromes,especially beta thalassemia trait (BTT),are the two most commonly ccuring microcytic hypochromic anemias highly prevalent in countries like India. Iron deficiency anemia is the first most common cause of anemia in pregnancy,beta thalassemia trait is the second most frequent cause of anemia of pregnancy. Patients with thalassemia trait shows an increased incidence of anemia during the second trimester of pregnancy. Beta Thalassemia Trait (BTT) patients are usually asymptomatic and ignorant of their carrier state unless diagnosed by testing. Screening for thalassemia can be done by measuring HbA2 levels MATERIAL AND METHOD- This is a retrospective study. The data were collected from a clinic and associated st pathology in Shivpuri and a private maternity hospital in Gwalior from 1 January 2019 to 30 June 2021.94 patients were included in the study.All pregnant women between the age of 18-45 years and at any gestational age with hemoglobin level <10g/dL and microcytic hypochromic anemia (report of CBC) were included in the study. High-Performance Liquid Chromatography (HPLC) and serum ferritin report were collected. RESULTS- In our study the most common age group in which the anemia was found between 19-35 years (80.85%).Most of the patients were primigravida (44.68%),between 26-37 wks of gestational age (82.97%),from a rural area (70.21%). Only 2 patients had a family history (2.12%) of beta-thalassemia and 6 patients had a history (6.38%) of blood transfusion. In our study moderate anemia was found in 55.31% of cases followed by mild anemia 25.53% and severe anemia 19.14%. In our study iron deficiency anemia was found in 87.23% only minor Beta-thalassemia was found to be 4.25%, of the patient,and the coexistence of iron deficiency anemia and beta-thalassemia in pregnant women is 8.51%. In our study total of 12 patients (4 cases of only minor beta-thalassemia and 8 cases of minor beta-thalassemia associated with IDA) The prevalence rate of beta-thalassemia in our study was 7.8%. CONCLUSION- the recommendation is to diagnose beta-thalassemia in pregnant patients is essential to give proper treatment.The screening of pregnant patients prevents unnecessary parental iron therapy and iron overload in case of anemia.further studies are needed in this field and less expensive and accurate methods should come in place.

Síndrome de Plummer-Vinson en un paciente con enfermedad celíaca. Reporte de un caso

2021 ◽  
Vol 51 (2) ◽  
Author(s):  
Oscar Bedini ◽  
Ariel Naves ◽  
Patricia San Miguel ◽  
José Brunetti
Keyword(s):  
Celiac Disease ◽  
Iron Deficiency ◽  
Esophageal Carcinoma ◽  
Iron Deficiency Anemia ◽  
Duodenal Bulb ◽  
Hypochromic Anemia ◽  
Deficiency Anemia ◽  
Esophageal Lumen ◽  
Plummer Vinson Syndrome ◽  
The Relationship

Plummer-Vinson syndrome is infrequent and is more common in middle-aged women. There are few reports of its association with celiac disease. Both entities can be linked to hypochromic anemia and esophageal carcinoma. We report the case of a 47-year-old female patient who, since the age of six, presented frequent episodes of iron deficiency anaemia, having required blood transfusions Eight months before the doctor’s appointment, when she swallowed a tablet, she presented a choking episode due to obstruction. Since then, she has been eating only soft foods. She had iron deficiency anemia, with low ferritin levels. A video swallow performed three months earlier showed a lack of fillong of 2 mm by 7 mm, which obliterated 75% of the esophageal lumen, and another similar image, 2 cm below the first one, arranged in the opposite direction, which obliterated the lumen by 50%. A video endoscopy was performed, which showed two membranes causing stenosis of the lumen in the cricopharyngeal region; they were removed. In the duodenal bulb and second portion, a flattened mucosa was observed, compatible with celiac disease. Biopsies were performed and the anatomopathological diagnosis was highly compatible with celiac disease, Marsh Oberhuber 3B. Conclusion. This observation demonstrates that celiac disease can coexist with Plummer Vinson syndrome. Therefore, it should be investigated in the context of this syndrome, with which it shares the relationship with iron deficiency anemia, and also taking into account the possibility of development of esophageal carcinoma in both entities.

scholarly journals Iron-Deficiency Anemia Related to Ancylostoma duodenale Infection in 67 Years Old Female Patient

2022 ◽  
Vol 6 (3) ◽  
pp. 1455-1459
Author(s):  
Widodo Adi Prasetyo ◽  
Armen Ahmad
Keyword(s):  
Abdominal Pain ◽  
Iron Deficiency ◽  
Physical Examination ◽  
Female Patient ◽  
Iron Deficiency Anemia ◽  
Clinical Manifestations ◽  
Hypochromic Anemia ◽  
Deficiency Anemia ◽  
Stool Examination ◽  
Ancylostoma Duodenale

Background. Ancylostomiasis is an infection caused by hookworms. It is estimated that hookworms infect 1.2 billion people worldwide and cause higher morbidity than other types, mainly due to iron deficiency anemia. Hookworm infection increases with age. The main clinical manifestations are abdominal pain, features of iron deficiency anemia and hypoproteinemia. Diagnosis is based on the finding of characteristic eggs in the stool. Case presentation. A 67-year-old female patient had been administered into the Internal Medicine Ward of Dr. M. Djamil Padang Hospital with the main complaint of weakness, fatigue, and lethargy which had increased since 3 days before being admitted to the hospital. The patient also had complaints of pale skin, fever, heartburn, decreased appetite and weight loss. The patient was admitted to the hospital with awareness of compost mentis, cooperative, and his general condition appeared to be moderately ill, blood pressure 130/90 mmHg, pulse rate 104 x/minute, regular pulse, adequate filling, respiratory rate 22 x/minute, temperature 37.8 C. On physical examination, the conjunctiva of the pantient’s eyes were anemic. Laboratory examination revealed Hemoglobin 4 g/dl, Hematocrit 16%, MCV/MCH/MCHC 62fl/15pg/25g/dL, Reticulocytes 0.5%, SI/TIBC 22/315 mg/dL, Ferritin 8.5 ng/mL, and peripheral blood smear showing severe hypochromic microcytic anemia and relative eosinofilia. Ancylostoma duodenale worm eggs were found on routine stool examination. Final diagnosis was Severe microcytic hypochromic anemia caused by an iron deficiency and Ancylostomiasis. Severe microcytic hypochromic anemia caused by iron deficiency and ancylostomiasis was established based on the patient’s history, physical examination and laboratory investigations. Conclusions. Hookworms infect many people worldwide and cause high morbidity, mainly due to iron deficiency anemia. The highest prevalence is found in the tropics and subtropics, including Indonesia. The main clinical manifestations are abdominal pain, features of iron deficiency anemia and hypoproteinemia. Diagnosis is based on the finding of characteristic eggs in the stool. Albendazole 400 mg single dose resulted in 80% cure and a dose of 200 mg/day for 3 days gave 100% cure. Treatment of anemia is by administering ferrous sulfate or ferrous gluconate orally 200 mg three times a day and continued for up to 3 months after normal hemoglobin levels are achieved to maintain iron stores.

scholarly journals A 12 Year-Old Girl with Severe Iron Deficiency Anemia Secondary to Chronic Pediculosis Infestation

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 19-19
Author(s):  
Nicholas Fustino ◽  
Joel Waddell ◽  
Zachary Panzer
Keyword(s):  
Iron Deficiency ◽  
Blood Cell ◽  
Iron Deficiency Anemia ◽  
Conflicts Of Interest ◽  
Head Louse ◽  
Iron Status ◽  
Hypochromic Anemia ◽  
The United States ◽  
Laboratory Evaluation ◽  
Deficiency Anemia

A 12 year-old female presented to an outside emergency department with her grandmother due to worsening fatigue over the preceding six months. She also reported intermittent right-sided abdominal discomfort for two months. The patient's past medical history was only remarkable for chronic infestation withPediculus humanus capitis(head louse), reportedly treated multiple times with topical medications without resolution. The infection had been persistent for six years. She did not consume excessive amounts of cow's milk. Physical exam was remarkable for pallor, tachycardia, systolic ejection murmur and visible nits. Laboratory studies showed hemoglobin 4.7 g/dL, mean corpuscular volume (MCV) 53.4 fL, reticulocytes 3.9%, white blood cell count 14.2 x 103 /µL, platelet count 449 x 103 /µL, total iron binding capacity (TIBC) 472 µg/dL, serum iron 8 µg/dL, iron saturation 2%, and ferritin 2 ng/mL. Peripheral blood smear showed a severe microcytic hypochromic anemia with anisopoikilocytosis, without schistocytes or blasts. She was premenarchal. Stool was negative for occult blood, ova and parasites, and celiac studies were negative. A diagnosis of iron deficiency of anemia (IDA) was made by the classic presentation of microcytic, hypochromic anemia with hypoferritinemia and elevated TIBC, along with an inappropriately low reticulocyte count. The most common etiologies of iron deficiency anemia in children were ruled out by history and laboratory evaluation, making chronic pediculosis the most likely cause in this patient. She received aggressive treatment for pediculosis, packed red blood cell transfusions, and oral ferrous sulfate. By day 65 after presentation, her laboratory values had normalized (hemoglobin of 13.6 g/dL, MCV of 80.3 fL, ferritin of 28 ng/mL). Pediculosis infestation remained resolved. Iron deficiency is the leading etiology of anemia worldwide and the most common hematologic disorder. Parasitic and vector-borne infections are a common cause of IDA internationally, but uncommon in developed countries. Severe iron deficiency secondary to pediculosis in children is an exceedingly rare entity despite high infestation rates, with nearly 40% of North American children affected.Pediculus humanusis an Arthropod species of sucking lice belonging to the familyPediculidae. The two subspecies arePediculus humanus capitis(head louse) andPediculus humanus humanus(body louse). The average child with pediculosis infestation will average 0.008 mL of blood loss per day due to louse consumption; however, heavily infested children can lose up to 0.7 mL per day. Thus, the patient may have had greater than 1.5 liters of blood consumed during her period of infestation. To our knowledge, this is the only reported case of a child in the United States with severe IDA secondary to chronic severe lice infestation. Iron deficiency is likely an under-recognized complication of severe and/or chronic pediculosis. In patients with history of mental health conditions, homelessness, or children who are in neglectful social situations, an evaluation of hemoglobin and iron status by the pediatrician may be a useful adjunct in severe cases. Disclosures No relevant conflicts of interest to declare.

scholarly journals Three-Month Iron Supplementation as Treatment for Microcytic Hypochromic Anemia in Pregnancy

2021 ◽  
Vol 53 (2) ◽  
Author(s):  
Donel Donel ◽  
Dhini Aiyulie Novri ◽  
Ruza Prima Rustam ◽  
Maya Savira
Keyword(s):  
Iron Deficiency ◽  
Pregnant Women ◽  
Iron Deficiency Anemia ◽  
Iron Supplementation ◽  
Hypochromic Anemia ◽  
Primary Data ◽  
Deficiency Anemia ◽  
Quasi Experimental ◽  
Anemia In Pregnancy ◽  
In Pregnancy

In pregnant women there is a twofold increase in iron requirements due to increased blood volume without the expansion of plasma volume. Pregnant women are very prone to suffering from iron deficiency anemia. Iron deficiency anemia generally has an erythrocyte index which represents hypochromic microcytic. This study aimed to determine the effect of three-month iron tablet supplementation as a therapy against microcytic hypochromic anemia in pregnancy. This was a quantitative quasi-experimental study using pre-test and post-test design. The study was conducted in May-September 2020 at the Arifin Achmad Regional General Hospital, Riau Province, Indonesia. Subjects were 30 pregnant women with microcytic hypochromic anemia. Primary data were analyzed using statistical paired sample t-tests. Results showed that there was an increase in hemoglobin levels after the supplementation of iron tablet from an average of 9.1 ± 1.2 gr/dl to 11.8 ± 1.0 g/dl. This change was significant based on the results of the T-test (p-0.003) Thus, iron supplementation for three month significantly increases hemoglobin levels in pregnant women.

scholarly journals Pattern of Red Cell Count and Red Cell Distribution Width (RDW %) in Beta Thalassaemia Trait in Adults

2018 ◽  
Vol 9 (1) ◽  
pp. 31-35
Author(s):  
MMU Rahman ◽  
M Nayem ◽  
W Begum ◽  
FA Begum ◽  
MNU Ahmed ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Cell Count ◽  
Iron Deficiency Anemia ◽  
Hypochromic Anemia ◽  
Deficiency Anemia ◽  
Beta Thalassemia ◽  
Red Cell ◽  
Red Cell Count ◽  
Thalassemia Trait ◽  
Rbc Count

Microcytic hypochromic anemia is one of the commonest hematological abnormalities in Bangladeshi population. Iron deficiency anemia and beta thalassemia traits are the most frequent causes of microcytic hypochromic anemia which are sometimes difficult to differentiate clinically and by routine laboratory examinations due to similar blood picture. To differentiate between patients of beta thalassemia trait and iron deficiency anemia, physicians need a group of investigations including peripheral blood film, estimation of HbA2, serum ferritin, serum iron, total iron binding capacity and transferrin saturation. But these tests are relatively expensive, time consuming and need sophisticated techniques. The aim of this study was to evaluate the pattern of red cell count and RDW-CV (%) in beta thalassemia trait in adults and thereby determine the role of these parameters in differentiation between patients of beta thalassemia trait and iron deficiency anaemia. In this study 50 confirmed cases of beta thalassemia trait aged 18 to 60 years, both male and female were included as cases and 50 age- and sex-matched iron deficiency subjects were included as control. RBC count and RDW-CV (%) were measured by an electronic cell counter device. The present study revealed that RBC count was higher in patients with beta thalassemia trait than that in iron deficiency anemia and RDW-CV(%) was significantly higher in patients with iron deficiency anemia than that in beta thalassemia trait.Bangladesh J Med Biochem 2016; 9(1): 31-35

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