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 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 Discriminant indexes to simplify the differential diagnosis between iron deficiency anemia and thalassemia minor in individuals with microcytic anemia

2020 ◽  
Vol 66 (9) ◽  
pp. 1277-1282
Author(s):  
Fernando Minervo Pimentel Reis ◽  
Raul Ribeiro de Andrade ◽  
Célio Fernando de Sousa Rodrigues ◽  
Fabiano Timbó Barbosa
Keyword(s):  
Differential Diagnosis ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Microcytic Anemia ◽  
Deficiency Anemia ◽  
Cross Sectional ◽  
Require Time ◽  
Additional Tool ◽  
Thalassemia Minor ◽  
Confirmatory Tests

SUMMARY INTRODUCTION: Microcytic anemias are very common in clinical practice, with iron deficiency anemia (IDA) and thalassemia minor (TT) being the most prevalent. Diagnostic confirmation of these clinical entities requires tests involving iron metabolism profile, hemoglobin electrophoresis, and molecular analysis. In this context, several discriminant indices have been proposed to simplify the differential diagnosis between IDA and TM. OBJECTIVE: The aim of this paper was to demonstrate the clinical relevance of the use of discriminant indices in individuals with microcytic anemia to simplify the differential diagnosis between iron deficiency anemia and minor thalassemia. METHODS: A bibliographic and cross-sectional search was performed in the PubMed, SciELO and LILACS databases, using the following descriptors: iron deficiency anemia, thalassemia minor, and differential diagnosis. RESULTS: More than 40 mathematical indices based on erythrocyte parameters have been proposed in the hematological literature in individuals with microcytosis. Green & King indexes (IGK), Ehsani index, and erythrocyte count (RBC) had excellent performances, especially when their efficacy was observed in adults and children. CONCLUSIONS: Confirmatory tests for differential diagnosis between IDA and TM require time-consuming and costly methods. Despite the excellent performances of IGK, Ehsani index, and RBC, none of them presented sufficient sensitivity and specificity to establish a diagnosis. However, they can provide a powerful additional tool for diagnostic simplification between IDA and TM.

The value of soluble transferrin receptor and Tfr-Ferritin index in the differential diagnosis of iron deficiency anemia

2009 ◽  
Vol 42 (4-5) ◽  
pp. 343-344
Author(s):  
Tulay Keskin ◽  
Ozlem Hurmeydan ◽  
Yalcin Onder ◽  
Lale Dagdelen ◽  
Nazli Caner ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Transferrin Receptor ◽  
Deficiency Anemia ◽  
Soluble Transferrin Receptor

scholarly journals Application of Bayesian Decision Tree in Hematology Research: Differential Diagnosis of β-Thalassemia Trait from Iron Deficiency Anemia

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Mina Jahangiri ◽  
Fakher Rahim ◽  
Najmaldin Saki ◽  
Amal Saki Malehi
Keyword(s):  
Differential Diagnosis ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Hematological Parameters ◽  
False Positive Rate ◽  
Deficiency Anemia ◽  
Beta Thalassemia ◽  
Bayesian Tree ◽  
Thalassemia Trait ◽  
Cart Algorithm

Objective. Several discriminating techniques have been proposed to discriminate between β-thalassemia trait (βTT) and iron deficiency anemia (IDA). These discrimination techniques are essential clinically, but they are challenging and typically difficult. This study is the first application of the Bayesian tree-based method for differential diagnosis of βTT from IDA. Method. This cross-sectional study included 907 patients with ages over 18 years old and a mean (±SD) age of 25 ± 16.1 with either βTT or IDA. Hematological parameters were measured using a Sysmex KX-21 automated hematology analyzer. Bayesian Logit Treed (BLTREED) and Classification and Regression Trees (CART) were implemented to discriminate βTT from IDA based on the hematological parameters. Results. This study proposes an automatic detection model of beta-thalassemia carriers based on a Bayesian tree-based method. The BLTREED model and CART showed that mean corpuscular volume (MCV) was the main predictor in diagnostic discrimination. According to the test dataset, CART indicated higher sensitivity and negative predictive value than BLTREED for differential diagnosis of βTT from IDA. However, the CART algorithm had a high false-positive rate. Overall, the BLTREED model showed better performance concerning the area under the curve (AUC). Conclusions. The BLTREED model showed excellent diagnostic accuracy for differentiating βTT from IDA. In addition, understanding tree-based methods are easy and do not need statistical experience. Thus, it can help physicians in making the right clinical decision. So, the proposed model could support medical decisions in the differential diagnosis of βTT from IDA to avoid much more expensive, time-consuming laboratory tests, especially in countries with limited recourses or poor health services.

Pseudothrombocytosis due to Microerythrocytosis: A Case of Beta Thalassemia Minor Complicated with Iron Deficiency Anemia

2013 ◽  
Vol 130 (2) ◽  
pp. 61-63 ◽  
Author(s):  
Sema Akinci ◽  
Tuba Hacibekiroglu ◽  
Abdulkadir Basturk ◽  
Sule Mine Bakanay ◽  
Tekin Guney ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Deficiency Anemia ◽  
Beta Thalassemia ◽  
Thalassemia Minor

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.

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