Anemia, Aplastic ; diagnosis ; Consensus ; Humans

Anemia, Aplastic ; diagnosis ; Diagnosis, Differential ; Humans ; Myelodysplastic Syndromes ; diagnosis

Anemia, Aplastic ; diagnosis ; therapy ; Child ; Diagnosis, Differential ; Humans ; Pediatrics

Anemia, Aplastic ; diagnosis ; pathology ; Humans ; Severity of Illness Index

Humans ; Anemia, Aplastic ; Leukemia, Large Granular Lymphocytic/diagnosis* ; Immunophenotyping

The author obtained index of red cell volume distribution width(RDW) and other red cell indices in 210 patients of various hematoncologic conditions and 200 healthy control group using, an automated blood analyzer, Coulter Counter Model S-plus II. This study performed to classify various etiologic anemia based on the MCV and RDW, to evaluate availability to the differential diagnosis in korean anemic distoders somewhat different from etiologies of anemias in foreginers. In the most of cases, the increase or decrease of MCV were always combined the pararell changes of MCH and MCHC: But the values of MCV and RDW were not correlated in control group and patient group. So the terms of heterogenous of homogenous anemia were meaningful morphologic classification than hypochromic or normochromic anemia. The heterogenous microcytic anemia contained iron deficiency anemia. In heterogenous normocytic anemia, myelophthisic anemia, acute leukemia were contained. In heterogenous macrocytic anemia, megaloblastic anemia, hemolytic anemia were contained. The homogenous microcytic anemia was observed in anemia of chronic disorders. In homogenous normocytic anemia, acute blood loss, chronic leukemia, multiple myeloma were contained. The aplastic anemia was belonged to homogenous macrocytic anemia. The diagnostic significance of RDW in hemoglobinopathies is most importhant. But this study was not contained hemoglobinopathies. Instead RDW was very helpful to differential diagnosis of most common anemias, iron deficiency anemia and anemia due to chronic disorders in Korea.
Anemia* ; Anemia, Aplastic ; Anemia, Hemolytic ; Anemia, Iron-Deficiency ; Anemia, Macrocytic ; Anemia, Megaloblastic ; Anemia, Myelophthisic ; Cell Size ; Classification* ; Diagnosis, Differential ; Erythrocyte Indices ; Hemoglobinopathies ; Humans ; Korea ; Leukemia ; Multiple Myeloma

BACKGROUND: Fanconi's anemia (FA) is an autosomal recessive disease characterized by aplastic anemia, pre-malignancy, congenital malformations and chromosome breakage syndromes. As up to 30% of patients have no detectable congenital anomalies, the modern diagnosis of FA rests on chromosomal breakage of patient's cells induced by chemical clastogens such as diepoxybutane (DEB) or mitomycin-C (MMC). METHODS: We have done chromosome breakage test to differentiate FA from 11 aplastic anemia, three Diamond-Blackfan syndrome, three myelodysplastic syndrome, one acute leukemia with congenital anomaly and three siblings of FA. The peripheral blood lymphocytes from each individual were co-cultured in phytohemagglutinin-containing medium by the three methods, i.e., DEB treated, MMC treated and un-treated. RESULTS: Five cases were found to have increased chromosomal breakages to DEB and MMC, confirming diagnosis of FA. Other 21 cases showed no increased chromosomal breakages. No overlap was found between FA group and others (P<0.01). In one FA, there was no increased spontaneous breakage, but increased breakage to DEB and MMC. Of five FA, one case showed no congenital anomalies. CONCLUSIONS: Chromosme breakage test was shown to be simple, reliable and useful in ascertaining the diagnosis of FA.
Anemia, Aplastic ; Chromosome Breakage* ; Diagnosis* ; Fanconi Anemia* ; Humans ; Leukemia ; Lymphocytes ; Mitomycin ; Mutagens ; Myelodysplastic Syndromes ; Siblings

A serum ferritin level is now the most sensitive and specific assay for iron deficiency. Incidence of iron deficiency anemia was determined by means of the serum ferritin level and the response to iron therapy, and changes in serum ferritin level were observed in 421 hospitalized pediatric patients with various diseases. The results were as follows : 1. Incidence of anemia was 45% of total hospitalized patients. Incidence of iron deficiency anemia was 5.9% of total patients and 13.3% of patients with anemia. It was most common between 6 moths and 2 years of age. 2. Serum ferritin levels were below 10ng/ml in 20(range;1-8.8ng/ml) and between 13.2 -24.5ng/ml in 5 out of 25 patients with iron deficiency anemia. Determination of the serum ferritin level, therefore, was thought to be an accurate method for the diagnosis of iron deficiency anemia. 3. Mean serum ferritin levels were 152.1ng/ml in total patients, 143.4ng/ml in patients without anemia, 7.9ng/ml in patient with iron deficiency anemia, and 199.9ng/ml in patients with anemia of other causes. Iron deficiency anemia was easily differentiated from the anemia of other causes by serum ferritin level. 4. Serum ferritin levels were elevated to significantly higher level in leukemia, aplastic anemia, rheumatoid arthritis, liver diseases and chronic infections.
Anemia ; Anemia, Aplastic ; Anemia, Iron-Deficiency* ; Arthritis, Rheumatoid ; Diagnosis ; Ferritins ; Humans ; Incidence ; Iron* ; Leukemia ; Liver Diseases ; Moths

OBJECTIVETo evaluate the value of mean corpuscular volume/RBC distribution width (MCV/RDW) combined with reticulocyte parameters in differential diagnosis of aplastic anemia (AA), myelodysplastic syndrome (MDS), megaloblastic anemia (MA) and hemolytic anemia (HA) in order to provide some laboratorial evidence for clinical doctors in first diagnosis of these diseases.

METHODSThe data of MCV/RDW and reticulocyte parameters of AA, MDS, MA and HA patients from January 1 of 2011 to August 31 of 2014 were retrospectively collected in West China Hospital of Sichuan University. And 158 healthy unrelated individuals with age-, sex-matched were collected as controls. The value of MCV/RDW and reticulocyte parameters in differentiating diagnosis of above mentioned 4 kinds of anemia diseases was assessed. ROC analysis was used to determine the cutoff value of MCV/RDW and the reticulocyte parameters were performed in differentiating diagnosis of AA and MDS.

RESULTSThe average values of MCV/RDW of 158 AA patients (79 acute AA patients and 79 chronic AA patients), 107 MDS patients, 13 MA patients and 81 HA patients increased in variable degrees as compared with the controls, and there was statistical difference between them, the MCV/RDW value of acute AA patients was obviously less than that of other patients. In the 4 kinds of anemia diseases, the reticulocyte absolute count in acute AA patients was the lowest, that of chronic AA, MA and MDS patients was higher, and that of HA patients was highest. The ratio of low fluorescent reticulocyte decreased, and the ratio of moderate and high fluorescent reticulocytes increased in the 4 kinds of anemia diseases, as compared to controls. The difference was statistically significant. The analysis of differential diagnosis of chronic AA and MDS showed that RDW-SD could differentiate the chronic AA from MDS. The area under the curve (AUC) of RDW-SD was 0.76 (P < 0.01). The cutoff value of RDW-SD was 22.75fl. The sensitivity and specificity of RDW-SD for differential of chronic AA and MDS was 49.5% and 98.7%, respectively.

CONCLUSIONMCV/RDW and reticulocyte parameters can be used as the laboratorial differential diagnostic indicators for AA, MDS, MA and HA diseases.

Anemia, Aplastic ; Anemia, Hemolytic ; Anemia, Megaloblastic ; China ; Diagnosis, Differential ; Erythrocyte Indices ; Humans ; Myelodysplastic Syndromes ; Reticulocyte Count ; Reticulocytes ; Retrospective Studies

The association between aplastic crisis and human parvovirus (HPV) B19 infection is well described in patients with sickle cell anemia. This association has also been described, although much less frequently, in patients with hereditary spherocytosis (HS). However, most cases of aplastic crises in patients with HS and induced by HPV B19 have been reported in children or adolescents. In this paper, we describe an aplastic crisis induced by HPV B19 in an adult with HS. A 34-year-old female presented with presyncope, febrile sensation, and myalgia. The complete blood counts showed severe anemia. The peripheral blood smear revealed spherocytosis with reticulocytopenia and pancytopenia. The direct Coombs' test was negative; the osmotic fragility test was positive. In the bone marrow aspirates, a few giant pronormoblasts with deep blue cytoplasm, pseudopods, and intracellular inclusion bodies were observed. The patient was given eight units of packed red blood cells. HPV B19 infection was proven by the presence of IgM antibodies to HPV B19 and the detection of viral DNA using the PCR technique. To the best of our knowledge, this is the first report in Korea that describes an adult with aplastic crisis presenting initially with HS.
Adult ; Anemia, Aplastic/*etiology ; Female ; Humans ; Parvoviridae Infections/*complications/diagnosis ; Parvovirus B19, Human ; Spherocytosis, Hereditary/*diagnosis