1.Modified classification of anemia by RDW.
Hyeong Ki HWANG ; Myung Soo HYUN ; Bong Sup SHIM
Yeungnam University Journal of Medicine 1993;10(1):58-67
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
2.Type of Anemia Due to Organic Solvents.
Choong Ryeol LEE ; Cheol In RYU
Korean Journal of Occupational and Environmental Medicine 1998;10(2):180-188
The purpose of this study Is whether we can presuppose the correlation between some type of anemia and exposure to organic solvents using some hematologic index such as MCV, RDW and MCHC. The authors conducted the hematological examination of 160 male workers who were exposed organic solvents and those of 167 control workers. The type of anemia was slightly macrocytic anemia, and the RDW was generally homogenous in workers exposed to organic solvents whereas those of control were normocytic and homogenous.
Anemia*
;
Anemia, Macrocytic
;
Humans
;
Male
;
Solvents*
3.A Case of Vitamin B12 Deficiency Megaloblastic Anemia Following Total Gastrectomy.
Jee Sook HAHN ; Dong Ki NAM ; Eun Jig LEE ; Sun Ju LEE ; Yun Woong KO ; Il Nam SUNWOO ; Kyong Sik LEE
Yonsei Medical Journal 1988;29(3):270-277
Megaloblastic anemia following gastrectomy is due to the total absence or inadequate secretion of intrinsic factor and is manifested by megalobastic changes in bone marrow, blood cells, and other proliferative cells. In Korea, detailed description and precise analyses of the cases of megaloblastic anemia following gastrectomy are relatively rare in contrast to the potential of its incidence from gastrectomy due to many causes or to the importance of its clinical significance. Here, we present the case of a 51-year old man who had undergone a total gastrectomy with esophagojejunostomy and incidental splenectomy due to early gastric cancer and developed megalobastic anemla 7 years after surgery. After gradual improvement of clinical and hematologic features with treatment of parenteral vltamin Bl2, he was followed-up with vitamin B12 maintenance therapy.
Anemia, Macrocytic/*etiology
;
Anemia, Megaloblastic/diagnosis/*etiology
;
Case Report
;
Gastrectomy/*adverse effects
;
Human
;
Male
;
Middle Age
;
Vitamin B 12 Deficiency/*etiology
4.Clinical Significance of Reticulocyte Maturation Parameters in the Differential Diagnosis of Macrocytic Anemias.
The Korean Journal of Laboratory Medicine 2007;27(1):13-18
BACKGROUND: Macrocytic anemias are commonly seen in clinical practice, and precise etiologic diagnosis is essential for proper management. We evaluated the clinical utility of reticulocyte maturation parameters in macrocytic anemias to discriminate among myelodysplastic syndrome (MDS), megaloblastic anemia (MA), and non-megaloblastic macrocytic anemia associated with chronic liver disease (MA-CLD). METHODS: Using an automated reticulocyte counter, we retrospectively analyzed and compared reticulocyte maturation parameters including immature reticulocyte fraction (IRF), mean reticulocyte volume (MRV), mean sphered cell volume (MSCV) of normal control (N=34), and patients diagnosed with MDS (N=31), MA (N=52), and MA-CLD (N=196). RESULTS: Macrocytic anemias from MA, MDS and MA-CLD showed higher values of reticulocyte maturation parameters including IRF, MRV and MSCV than normal control (P<0.01). MDS showed higher values of reticulocyte maturation parameters including IRF, MRV and MSCV than MA-CLD (P<0.01). IRF and MRV were significantly lower in MA-CLD than in both MA and MDS (P<0.01). MSCV was significantly higher in MDS than in MA (P<0.01). CONCLUSIONS: This study indicates that the measurement of reticulocyte maturation parameters may be a useful tool in the differential diagnosis of macrocytic anemia. The presence of high values of IRF (> or = 0.39), MRV (> or = 129.5 fL), and MSCV (> or = 102.3 fL) makes the diagnosis of MA-CLD unlikely and underlying MDS should be considered.
Adult
;
Anemia, Macrocytic/*diagnosis
;
Anemia, Megaloblastic/*diagnosis
;
Chronic Disease
;
Diagnosis, Differential
;
Female
;
Humans
;
Liver Diseases/*diagnosis
;
Male
;
Middle Aged
;
Myelodysplastic Syndromes/*diagnosis
;
Reticulocyte Count/*methods
5.Spontaneous Remission of Pernicious Anemia.
Hyoung SUL ; Woo Ram MOON ; Hee Jeong LEE ; Sang Gon PARK ; Choon Hae CHUNG ; Chi Young PARK
Korean Journal of Medicine 2017;92(2):209-212
Pernicious anemia is a macrocytic anemia that is caused by vitamin B12 deficiency, itself a result of the absence of intrinsic factors due to autoimmune destruction of parietal cells. We report here the case of a 43-year-old female with spontaneous remission of pernicious anemia. The patient presented with fatigue. Her serum vitamin B12 level was low, hemoglobin level was 7.6 g/dL, and serologic tests for anti-intrinsic factor and anti-parietal cell antibodies were positive. We diagnosed her with pernicious anemia, but did not administer vitamin B12 because her hemoglobin level increased spontaneously. Since then, the patient's hemoglobin and serum vitamin B12 levels have been within the normal range.
Adult
;
Anemia, Macrocytic
;
Anemia, Pernicious*
;
Antibodies
;
Fatigue
;
Female
;
Humans
;
Intrinsic Factor
;
Rabeprazole
;
Reference Values
;
Remission, Spontaneous*
;
Serologic Tests
;
Vitamin B 12
;
Vitamin B 12 Deficiency
7.Anemia in Individuals over Age 80: Unattended Issue in Clinical Practice.
Yun Jin JEONG ; Joo Kyoung CHA ; Hyun Jung LEE ; Seok Lae CHAE ; Hee Jin HUH ; Jae Woo CHUNG ; Do Yeun KIM
The Ewha Medical Journal 2016;39(3):69-75
OBJECTIVES: To assess the current state of anemia evaluation in the elderly over 80 years of age. METHODS: Patients who were more than 80 years old and visited Dongguk University Ilsan Hospital from April 2005 to February 2014 were included. Statistical analysis were assessed using the logistic regression model. RESULTS: Total 548 patients, who had anemia according to WHO criteria, were identified. The median age was 85 years old (range, 82 to 99 years) and median hemoglobin level was 11.0 g/dL (range, 2.7 to 12.9 g/dL). Twenty-eight, 468, and 52 patients were classified as microcytic anemia, normocytic anemia, and macrocytic anemia, respectively. Among them, 397 patients (72.4%) did not undergo proper evaluation for the cause anemia i.e., 8 cases (28.5%) of microcytic anemia, 361 cases (77.1%) of normocytic anemia, and the 28 cases (53.84%) of 52 macrocytic anemia patients. The remaining 151 patients (27.6%) had completed the evaluation, and 24 patients (15.9%) were diagnosed as solid malignancies. In the assessment of iron deficiency anemia, hemoglobin levels, and age had no effect on whether or not to perform esophagogastroduodenoscopy. CONCLUSION: This finding showed that physicians often neglected anemia in individuals over 80 years of age. Though these patients have limited life expectancy, physicians should carefully discriminate the sub-population who will be benefit from adequate evaluation and treatment.
Aged
;
Anemia*
;
Anemia, Iron-Deficiency
;
Anemia, Macrocytic
;
Endoscopy, Digestive System
;
Humans
;
Life Expectancy
;
Logistic Models
9.Acquired Pure Red Cell Aplasia following Autoimmune Hemolytic Anemia in Systemic Lupus Erythematosus.
Mi Hee KIM ; Ji Yeon CHOI ; Sang Min LEE ; Seung Won AHN ; Seung Min JUNG ; Hyunjung KIM ; Hye Sung WON
Korean Journal of Medicine 2016;90(6):554-558
Pure red cell aplasia (PRCA) is a rare hematological disorder characterized by severe normochromic normocytic anemia and reticulocytopenia due to erythroid progenitor depletion in an otherwise normal bone marrow. Autoimmune hemolytic anemia (AIHA) is caused by autoantibodies directed against red blood cells with normocytic or macrocytic anemia with reticulocytosis. Both diseases can develop in conjunction with various underlying diseases, such as immunological disorders. Although rare, there have been a few cases of AIHA followed by PRCA. Here, we report a patient who developed PRCA following AIHA and was later diagnosed with systemic lupus erythematosus.
Anemia
;
Anemia, Hemolytic, Autoimmune*
;
Anemia, Macrocytic
;
Autoantibodies
;
Bone Marrow
;
Erythrocytes
;
Humans
;
Lupus Erythematosus, Systemic*
;
Red-Cell Aplasia, Pure*
;
Reticulocytosis