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Severe Anaemia (severe + anaemia)
Selected AbstractsHaemoglobin H disease due to (,,,SEA) ,-globin gene deletion and ,2-codon 30 (,GAG) mutation: a family studyINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 5 2001S.K. Ma A Chinese family in which two siblings suffer from haemogloblin (Hb) H disease due to (,,,SEA) ,-globin gene deletion and ,2-codon 30 (,GAG) mutation is described. Both siblings are transfusion-independent and have survived to adulthood. In contrast to previous report of hydrops fetalis associated with ,-,-thal-1 and ,2-codon 30 (,GAG) mutation, the ,-globin genes are intact in the two siblings, which most probably alleviates the ,-chain excess and protects the fetus from severe anaemia. Correlation of genotype with phenotype in Hb H disease is important for genetic counselling, especially in the antenatal setting. [source] Blood ribavirin concentration in high-dose ribavirin for adenovirus-induced haemorrhagic cystitis , a case reportJOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 1 2008M. Homma PhD Summary Blood ribavirin concentration was monitored after the administration of high-dose oral ribavirin in a case of adenovirus-induced haemorrhagic cystitis post-stem-cell transplantation. Combination use of intravenous gamma immunoglobulin (15 g/3 days) and high-dose ribavirin (RBV; 9000 mg/4 days) provided plasma ribavirin concentration of 24·3 ,m and achieved virus eradication. High level of erythrocyte ribavirin (1085 ,m; mostly as phosphorylated metabolites) with long half-life (15 days) caused severe anaemia, which required several blood transfusions for 2 weeks after the cessation of the ribavirin treatment. It was suggested that blood transfusion and intensive haemoglobin level monitoring is necessary for at least 4 weeks after the RBV, because of the high accumulation of phosphorylated ribavirin in erythrocytes even after stopping ribavirin administration. [source] Invasive pulmonary aspergillosis resulting in respiratory failure during neutrophil recovery from postchemotherapy neutropenia in three patients with acute leukaemiaJOURNAL OF INTERNAL MEDICINE, Issue 2 2002T. Takuma Abstract.,Takuma T, Okada K, Uchida Y, Yamagata A, Sawae Y (Kyushu University Graduate School of Sciences, Fukuoka, Japan; University of California, CA, USA; and Shin-kokura Hospital, Fukuoka, Japan). Invasive pulmonary aspergillosis resulting in respiratory failure during neutrophil recovery from postchemotherapy neutropenia in three patients with acute leukaemia (Case Report). J Intern Med 2002; 252: 173,177. Respiratory failure is a severe complication of invasive pulmonary aspergillosis (IPA). Its pathogenesis is not well understood. We herein describe three cases of subacute respiratory failure that occurred during the recovery phase of neutropenia following induction chemotherapy for acute leukaemia with IPA. In each case, severe neutropenia (19,85 days), high-grade fever, severe anaemia, the use of granulocyte-colony-stimulating factor and increasing infusion volume were noted. As the neutrophil count was recovering, the shadows on the chest X-ray expanded with progressing hypoxia. We should pay attention to the respiratory failure during the recovery phase of neutropenia in patients with IPA. [source] Generalized skull vault thickening in association with a large arteriovenous malformationJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 1 2006P Govender Summary Generalized thickening of the skull is unusual but has a number of recognized associations such as chronic severe anaemia, Paget disease and phenytoin therapy. We report a case of generalized skull vault thickening seen in association with a large arteriovenous malformation of the brain. [source] First report of canine African trypanosomosis in the UKJOURNAL OF SMALL ANIMAL PRACTICE, Issue 11 2007A. G. Gow A six-year-old neutered male Jack Russell terrier was presented two years after importation into the UK from southern Africa with severe anaemia and abdominal distension. Abdominal ultrasonography revealed the presence of hepato-splenomegaly and ascites. A diagnosis of trypanosomosis was made by blood smear examination. Shortly after admission the dog collapsed and died. PCR analysis revealed a single infection with Trypanosoma congolense savannah type. This is the first reported case of canine African trypanosomosis in Europe and suggests that chronic trypanosomosis may allow importation of the disease in apparently asymptomatic animals, even with extended quarantine periods. [source] CD4+ T cells mediate mucosal and systemic immune responses to experimental hookworm infectionPARASITE IMMUNOLOGY, Issue 6 2010B. DONDJI Summary Hookworm infection is associated with anaemia and malnutrition in many resource-limited countries. Ancylostoma hookworms have previously been shown to modulate host cellular immune responses through multiple mechanisms, including reduced mitogen-mediated lymphocyte proliferation, impaired antigen presentation/processing, and relative reductions in CD4+ T cells in the spleen and mesenteric lymph nodes. Syrian hamsters were depleted of CD4+ for up to 9 days following intraperitoneal injection (200 ,g) of a murine anti-mouse CD4 monoclonal IgG (clone GK1·5). CD4+ T-cell-depleted hamsters infected with the hookworm Ancylostoma ceylanicum exhibited a threefold higher mean intestinal worm burden and more severe anaemia than animals that received isotype control IgG. In addition, depletion of CD4+ T cells was associated with impaired cellular and humoral (serum and mucosal) immune responses to hookworm antigens. These data demonstrate an effector role for CD4+ T cells in hookworm immunity and disease pathogenesis. Ultimately, these studies may yield important insights into the relationship between intestinal nematode infections and diseases that are associated with CD4+ T-cell depletion, including HIV. [source] Effects of 7,12-dimethylbenz(a)anthracene on growth and haematological parameters in Korean rockfish, Sebastes schlegeli (Hilgendorf)AQUACULTURE RESEARCH, Issue 5 2006Jung-Hoon Jee Abstract The objectives of the present experiment were to determine the effects on growth factors and some haematological parameters in Korean rockfish, Sebastes schlegeil, after dietary 7,12-dimethylbenz(a)anthracene (DMBA) exposure at 0.6, 1.2, 2.4 and 4.8 mg kg,1 diet for 8 weeks. The specific growth rate of the fish exposed to DMBA (,1.2 mg kg,1) showed significantly lower performance than the control. Following 8 weeks of exposure, the DMBA-exposed groups (2.4 and 4.8 mg kg,1) had a significantly higher mean hepatosomatic index. Condition factor of the fish exposed to DMBA did not show any statistically significant deviation from the control (P>0.05), although the mean values were somewhat lower than those of the control group. Observations on haematological parameters indicated DMBA treatment induced a severe anaemia. Total protein, albumin and total cholesterol concentrations decreased following exposure to DMBA at 2.4 and 4.8 mg kg,1. In contrast, serum bilirubin and blood urea nitrogen in fish exposed to DMBA increased. Significant decreases in serum electrolytes, chloride, phosphorus, magnesium and calcium, and osmolality were observed in all DMBA-treatment groups. All DMBA-treatment groups showed a significantly higher activity of lactate dehydrogenase and alkaline phosphatase. Serum transaminase activity after the highest level of 4.8 mg kg,1 DMBA was significantly increased. The key finding from this study is that rockfish exposed to dietary DMBA at concentrations of 1.2 and 2.4 mg kg,1 diet are likely to experience adverse impacts in growth and haematological property respectively. [source] Dicoumarol toxicity in cattle associated with ingestion of silage containing sweet vernal grass (Anthoxanthum odoratum)AUSTRALIAN VETERINARY JOURNAL, Issue 1-2 2002DJ RUNCIMAN A diagnosis of dicoumarol toxicity in a herd of Friesian cattle was made following investigation of the deaths of three mature cows and eleven yearling heifers. Affected stock had been fed wrapped, bailed silage containing approximately 90% sweet vernal grass (Anthoxanthum odoratum). Sweet vernal grass contains coumarin, which can be converted to dicoumarol, a vitamin K antagonist, through the action of moulds. Most deaths were preceded by lethargy, severe anaemia and subcutaneous and internal haemorrhage. Dicoumarol toxicosis was suspected based on clinical signs, necropsy findings and prolonged prothrombin and activated partial thromboplastin times. Dicoumarol analysis of blood from affected animals and silage confirmed the diagnosis. [source] Dicoumarol toxicity in cattle associated with ingestion of silage containing sweet vernal grass (Anthoxanthum odoratum)AUSTRALIAN VETERINARY JOURNAL, Issue 1 2002DJ RUNCIMAN A diagnosis of dicoumarol toxicity in a herd of Friesian cattle was made following investigation of the deaths of three mature cows and eleven yearling heifers. Affected stock had been fed wrapped, bailed silage containing approximately 90% sweet vernal grass (Anthoxanthum odoratum). Sweet vernal grass contains coumarin, which can be converted to dicoumarol, a vitamin K antagonist, through the action of moulds. Most deaths were preceded by lethargy, severe anaemia and subcutaneous and internal haemorrhage. Dicoumarol toxicosis was suspected based on clinical signs, necropsy findings and prolonged prothrombin and activated partial thromboplastin times. Dicoumarol analysis of blood from affected animals and silage confirmed the diagnosis. [source] Maternal medicine: Randomised trial of vitamin A supplementation in pregnant women in rural Malawi found to be anaemic on screening by HemoCueBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 5 2006NR Van Den Broek Objective, To assess the effects of vitamin A supplementation in women with anaemia during pregnancy. Design, Single-centre randomised controlled trial. Setting, Rural community in southern Malawi, central Africa. Population, Seven hundred women with singleton pregnancies at 12,24 weeks measured by ultrasound scan and with haemoglobin <11.0 g/dl by HemoCue screening method. Analysis was by intention to treat. All received iron and folate, and sulphadoxine/pyrimethamine for antimalarial prophylaxis. Methods, Women were randomised to receive oral supplementation with daily 5000 or 10 000 iu vitamin A, or placebo. Main outcome measures, Anaemia, as assessed by Coulter counter, severe anaemia, iron status and indices of infection. Results, Vitamin A deficiency was, in this rural population, less common than predicted. Vitamin A supplementation had no significant impact on anaemia, severe anaemia, iron status and indices of infection. Vitamin A stores were less likely to be depleted at the end of pregnancy in supplemented groups. Conclusions, Vitamin A supplementation programmes to reduce anaemia should not be implemented in similar antenatal populations in rural sub-Saharan Africa unless evidence emerges of positive benefit on substantive clinical outcomes. Introducing public health interventions of unknown benefit and with unclear biological mechanisms can divert scarce resources from clinical and social interventions more likely to impact maternal mortality. [source] Iron plus folate is more effective than iron alone in the treatment of iron deficiency anaemia in pregnancy: a randomised, double blind clinical trialBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 9 2002Jorge Juarez-Vazquez Objective To evaluate whether folate supplementation to iron is able to accelerate solving of iron deficiency anaemia in pregnancy. Design Multicentre, double blind, randomised clinical trial. Setting Nine hospital gynaecologic units located in Mexico. Population Three hundred seventy-one women with iron deficiency anaemia between 14 and 27 weeks of pregnancy. Methods Random allocation of the study population to receive 80 mg iron proteinsuccinylate, with or without 0.370 mg folinic acid daily for 60 days. Main outcome measure Haemoglobin concentration increase. Results Combined iron and folate therapy showed a better therapeutic response: the increase in haemoglobin levels from baseline was 1.42 (0.14) g/dL for women treated with both compounds vs 0.80 (0.125) g/dL for those given iron only (P < 0.001). A multivariable regression analysis showed that this effect was independent of basal levels of blood iron, ferritine and serum folate and was more evident in women with more severe anaemia. In the 64 women belonging to the subgroup defined by the per-protocol (PP) population and the lowest quartile of baseline haemoglobin values (mean 8.96, range 5.9,9.8 g/dL), the increase at day 60 was estimated 2.3 (0.53) g/dL for the combined therapy vs 0.5 (0.5) g/dL for iron only (P= 0.07). No significant differences in tolerability were observed between the two groups. Conclusion Folate supplementation is recommended in pregnant women with iron deficiency anaemia irrespective of the serum levels of folate. [source] Effects of vitamin A deficiency during pregnancy on maternal and child healthBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 6 2002M.S. Radhika Objective To examine the association between biochemical vitamin A deficiency in pregnancy and maternal and fetal health. Design A cross sectional clinical study. Setting Antenatal clinic of nutrition unit of Niloufer Hospital catering for a low socio-economic population, and a private nursing home (Swapna nursing home) catering for a high socio-economic population. Population 736 pregnant women in their third trimester of pregnancy belonging to low (n= 522) and high socio-economic groups (n= 214). Methods All the women were subjected to a detailed clinical, anthropometric and obstetric examination. Night blindness was assessed by administering the standard WHO questionnaire. Birthweight and gestational age of the infants, maternal anaemia and development of pregnancy-induced hypertension in the mother were recorded. Haemoglobin and serum retinol were estimated at the time of recruitment to the study. Main outcome measures Serum retinol levels, anaemia, pregnancy-induced hypertension, birthweight and gestational age of the infant. Results Night blindness was observed in 2.9% of the women and subclincal vitamin A deficiency (serum retinol <20 ,g/dL with no clinical signs) in 27% of the women. Moderate to severe anaemia was observed in 41.2% of the women, and 15.8% of the women developed pregnancy-induced hypertension. Sixty-one (9.4%) women delivered preterm. Univariate analysis identified a significant association between serum retinol <20 ,g/dL and preterm delivery (OR = 1.74, 95% CI 1.03,2.96), maternal anaemia (OR = 1.82, 95% CI 1.28,2.60) and pregnancy-induced hypertension (OR = 1.56, 95% CI 1.02,2.83). After adjusting for the confounding variables (body mass index, parity, age and socio-economic status) in a multivariate analysis, the significant associations between serum retinol <20 ,g/dL and preterm delivery (P= 0.02) and anaemia (P= 0.003) persisted, while that for pregnancy-induced hypertension disappeared (P= 0.71). Conclusion The study suggests that subclinical vitamin A deficiency is a problem during the third trimester of pregnancy. Serum concentration of retinol <20 ,g/dL appears to indicate a deficient status, and is associated with an increased risk of preterm delivery and maternal anaemia. [source] Clinical manifestations of infants with nutritional vitamin B12 deficiency due to maternal dietary deficiencyACTA PAEDIATRICA, Issue 1 2009E Zengin Abstract Aim: In developing countries, nutritional vitamin B12 deficiency in infants due to maternal diet without adequate protein of animal origin has some characteristic clinical features. In this study, haematological, neurological and gastrointestinal characteristics of nutritional vitamin B12 deficiency are presented. Methods: Hospital records of 27 infants diagnosed in a paediatric haematology unit between 2000 and 2008 were evaluated retrospectively. Results: The median age at diagnosis was 10.5 months (3,24 months). All the infants were exclusively breast fed and they presented with severe nonspecific manifestations, such as weakness, failure to thrive, refusal to wean, vomiting, developmental delay, irritability and tremor in addition to megaloblastic anaemia. The diagnosis was confirmed by complete blood counts, blood and marrow smears and serum vitamin B12 and folic acid levels. The median haemoglobin level was 6.4 g/dL (3.1,10.6) and mean corpuscular volume (MCV) was 96.8 fL (73,112.3). Some patients also had thrombocytopaenia and neutropaenia. All the infants showed clinical and haematological improvement with vitamin B12 administration. Patients with severe anaemia causing heart failure received packed red blood cell transfusions as the initial therapy. Conclusion: Paediatricians must consider nutritional vitamin B12 deficiency due to maternal dietary deficiency in the differential diagnosis of some gastrointestinal, haematological, developmental and neurological disorders of infants with poor socioeconomic status. Delay in diagnosis may cause irreversible neurological damage. [source] | ||||||||||