BACKGROUND: Platelet (PLT) counts (PCs) underwent various changes during pregnancy that occur due to hormonal profiles. A reduction in PC is the major event that occurs in PLT disorder during pregnancy. The common laboratory and clinical findings of these disorders make the diagnosis challenging. OBJECTIVES: The study aimed to evaluate the effect of pregnancy on PLT indices among healthy pregnant ladies. METHODS: A case–control hospital-based study was carried out from February 2020 to February 2021 on 150 participants, 100 of them were healthy pregnant Sudanese ladies at different trimesters (36 pregnant in 1st trimester, 33 pregnant in 2nd trimester, and 31 pregnant in 3rd trimester). The control group included 50 healthy nonpregnant Sudanese ladies matched according to age and body mass index. A structured questionnaire was used covering data about demographic history, trimetric period, number of pregnancies, and parity. Five milliliters of blood samples was obtained for the measurement of PLT indices using Sysmex KX-21 automated hematology analyzer. Data were analyzed using the SPSS computer programs version 2S. Independent sample t-test was used to compare the PLT indices between the healthy pregnant and nonpregnant (control). P ≤ 0.05 is considered statistically significant. RESULTS: The mean of participant's age was found to be 25 years (range of 18–45 years) and all of the participants were within the reproductive age. In all pregnant groups, the mean of PCs, mean PLT volume (MPV), and PLT distribution width (PDW) were found to be 284.3 ± 71.7 × 103/μL, 8.8 ± 1.0 fL, and 13.7 ± 2.5, respectively. While in control groups, the mean of PCs, PMV, and PDW was found to be 218 ± 14.4 × 103/μL, 10.3 ± 3.2 fL, and 11.5 ± 2.5, respectively. The MPV was not significantly changed during pregnancy (P = 0.774). However, the changes in the PC and PDW between the pregnant and nonpregnant (control) group were significant with a P = 0.020 and 0.007, respectively. In the course of pregnancy, the PC in the first, second, and third trimesters was found to be 312 ± 78.3 × 103/μL, 268 ± 62.5 × 103/μL, and 273 ± 65.8 × 103/μL with only statistically significant change between the 1st and 2nd trimesters of pregnancy (P = 0.027). The MPV in the first, second, and third trimesters was found to be 8.7 ± 0.92 fL, 8.9 ± 1.1 fL, and 8.8 ± 1.0 fL, with no statistically significant change during the course of pregnancy. The PDW in the first, second, and third trimesters was found to be 12.8 ± 2.6, 13.7 ± 2.5, and 15 ± 1.8 with only statistically significant change between the 1st and 3rd trimesters of pregnancy (P = 0.001). CONCLUSION: The PC and PDW increase significantly during pregnancy in comparison to the control group. PC has the highest reading in the first trimester, and the PDW has the highest reading in the third trimester in comparison to the other trimesters. On the other hand, the MPV is nonsignificantly decreased throughout the three trimesters of pregnancy
{"title":"Evaluation of platelet count and platelet distribution width during Normal pregnancy course","authors":"I. Ali, Mohamed Ahmed","doi":"10.4103/ijh.ijh_28_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_28_23","url":null,"abstract":"BACKGROUND: Platelet (PLT) counts (PCs) underwent various changes during pregnancy that occur due to hormonal profiles. A reduction in PC is the major event that occurs in PLT disorder during pregnancy. The common laboratory and clinical findings of these disorders make the diagnosis challenging. OBJECTIVES: The study aimed to evaluate the effect of pregnancy on PLT indices among healthy pregnant ladies. METHODS: A case–control hospital-based study was carried out from February 2020 to February 2021 on 150 participants, 100 of them were healthy pregnant Sudanese ladies at different trimesters (36 pregnant in 1st trimester, 33 pregnant in 2nd trimester, and 31 pregnant in 3rd trimester). The control group included 50 healthy nonpregnant Sudanese ladies matched according to age and body mass index. A structured questionnaire was used covering data about demographic history, trimetric period, number of pregnancies, and parity. Five milliliters of blood samples was obtained for the measurement of PLT indices using Sysmex KX-21 automated hematology analyzer. Data were analyzed using the SPSS computer programs version 2S. Independent sample t-test was used to compare the PLT indices between the healthy pregnant and nonpregnant (control). P ≤ 0.05 is considered statistically significant. RESULTS: The mean of participant's age was found to be 25 years (range of 18–45 years) and all of the participants were within the reproductive age. In all pregnant groups, the mean of PCs, mean PLT volume (MPV), and PLT distribution width (PDW) were found to be 284.3 ± 71.7 × 103/μL, 8.8 ± 1.0 fL, and 13.7 ± 2.5, respectively. While in control groups, the mean of PCs, PMV, and PDW was found to be 218 ± 14.4 × 103/μL, 10.3 ± 3.2 fL, and 11.5 ± 2.5, respectively. The MPV was not significantly changed during pregnancy (P = 0.774). However, the changes in the PC and PDW between the pregnant and nonpregnant (control) group were significant with a P = 0.020 and 0.007, respectively. In the course of pregnancy, the PC in the first, second, and third trimesters was found to be 312 ± 78.3 × 103/μL, 268 ± 62.5 × 103/μL, and 273 ± 65.8 × 103/μL with only statistically significant change between the 1st and 2nd trimesters of pregnancy (P = 0.027). The MPV in the first, second, and third trimesters was found to be 8.7 ± 0.92 fL, 8.9 ± 1.1 fL, and 8.8 ± 1.0 fL, with no statistically significant change during the course of pregnancy. The PDW in the first, second, and third trimesters was found to be 12.8 ± 2.6, 13.7 ± 2.5, and 15 ± 1.8 with only statistically significant change between the 1st and 3rd trimesters of pregnancy (P = 0.001). CONCLUSION: The PC and PDW increase significantly during pregnancy in comparison to the control group. PC has the highest reading in the first trimester, and the PDW has the highest reading in the third trimester in comparison to the other trimesters. On the other hand, the MPV is nonsignificantly decreased throughout the three trimesters of pregnancy","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41919033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amyloidosis is a group of diseases characterized by extracellular abnormal proteinaceous material (amyloid) deposition in various organs. As amyloid fibrils accumulate, tissues and organs may fail to function properly. Evidence of amyloid deposition in duodenal biopsies and bone marrow (BM) aspirates is uncommon and often overlooked. Here, we present a patient diagnosed with primary systemic amyloidosis who complained of pain in the abdomen, vomiting, loose stools, and generalized weakness. Histological examination of an endoscopic duodenal biopsy revealed amyloid deposits. BM aspiration cytology revealed amyloid deposition with BM plasmacytosis. She was eventually diagnosed with plasma cell dyscrasia based on a series of biochemical tests. To the best of our knowledge, reports of simultaneous amyloid deposition in the duodenum and BM aspirate smears are very rare and unpublished. This case serves to highlight the significance of careful microscopic histo-cytology and the utility of special stains for prompt diagnosis and treatment outcomes in a disease of poor prognosis.
{"title":"A case of primary systemic amyloidosis with amyloid deposits in the duodenum and bone marrow aspirate: A rare finding","authors":"M. Momin, A. Ingle, R. Reddy, G. Krishna Reddy","doi":"10.4103/ijh.ijh_15_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_15_23","url":null,"abstract":"Amyloidosis is a group of diseases characterized by extracellular abnormal proteinaceous material (amyloid) deposition in various organs. As amyloid fibrils accumulate, tissues and organs may fail to function properly. Evidence of amyloid deposition in duodenal biopsies and bone marrow (BM) aspirates is uncommon and often overlooked. Here, we present a patient diagnosed with primary systemic amyloidosis who complained of pain in the abdomen, vomiting, loose stools, and generalized weakness. Histological examination of an endoscopic duodenal biopsy revealed amyloid deposits. BM aspiration cytology revealed amyloid deposition with BM plasmacytosis. She was eventually diagnosed with plasma cell dyscrasia based on a series of biochemical tests. To the best of our knowledge, reports of simultaneous amyloid deposition in the duodenum and BM aspirate smears are very rare and unpublished. This case serves to highlight the significance of careful microscopic histo-cytology and the utility of special stains for prompt diagnosis and treatment outcomes in a disease of poor prognosis.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46091894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Narayanan, Sugeeth M. Thambi, P. Prabhakaran, T. Anoop, S. Nair
BACKGROUND: Biclonal gammopathies are characterized by the production of two distinct monoclonal proteins. It is defined as the presence of two distinct M bands in serum protein electrophoresis. Biclonal myeloma accounted for approximately 1% of newly diagnosed cases of multiple myeloma. OBJECTIVE: The aims was to study the clinical characteristics and treatment outcomes of 13 patients with biclonal gammopathy treated at a tertiary cancer center. MATERIALS AND METHODS: The details of clinical presentation, diagnosis, treatment, and survival were noted from medical records. RESULTS: The median age was 65 years, there were 10 males and 3 females. Eleven patients had multiple myeloma, one had plasmacytoma, and one had monoclonal gammopathy of undetermined significance (MGUS). Twelve patients had biclonal gammopathy at diagnosis and one developed biclonal gammopathy at relapse. Immunofixation showed IgG/IgA in seven cases, IgA/IgG in four, and IgG/IgG in two patients. The patient with MGUS is on follow at 44 months and one with plasmacytoma received radical radiotherapy and alive at 45 months. Ten patients with myeloma received systemic treatment, eight are alive with survival ranging from 44 to 110 months, and four patients are alive more than 5 years. CONCLUSION: Biclonal gammopathies are rare characterized by the presence of two distinct monoclonal proteins. The most frequent combination was IgG/IgA. Treatment of biclonal gammopathy is similar to monoclonal gammopathy with comparable outcomes. During follow-up, both paraproteins have to be addressed.
{"title":"Biclonal gammopathy – A single-center experience","authors":"G. Narayanan, Sugeeth M. Thambi, P. Prabhakaran, T. Anoop, S. Nair","doi":"10.4103/ijh.ijh_56_22","DOIUrl":"https://doi.org/10.4103/ijh.ijh_56_22","url":null,"abstract":"BACKGROUND: Biclonal gammopathies are characterized by the production of two distinct monoclonal proteins. It is defined as the presence of two distinct M bands in serum protein electrophoresis. Biclonal myeloma accounted for approximately 1% of newly diagnosed cases of multiple myeloma. OBJECTIVE: The aims was to study the clinical characteristics and treatment outcomes of 13 patients with biclonal gammopathy treated at a tertiary cancer center. MATERIALS AND METHODS: The details of clinical presentation, diagnosis, treatment, and survival were noted from medical records. RESULTS: The median age was 65 years, there were 10 males and 3 females. Eleven patients had multiple myeloma, one had plasmacytoma, and one had monoclonal gammopathy of undetermined significance (MGUS). Twelve patients had biclonal gammopathy at diagnosis and one developed biclonal gammopathy at relapse. Immunofixation showed IgG/IgA in seven cases, IgA/IgG in four, and IgG/IgG in two patients. The patient with MGUS is on follow at 44 months and one with plasmacytoma received radical radiotherapy and alive at 45 months. Ten patients with myeloma received systemic treatment, eight are alive with survival ranging from 44 to 110 months, and four patients are alive more than 5 years. CONCLUSION: Biclonal gammopathies are rare characterized by the presence of two distinct monoclonal proteins. The most frequent combination was IgG/IgA. Treatment of biclonal gammopathy is similar to monoclonal gammopathy with comparable outcomes. During follow-up, both paraproteins have to be addressed.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46317971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
INTRODUCTION: The impact of severe acute respiratory syndrome coronavirus 2 on global health has been considerable since its emergence. Clinical laboratories are crucial in the diagnosis, treatment, and prognosis of patients with coronavirus disease 2019 (COVID-19). The study aims to review the published literature on the abnormal morphological features found in the peripheral blood smears of patients with COVID-19. MATERIALS AND METHODS: A nonsystematic narrative review was carried out, utilizing four databases to search for publications that presented qualitative alterations in the peripheral blood cells of individuals with COVID-19. Thirty-three studies published between January 2020 and July 2022 were ultimately included in the review. RESULTS: The majority of the studies reviewed focused on qualitative changes, with peripheral blood cell shape identified as an indicator of post-COVID-19 syndrome severity. Plasmacytic cells were found to be a relatively specific marker for COVID-19, while fragmented neutrophils were identified as an extremely sensitive morphological marker. Activation of monocytes was a strong predictor of disease outcome, and platelet aggregates served as an indicator of disease progression. CONCLUSIONS: The identification of morphological abnormalities in peripheral blood cells can aid in diagnosing and prognosticating COVID-19 patients. Daily complete blood count tests in hospitalized patients are crucial for identifying numerical and morphological irregularities that indicate poor clinical outcomes and disease progression.
{"title":"Coronavirus disease 2019: Morphological changes in peripheral blood cells","authors":"Amin A. Alamin","doi":"10.4103/ijh.ijh_30_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_30_23","url":null,"abstract":"INTRODUCTION: The impact of severe acute respiratory syndrome coronavirus 2 on global health has been considerable since its emergence. Clinical laboratories are crucial in the diagnosis, treatment, and prognosis of patients with coronavirus disease 2019 (COVID-19). The study aims to review the published literature on the abnormal morphological features found in the peripheral blood smears of patients with COVID-19. MATERIALS AND METHODS: A nonsystematic narrative review was carried out, utilizing four databases to search for publications that presented qualitative alterations in the peripheral blood cells of individuals with COVID-19. Thirty-three studies published between January 2020 and July 2022 were ultimately included in the review. RESULTS: The majority of the studies reviewed focused on qualitative changes, with peripheral blood cell shape identified as an indicator of post-COVID-19 syndrome severity. Plasmacytic cells were found to be a relatively specific marker for COVID-19, while fragmented neutrophils were identified as an extremely sensitive morphological marker. Activation of monocytes was a strong predictor of disease outcome, and platelet aggregates served as an indicator of disease progression. CONCLUSIONS: The identification of morphological abnormalities in peripheral blood cells can aid in diagnosing and prognosticating COVID-19 patients. Daily complete blood count tests in hospitalized patients are crucial for identifying numerical and morphological irregularities that indicate poor clinical outcomes and disease progression.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42041407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: Matrix metalloproteinases (MMPs) are proteases responsible for cleaving and rebuilding connective tissue components and also affect early carcinogenesis events, tumor development, growth, and neovascularization. The study aimed to evaluate the level of MMP-2 in acute myeloid leukemia (AML) patients in comparison with that in remission status, and healthy subjects, and to find its correlation with hematologic parameters. PATIENTS, MATERIALS, AND METHODS: This study included sixty newly diagnosed AML patients. Remission status was assessed after induction chemotherapy. The overall survival (OS) was determined after 6 months. The plasma MMP-2 level was measured at diagnosis by enzyme immunoassay. Twenty-eight healthy individuals were recruited as a control group. RESULTS: Plasma MMP-2 was higher in AML patients than in healthy individuals (P = 0.005). The level of MMP-2 was much higher in the M5 subtype than in the other subtypes (P = 0.0001). There was no statistically significant difference in the level of MMP-2 between patients who achieved complete remission and those who did not (P = 0.113). After 6 months, no significant difference in the initial MMP-2 levels was found between deceased and alive patients (P = 0.174). A positive correlation of MMP-2 level was found with white blood cell (WBC) count and hemoglobin (P = 0.0001 and 0.033, respectively) while insignificant with age, platelet count, and blast counts. CONCLUSIONS: The high MMP-2 level in AML patients suggests a possible role in the pathogenesis. However, it does not show any association with remission status or OS. The elevation was significantly associated with marrow monocytosis (M5) and correlated with a higher WBC count.
{"title":"Comparison of circulating matrix metalloproteinase-2 levels in untreated acute myeloid leukemia patients with remission status","authors":"Zena Shooman, Haithem A Al-Rubaie","doi":"10.4103/ijh.ijh_20_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_20_23","url":null,"abstract":"BACKGROUND: Matrix metalloproteinases (MMPs) are proteases responsible for cleaving and rebuilding connective tissue components and also affect early carcinogenesis events, tumor development, growth, and neovascularization. The study aimed to evaluate the level of MMP-2 in acute myeloid leukemia (AML) patients in comparison with that in remission status, and healthy subjects, and to find its correlation with hematologic parameters. PATIENTS, MATERIALS, AND METHODS: This study included sixty newly diagnosed AML patients. Remission status was assessed after induction chemotherapy. The overall survival (OS) was determined after 6 months. The plasma MMP-2 level was measured at diagnosis by enzyme immunoassay. Twenty-eight healthy individuals were recruited as a control group. RESULTS: Plasma MMP-2 was higher in AML patients than in healthy individuals (P = 0.005). The level of MMP-2 was much higher in the M5 subtype than in the other subtypes (P = 0.0001). There was no statistically significant difference in the level of MMP-2 between patients who achieved complete remission and those who did not (P = 0.113). After 6 months, no significant difference in the initial MMP-2 levels was found between deceased and alive patients (P = 0.174). A positive correlation of MMP-2 level was found with white blood cell (WBC) count and hemoglobin (P = 0.0001 and 0.033, respectively) while insignificant with age, platelet count, and blast counts. CONCLUSIONS: The high MMP-2 level in AML patients suggests a possible role in the pathogenesis. However, it does not show any association with remission status or OS. The elevation was significantly associated with marrow monocytosis (M5) and correlated with a higher WBC count.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45650773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: Calprotectin is a protein found in the cytoplasm of neutrophils and monocytes and its serum level increases in inflammatory conditions and some cancer cases. It was aimed to determine the diagnostic and prognostic importance of serum calprotectin levels in patients with lymphoma in this study. MATERIALS AND METHODS: In this study, 32 newly diagnosed or relapsed Hodgkin lymphoma (HL), 31 diffuse large B-cell lymphoma (DLBCL), and 26 healthy cases followed in the Hematology clinic of Atatürk University Medical Faculty Hospital were evaluated prospectively. Serum calprotectin levels of lymphoma cases and control groups were compared. In addition, the relationship between serum calprotectin level and bulky mass, B symptoms, Ann Arbor stage, extranodal involvement, and response to chemotherapy was investigated in lymphoma groups. RESULTS: Serum calprotectin level was higher in the HL than that in the DLBCL and control groups (P = 0.01, P = 0.001, respectively). There was a correlation between serum calprotectin level and bulky mass, B symptoms, and Ann Arbor stage (P = 0.03, P = 0.02, and P = 0.001, respectively) in the HL group. Serum calprotectin level and international prognostic score were associated in the DLBCL group (P = 0.001). CONCLUSION: Serum calprotectin level can be used as an additional diagnostic biomarker in HL. In addition, it is associated with some prognostic biomarkers in lymphoma cases.
{"title":"The importance of serum calprotectin level in patients with lymphoma","authors":"G. Sincan, Emel Ayvaz, F. Erdem, A. Kızıltunç","doi":"10.4103/ijh.ijh_54_22","DOIUrl":"https://doi.org/10.4103/ijh.ijh_54_22","url":null,"abstract":"BACKGROUND: Calprotectin is a protein found in the cytoplasm of neutrophils and monocytes and its serum level increases in inflammatory conditions and some cancer cases. It was aimed to determine the diagnostic and prognostic importance of serum calprotectin levels in patients with lymphoma in this study. MATERIALS AND METHODS: In this study, 32 newly diagnosed or relapsed Hodgkin lymphoma (HL), 31 diffuse large B-cell lymphoma (DLBCL), and 26 healthy cases followed in the Hematology clinic of Atatürk University Medical Faculty Hospital were evaluated prospectively. Serum calprotectin levels of lymphoma cases and control groups were compared. In addition, the relationship between serum calprotectin level and bulky mass, B symptoms, Ann Arbor stage, extranodal involvement, and response to chemotherapy was investigated in lymphoma groups. RESULTS: Serum calprotectin level was higher in the HL than that in the DLBCL and control groups (P = 0.01, P = 0.001, respectively). There was a correlation between serum calprotectin level and bulky mass, B symptoms, and Ann Arbor stage (P = 0.03, P = 0.02, and P = 0.001, respectively) in the HL group. Serum calprotectin level and international prognostic score were associated in the DLBCL group (P = 0.001). CONCLUSION: Serum calprotectin level can be used as an additional diagnostic biomarker in HL. In addition, it is associated with some prognostic biomarkers in lymphoma cases.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49311142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Microalbuminuria among children and adolescents with sickle cell disease","authors":"M. Al-Mendalawi, M. Al-Khalidi","doi":"10.4103/ijh.ijh_14_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_14_23","url":null,"abstract":"","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45450436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: Platelet parameters in steady-state sickle cell anemia (SCA) are affected by the red cell sickling, vaso-occlusion, and chronic hemolysis occasioned by the disease; and the occurrence of bone pain crises may further alter these parameters. Knowledge of platelet parameters in SCA augments our understanding of the pathophysiology of the disease and may influence disease management modalities. OBJECTIVES: The objective of the study is to determine and compare platelet parameters of SCA patients during bone pain crises and in steady states. PATIENTS AND METHODS: A longitudinal study involving 50 adult SCA patients who had platelet parameters determined during bone pain crises and later in steady states. Platelet count and platelet indices (mean platelet volume, platelet distribution width, plateletcrit, and platelet-large cell ratio (P-LCR)) were determined through automation. RESULTS: SCA patients during both bone pain crises and steady states had higher mean platelet counts when compared with normal non-SCA reference values. P-LCR was found to be significantly different between the bone pain crises and steady states with mean values of 18.20 ± 5.55 versus 15.96 ± 4.91 respectively; P = 0.034. During the bone pain crises state, platelet parameters did not significantly differ based on the severity of pain. CONCLUSIONS: Platelet count of both steady and bone pain crises states SCA patients were higher than the reference range for the normal non-SCA population. The P-LCR was the only platelet parameter that significantly differed between the two clinical states of SCA as it rose during the bone pain crises state; a finding reflecting increased peripheral platelet activation and the presence of larger circulating platelets during the vaso-occlusive crises.
{"title":"A comparative analysis of platelet parameters of sickle cell anemia patients during bone pain crises and in steady states","authors":"A. Musa, M. Ndakotsu","doi":"10.4103/ijh.ijh_24_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_24_23","url":null,"abstract":"BACKGROUND: Platelet parameters in steady-state sickle cell anemia (SCA) are affected by the red cell sickling, vaso-occlusion, and chronic hemolysis occasioned by the disease; and the occurrence of bone pain crises may further alter these parameters. Knowledge of platelet parameters in SCA augments our understanding of the pathophysiology of the disease and may influence disease management modalities. OBJECTIVES: The objective of the study is to determine and compare platelet parameters of SCA patients during bone pain crises and in steady states. PATIENTS AND METHODS: A longitudinal study involving 50 adult SCA patients who had platelet parameters determined during bone pain crises and later in steady states. Platelet count and platelet indices (mean platelet volume, platelet distribution width, plateletcrit, and platelet-large cell ratio (P-LCR)) were determined through automation. RESULTS: SCA patients during both bone pain crises and steady states had higher mean platelet counts when compared with normal non-SCA reference values. P-LCR was found to be significantly different between the bone pain crises and steady states with mean values of 18.20 ± 5.55 versus 15.96 ± 4.91 respectively; P = 0.034. During the bone pain crises state, platelet parameters did not significantly differ based on the severity of pain. CONCLUSIONS: Platelet count of both steady and bone pain crises states SCA patients were higher than the reference range for the normal non-SCA population. The P-LCR was the only platelet parameter that significantly differed between the two clinical states of SCA as it rose during the bone pain crises state; a finding reflecting increased peripheral platelet activation and the presence of larger circulating platelets during the vaso-occlusive crises.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43751491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: According to the World Health Organization (WHO), erythropoietin (EPO) is only a minor criterion for the diagnosis of polycythemia vera (PV), but its diagnostic validity is controversial. OBJECTIVES: The objective was to assess the diagnostic accuracy of EPO levels and the different combinations of the laboratory and clinical criteria, defined by the latest WHO report, as markers for the diagnosis of PV in Iraqi patients. PATIENTS, MATERIALS AND METHODS: This cross-sectional study included 158 myeloproliferative neoplasm-suspected patients (48 PV, 47 essential thrombocythemia, 25 secondary thrombocytosis, and 35 nonclonal erythrocytosis). Patients were assessed for the presence of Janus Kinase 2 (JAK2) V617F mutation. Subsequently, JAK2V617F-negative patients were evaluated for the presence of JAK2 exon 12 mutations. Plasma EPO was measured in PV and nonclonal erythrocytosis patients. RESULTS: Male was more prevalent among the nonclonal erythrocytosis patients. PV patients were older and had higher levels of all hematological variables examined in the study. Although all obtained EPO levels were normal, PV patients had significantly lower levels of EPO than nonclonal erythrocytosis. In addition, the hemoglobin and hematocrit had a better diagnostic accuracy than EPO levels in both male and female patients with PV. Furthermore, a better diagnostic accuracy was obtained when JAK2 mutation status was added to the evaluation of hemoglobin or hematocrit. CONCLUSION: The low EPO level is not a good predictive marker for PV. Hemoglobin and hematocrit had equal predictive validity in the diagnosis of PV. It is convenient to evaluate JAK2 mutation as one of the major criteria in the diagnosis of PV.
{"title":"The role of erythropoietin levels and other hematological factors in the diagnosis of polycythemia vera in Iraqi patients","authors":"Aseel Al Dayyeni, B. Al-Gailani, M. Mahdi","doi":"10.4103/ijh.ijh_8_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_8_23","url":null,"abstract":"BACKGROUND: According to the World Health Organization (WHO), erythropoietin (EPO) is only a minor criterion for the diagnosis of polycythemia vera (PV), but its diagnostic validity is controversial. OBJECTIVES: The objective was to assess the diagnostic accuracy of EPO levels and the different combinations of the laboratory and clinical criteria, defined by the latest WHO report, as markers for the diagnosis of PV in Iraqi patients. PATIENTS, MATERIALS AND METHODS: This cross-sectional study included 158 myeloproliferative neoplasm-suspected patients (48 PV, 47 essential thrombocythemia, 25 secondary thrombocytosis, and 35 nonclonal erythrocytosis). Patients were assessed for the presence of Janus Kinase 2 (JAK2) V617F mutation. Subsequently, JAK2V617F-negative patients were evaluated for the presence of JAK2 exon 12 mutations. Plasma EPO was measured in PV and nonclonal erythrocytosis patients. RESULTS: Male was more prevalent among the nonclonal erythrocytosis patients. PV patients were older and had higher levels of all hematological variables examined in the study. Although all obtained EPO levels were normal, PV patients had significantly lower levels of EPO than nonclonal erythrocytosis. In addition, the hemoglobin and hematocrit had a better diagnostic accuracy than EPO levels in both male and female patients with PV. Furthermore, a better diagnostic accuracy was obtained when JAK2 mutation status was added to the evaluation of hemoglobin or hematocrit. CONCLUSION: The low EPO level is not a good predictive marker for PV. Hemoglobin and hematocrit had equal predictive validity in the diagnosis of PV. It is convenient to evaluate JAK2 mutation as one of the major criteria in the diagnosis of PV.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45717001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: Selective immunoglobulin (Ig) A deficiency is the most common Ig deficiency in the world. Serum IgA level is reduced, 7 mg/dL (70 μg/mL), thus, associating with a wide range of clinical symptoms and signs that are related directly and indirectly to disturbances in the body immune system. Selective IgA deficiency patients are known to develop antibodies against lacking IgA. Whenever these antibodies are found in an individual's circulating blood, a severe allergic response and anaphylaxis can ensue upon receiving IgA containing blood or blood components. Hence, certain protocols are recommended in populations with increased prevalence of selective IgA deficiency including the use of red blood cell (RBC) washing machines or IgA-deficient blood components. Both measures are costly and require special maintenance procedures. objectives: The aim of this study was to screen for the presence of selective IgA deficiency in a group of blood donors and its probable role in the events of transfusion reactions that frequently occur which may necessitate the application of protocols that involve sophisticated procedures and highly-demanding machines. SUBJECTS AND METHODS: This was a laboratory study that included 300 volunteer blood donors in the National Blood Transfusion Center. They were screened for their serum IgA levels. Related questionnaire was conducted and chemiluminescence immunoassay technique with MAGLUMI 600 series machine was used. This machine is already used by the National Center of Teaching Laboratories for variety of biochemical and immunological assays. Serum IgA levels then were plotted against age, blood group and smoking status. RESULTS: No single case of Selective IgA deficiency was documented. Serum IgA levels showed increased levels with age and smoking demonstrated no significant effect on the Ig levels. CONCLUSION: In light of these results, it does not seem urgent or necessary at this point of time to introduce the highly demanding and expensive RBC washing machines in blood banks in Iraq. We recommend conducting a larger study that is more comprehensive with wider involvement of population, considering age, gender, and ethnicity.
{"title":"Selective immunoglobulin A deficiency in a sample of Iraqi blood donors in the National Blood Transfusion Center-Baghdad","authors":"Shams Mahdi, A. Abdulsalam, A. Rijub-Agha","doi":"10.4103/ijh.ijh_5_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_5_23","url":null,"abstract":"BACKGROUND: Selective immunoglobulin (Ig) A deficiency is the most common Ig deficiency in the world. Serum IgA level is reduced, 7 mg/dL (70 μg/mL), thus, associating with a wide range of clinical symptoms and signs that are related directly and indirectly to disturbances in the body immune system. Selective IgA deficiency patients are known to develop antibodies against lacking IgA. Whenever these antibodies are found in an individual's circulating blood, a severe allergic response and anaphylaxis can ensue upon receiving IgA containing blood or blood components. Hence, certain protocols are recommended in populations with increased prevalence of selective IgA deficiency including the use of red blood cell (RBC) washing machines or IgA-deficient blood components. Both measures are costly and require special maintenance procedures. objectives: The aim of this study was to screen for the presence of selective IgA deficiency in a group of blood donors and its probable role in the events of transfusion reactions that frequently occur which may necessitate the application of protocols that involve sophisticated procedures and highly-demanding machines. SUBJECTS AND METHODS: This was a laboratory study that included 300 volunteer blood donors in the National Blood Transfusion Center. They were screened for their serum IgA levels. Related questionnaire was conducted and chemiluminescence immunoassay technique with MAGLUMI 600 series machine was used. This machine is already used by the National Center of Teaching Laboratories for variety of biochemical and immunological assays. Serum IgA levels then were plotted against age, blood group and smoking status. RESULTS: No single case of Selective IgA deficiency was documented. Serum IgA levels showed increased levels with age and smoking demonstrated no significant effect on the Ig levels. CONCLUSION: In light of these results, it does not seem urgent or necessary at this point of time to introduce the highly demanding and expensive RBC washing machines in blood banks in Iraq. We recommend conducting a larger study that is more comprehensive with wider involvement of population, considering age, gender, and ethnicity.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46252568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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