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Query: UMLS:C0002871 (anemia)
 52,094 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors report a case of myelopathy associated with macrotic anemia. The prior inefficacy of treatment with B1, B6 and B12 vitamins, in spite of a normal Schilling test, suggested the possibility of folate deficiency, the concentration of which was found very low in the serum (1.5 mg/ml). The addition of folic acid to the vitamins already administered without success, was followed by rapid recovery of the anemia and a frank neurological improvement maintained after 10 months follow-up. The rare similar cases observed in the world literature are analysed here. The other neurological manifestations, due to folate deficiency, the etiological circumstances and the methods of diagnosis are recalled.
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PMID:[Myelopathy and macrocytic anemia associated with a folate deficiency. Cure by folic acid]. 122 61

Biochemical disturbances common to vitamin B12 and folate deficiency were investigated in leukocytes from patients with cobalamin deficiency. The investigations focused on the only two human metabolic pathways known to require vitamin B12. In the propionate pathway, deoxyadenosylcobalamin is required for isomerization of methylmalonyl-CoA to succinyl-CoA. Leukocyte oxidation of 14C-propionate to 14CO2 was markedly decreased in 9 patients with Addisonian cobalamin deficiency and 2 patients with low serum cobalamin associated with folate deficiency, whereas 14C-succinate oxidation was normal. Three of the Addisonian patients had only minimal anemia. Within 4 days after one injection of 1,000 mug of cyanocobalamin, in 7 out of 8 patients studied, leukocyte propionate oxidation increased to normal levels. In folate-mediated one-carbon metabolism, as measured by serine biosynthesis from formate, methylcobalamin is required for conversion of methyl-folate to tetrahydrofolate. Leukocyte formation of 14C-serine from 14C-formate was significantly depressed in 5 patients with low serum cobalamin, little or no anemia, and only marginally low total red cell folate, the low serum cobalamin in 2 of these patients was associated with folate deficiency. After 1,000 mug of cyanocobalamin, in 2 of 3 patients, leukocyte serine biosynthesis increased to the normal range. These observations demonstrated that these two metabolic pathways in leukocytes were sensitive to cobalamin deficiency, and responsive to cobalamin therapy. Although there was no correlation between either of these metabolic activities and the serum cobalamin, red cell folate, or hematocrit, there was a striking correlation between impairment of leukocyte propionate oxidation and of leukocyte serine biosynthesis in 5 patients who were minimally anemic. The remarkably close correspondence between effects of low cobalamin on these two metabolic pathways, in nonanemic patients, must be a direct consequence of their common requirements for a cobalamin co-enzyme. These findings emphasize the importance of cobalamin in folate metabolism, and are consistent with the hypothesis that folate is "trapped" as methyl-folate in cobalamin deficiency, but do not exclude the possibility that this "trapping" is caused by a third metabolic function of cobalamin which might mediate transport of folate into cells.
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PMID:Defective leukocyte metabolism in human cobalamin deficiency: impaired propionate oxidation and serine biosynthesis reversible by cyanocobalamin therapy. 124 86

In an unselected series of 202 patients with hypothyroidism anaemia was present on diagnosis in 39 of 172 women and 14 of 30 men. Microcytic anaemia was present in only nine patients in the entire series. The average of the mean corpuscular volume (MCV) of all the patients was 90 fl. Fifty-three of 118 patients who were studied in detail had normal serum concentrations of vitamin B12, folic acid and iron. The haemoglobin was low in 13 of these 53 patients and rose on treatment with thyroxine alone. The MCV exceeded 90 fl in 29 of these 53 patients and in three it was greater than 100 fl. The MCV invariably fell on treatment with thyroxine even if the initial value was within the normal range. Nine of this group of 53 patients had both anaemia and an increased MCV--the macrocytic anaemia of hypothyroidism. A minor degree of anisocytosis of the red blood cells, which was reduced by treatment with thyroxine, was also demonstrated. Acanthocytes were present in the blood films of 32 out of 172 patients but in only five did the abnormal cells comprise more than 0-5 per cent of the red cell population. The incidence of new cases of pernicious anaemia diagnosed concurrently with the hypothyroidism in the carefully studied group of 118 patients was 8-5 per cent. The MCV of hypothyroid patients with low levels of vitamin B12 was often no greater than in patients with uncomplicated hypothyroidism. The MCV is not therefore a useful discriminant in the diagnosis of pernicious anaemia in hypothyroidism. The serum iron concentration was less than 12 mumol/1 in 60 out of 118 patients. The total iron binding capacity of the serum was increased in only 21 of these 60 patients. In 42 hypothyroid patients the low serum iron concentration was not associated with low levels of either vitamin B12 or folate and of these patients 22 were anaemic. Despite the very low percentage saturation of the iron binding capacity in all of these patients with a low serum iron, a lack of iron did not seem to be the usual determinant of anaemia when it occurred.
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PMID:The haematology of hypothyroidism. 125 98

Hb and PCV values were studied in three groups of Addis Ababa women during their last month of pregnancy and compared with those in a control group of non-pregnant Addis Ababa women. Irrespective of socio-economic group and parity, the Hb and PCV values were almost identical in all four groups. In one of the three test groups, a group of 'non-privileged' multiparae, S-iron, S-transferrin (TIBC), S-folate and S-vitamin B12 were also examined and showed normal values. These findings indicate a rarity not only of true anaemia but also of 'physiological anaemia of pregnancy'. This latter may not, therefore, be an adaptive phenomenon of regular occurrence as has usually been assumed hitherto. The explanation for the aberrant haematological behavior in pregnant women living in highland Ethiopia is probably the lifelong exposure to a very high iron intake combined with hypoxia due to the high altitude.
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PMID:Rarity of anaemia of pregnancy in Ethiopia. 127 11

In this work, of 51 patients treated by rHuEpo, 25 were selected for study. The selection criteria were absence of clinically evident causes of anaemia other than end-stage renal failure, such as chronic infection, active systemic disease, bleeding sites, and vitamin B12 or iron deficiencies. Serum aluminum was assessed before dialysis and the presence of aluminium overload was confirmed by a DFO test. rHuEpo was given in a dose of 50 U/kg body-weight after each dialysis session three times weekly and the response to treatment was evaluated monthly for 8 months. Our data showed significant correlation between serum aluminum and the response to rHuEpo. The response was significantly greater in those with lower serum aluminium. We conclude that the aluminium load in chronic haemodialysis patients may have an effect on the response to rHuEpo.
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PMID:Aluminium overload and response to recombinant human erythropoietin in patients under chronic haemodialysis. 132 42

We describe the first reported case of resistance to human recombinant erythropoietin (rhEPO) treatment caused by vitamin B12 deficiency in a chronic hemodialysis patient. Despite a normal B12 level before rhEPO treatment, resistant anemia together with a low B12 level and a megaloblastic bone marrow developed after only 8 months of rhEPO. There was a rapid reticulocyte response to B12 supplements, and transfusion requirements dropped from 2 units monthly to nothing. Atrophic gastritis was diagnosed through endoscopy and biopsy. Because of the fall in B12 level after 8 months of rhEPO treatment, we analyzed the results of routinely measured B12 levels in 30 hemodialysis patients treated with rhEPO, and found the mean B12 levels to be unchanged before and after rhEPO treatment. Although we found screening for B12 deficiency of little benefit, any patient with rhEPO resistance should have B12 levels tested, given the potentially serious extra-hematological effects of B12 deficiency.
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PMID:Erythropoietin resistance due to vitamin B12 deficiency. Case report and retrospective analysis of B12 levels after erythropoietin treatment. 141 79

Anamnesis of patients treated for anemia at the Department of Internal and Occupational Diseases in Zabrze in 1984-1988 were analysed. It was found that the incidence of anemia in patients over 60 years of age was significantly higher. Decreased function of hematopoietic system, more frequent deficits of factors indispensable for the normal erythropoiesis, i.e. iron and vitamin B12, and coexisting diseases, especially neoplasms and uremia, predispose to anemia in this age group. Anemia seen in the group of patients with diabetes mellitus type 2 was most probably a result of the chronic treatment with sulfonylurea derivatives.
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PMID:[Analysis of the causes and clinical course of anemia in elderly patients]. 143 76

Alcoholic patients who present with anemia can pose a diagnostic challenge. Although deficiencies of iron, vitamin B12, and folate commonly result in anemia, bone marrow suppression of red blood cell production related to the direct toxic effects of alcohol can cause a form called sideroblastic anemia. This case report describes a patient presenting with acute alcohol intoxication and anemia in whom extensive evaluation revealed a hematologic picture compatible with acquired sideroblastic anemia.
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PMID:Sideroblastic anemia. A diagnosis to consider in alcoholic patients. 143 11

The paper reports the action of the polypeptide preparation made of red cells on erythron system in rat toxic anemia. These polypeptides proved more effective as to erythropoiesis stimulation in phenylhydrasine anemia than vitamin B12 or lek. Red cell polypeptides are considered possible regulators of erythropoiesis.
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PMID:[The effect of erythrocyte polypeptides on the erythron system in experimental anemia]. 146 71

In a prospective study of thirty five consecutive patients with decreased plasma cobalamine (P-Cbl), twenty-two (63%) were diagnosed as having pernicious anaemia (PA) (no age or sex differences) on basis of the B12-absorption test and/or megaloblastic changes in the bone marrow. In this group ten patients were anaemic (six of whom were characterized as macrocytic), sixteen of nineteen examined had megaloblastic changes in the bone marrow, and all of thirteen examined had achlorhydria with positive correlation to Parietal Cell Antibodies (PCA). Two patients with PA had normal Cbl-absorption and two had malabsorption at the time of diagnosis. Twenty-one patients (95%) had PCA and thirteen (59%) were Intrinsic Factor Antibody (IFAb) positive. Three patients IFAb-seroconverted within a year. Among the remaining thirteen patients (37%), one had PCA but not IFAb and three were IFAb-positive all of whom had normal Cbl-absorption. Of the three patients with IFAb one had also PCA, one IFAb-seroconverted within three months, and one had microcytic anaemia with iron depleted bone marrow due to coecal cancer. Among twenty two healthy adult controls four (18%) had PCA while none had IFAb. This investigation shows that at the debut half of PA patients (55%) do not have anaemia, some have normal Cbl-absorption and some have malabsorption. 95% have PCA and 59% have IFAb. So, IFAb-negative PA is often seen (41%) and seroconversion can take place. Diagnosis is even more reliable, when achlorhydria is present in PCA-positive persons. Healthy PCA-positive persons are probably predisposed to develop PA. Patients with cbl-deficiency, IFAb and/or PCA must be considered as having latent PA even if they have normal haemoglobin and normal Cbl-absorption. These patients should be followed and, in case of anaemia or signs of neuropathia, treated.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Pernicious anemia. A study of initial forms of the disease and diagnostic significance of determination of the intrinsic factor antibody and parietal cell antibody]. 846 Apr 41


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