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Query: UMLS:C0240066 (iron deficiency)
 7,156 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During a 5 year period, 28 adult patients with megaloblastic anaemia (MA) were treated in University Hospital. 71% of the patients were Indians. Symptoms of anaemia was the main presenting complaint in 18 (64%) of patients while in 2 patients peripheral neuropathy was the main problem. Pancytopenia was a common finding (present in 18 (64%) patients) while 6 (21%) patients had severe thrombocytopenia (less than 20 x 10(9)/L). The peripheral blood morphology provided important diagnostic clues i.e. macrocytes and/or hypersegmented neutrophils seen in most patients. Concurrent iron deficiency 'dampened' the megaloblastic picture. Though most patients suffered from MA of nutritional origin, 3 patients were diagnosed to have pernicious anaemia and 2 patients had myelodysplastic syndrome. Important practice points were detection of concurrent infection and hypokalemia which necessitated appropriate treatment. The controversy of blood transfusion in treatment of MA and the importance of reassessing patients after treatment were highlighted.
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PMID:Megaloblastic anaemia--a review from University Hospital, Kuala Lumpur. 340 25

Mild-to-moderate thrombocytopenia has been reported as an occasional finding in patients with iron deficiency. The present case describes a multiparous woman who presented with increased menorrhagia, severe anemia (3.0 g/dl) and thrombocytopenia (9,000 platelets/mm3). Her bone marrow examination showed iron deficiency, megakaryocytopenia, and erythroid hypoplasia but no other evidence of a primary marrow disorder. Her symptoms, the thrombocytopenia and the megakaryocytopenia, resolved with iron replacement. This case demonstrates the profound degree to which thrombopoiesis can be affected in iron deficiency.
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PMID:Severe thrombocytopenia in iron deficiency anemia. 356 74

We describe a patient with iron-deficiency anemia, thrombocytopenia and paucity of marrow megakaryocytes, in whom the anemia and the thrombocytopenia responded to the administration of iron. Thrombocytopenia recurred, despite maintenance of normal hemoglobin and iron levels and adequate marrow megakaryocytes. Corticosteroids and splenectomy were required for the control of the thrombocytopenia. In this patient, the initial manifestations of idiopathic thrombocytopenic purpura were modified by the presence of severe iron deficiency. This case strengthens the contention that iron is essential for megakaryopoiesis and thrombopoiesis.
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PMID:Idiopathic thrombocytopenic purpura presenting as iron-responsive thrombocytopenia. 359 56

Classification of platelet disorders has been based on the platelet count. Addition of a second variable, mean platelet volume (MPV), to the routine blood count allows classification of patients into 9 categories: high, low, or normal MPV, and high, low or normal platelet count. We studied 1,244 adult inpatients. 1,134 had both platelet values normal. 11 patients had high MPV and low platelet count: all had hyperdestructive causes. 15 patients had high MPV and normal platelet count: 12 had heterozygous thalassemia, and three had iron deficiency. Seven patients had high MPV and high platelet count: causes included myeloproliferative disorders, inflammation, iron deficiency, and splenectomy, 25 patients had high platelet counts and normal MPV: the causes were inflammation, infection, sickle cell anemia, iron deficiency, or chronic myelogenous leukemia. 52 patients had an MPV that was inappropriately low for the platelet count (high, normal, or low). All had sepsis, splenomegaly, aplastic anemia, chronic renal failure, or a disease being treated with myelosuppressive drugs. High MPV thus appears correlated with myeloproliferative disease or thalassemia; and low MPV, with cytotoxic drugs or marrow hypoplasia. Addition of MPV to the platelet count allows subtler disorders to be detected (when the platelet count is normal), and allows distinction of the cause of thrombocytopenia.
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PMID:Use of mean platelet volume improves detection of platelet disorders. 407 87

A patient affected with thrombocytopenia and bilateral absence of radius is described. Authors present data suggesting an acquired etiology: intrauterine cytomegalovirus infection and X-ray exposure during the ovulatory period. Patient showed some radiological features not previously described: methacarpian synostosis and absence of sternum ossification centers. Anemia was etiologically related to the iron deficiency secondary to bleeding. Chronic diarrhea, a feature common in this syndrome, was caused by cow's milk protein intolerance, other causes of chronic diarrhea, like pancreatic malfunction or disaccharidal intolerance were discarted. Finally comments on the differential diagnosis of the illness, its' evolution and treatment, pointing out the possibility of an intrauterine diagnosis, crucial for a correct genetic counselling are made.
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PMID:[Thrombocytopenia-absent radius syndrome (author's transl)]. 628 59

Twenty-seven patients with lysinuric protein intolerance, an autosomal recessive disorder of diamino acid transport, have been followed at our hospital since 1965. Many of the patients had recurrent mild normochromic anaemia without apparent iron deficiency, and leuko- and/or thrombocytopenia. Serum ferritin concentrations were inappropriately high. Serum ferritin concentration appears to be a valuable index of the control of this disease.
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PMID:Changes in peripheral blood cells and serum ferritin in lysinuric protein intolerance. 678 26

We determined the platelet count and MPV in 100 normal subjects, in 147 subjects with thrombocytopenia or thrombocytosis due to other than primary hematologic disorders, and in smaller groups with immune or septic thrombocytopenia or iron deficiency. In these groups, the inverse, nonlinear relation between MPV and platelet count was the same as in a previous study of normal subjects. The same relation between platelet volume and count was found in individual patients as platelet counts rose during recovery from immune or septic thrombocytopenia. The concomitant progressive fall in MPV during recovery from thrombocytopenia, at which times rapidly rising platelets counts were necessarily associated with a population of young platelets, suggests that magnitude of stimulation of thrombopoiesis, not platelet age, is the major determinant of platelet volume. In contrast, as compared to normal persons with similar platelet counts, MPV was increased in subjects with heterozygous thalassemia but decreased in patients receiving chemotherapy for malignancy or renal transplantation. The undefined mechanism of regulation of platelet formation from megakaryocytes, reflected by the inverse relation of platelet size and count, thus seems altered in these disorders. Platelet volume is an easily obtained variable that appears to be useful in the evaluation of abnormal platelet production.
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PMID:The inverse relation between platelet volume and platelet number. Abnormalities in hematologic disease and evidence that platelet size does not correlate with platelet age. 682 64

The long-term management of cyanotic congenital heart disease requires treatment of raised haematocrit (> 65%) whilst conserving the quality of the red blood cells [mean corpuscular volume, mean corpuscular haemoglobin concentration (MCHC)]. Since 1975, the author has chosen chemotherapy (hydroxyurea, pipobroman) as first-line treatment, reserving iron supplements, phlebotomy and platelet antagonists as adjuvant therapy. Pre-treatment data of 170 patients showed: a high prevalence of hypochromic microcytosis due to iron deficiency and of thrombopaenia, in relation to the severity and duration of the polycythaemia. Hyperuricaemia was greater than 420 mumol/l in 67% of cases; effort tolerance and hyperviscosity were related to the haematocrit and iron deficiency. One hundred and forty seven patients were followed up for a total duration of 769 years of chemotherapy. Clinical tolerance was good: biological tolerance was marked by a high frequency of thrombocytopaenia requiring withdrawal (10 cases) or reduction of treatment (34 cases). The causes of the 39 deaths observed are analysed: none was related to the hydroxyurea or pipobroman. The treatment or follow-up was stopped in 29 cases: the reasons are reported. Seventy eight patients under treatment had a favourable outcome with normal social reinsertion in 74 cases. This efficiency was related to maintenance of a haematocrit < 65%, to correction of the iron deficiency and increase in the MCHC. These results were obtained with an average dosage of 19 +/- 4.5 mg/kg/day of hydroxyurea (69 patients). By slowing erythropoiesis, chemotherapy reduces the indication of phlebotomy, so reducing iron loss: it also inhibits excessive bouts of polycythaemia in cases of iron therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Long-term hematological management of cyanotic congenital heart diseases]. 777 87

Although full blood counts (FBC) are among the most commonly performed laboratory tests, the contribution of routine FBCs to the diagnosis of new problems is controversial. This study represents a unique linkage of a consultant haematology team, reviewing all abnormal blood counts, to an organization providing ambulatory health care to 350,000 patients. The objective was to establish the underlying clinical disorders responsible for all abnormal FBCs during a 2-month period, and to estimate the impact of the haematology team on the diagnostic work-up and management of newly identified problems. 572 (2.55%) of the 22,454 FBCs were abnormal. Of these, 357 showed microcytosis, caused by iron deficiency (58%), thalassaemia minor (35%), inflammation (6%) or chronic renal failure (1%). The most common causes of normocytic anaemia (25 patients) were disseminated malignancy and acute blood loss; of macrocytosis (27 patients), chronic liver disease and cancer; of erythrocytosis (16 patients), chronic hypoxia; of thrombocytopaenia (48 patients), chronic liver disease and ITP; of thrombocytosis (47 patients), iron deficiency and inflammation; of leukopaenia or pancytopaenia (20 patients), cirrhosis and disseminated malignancy; and of leukocytosis (26 patients), chronic leukaemias in the elderly and infection in children. Major new haematological abnormalities were encountered in 0.24% of all blood counts, representing about one new diagnosis per day. Routine blood counts do contribute to the health care of a population. Screening for haematological disease through a central clinical laboratory covering a large high-risk ambulatory population offers a cost-effective way of searching for serious clinical problems, alerting the primary physicians of their existence, and offering advice in continued evaluation and problem management.
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PMID:The haematologist as watchdog of community health by full blood count. 779 88

Anemia is a frequent complication in patients with cirrhosis. Only one study has been previously reported regarding the etiology of anemias in Thai cirrhotic patients. The diagnosis of iron deficiency in the study however was not based on standard criteria. Herein we report the frequency and hematological manifestations of various causes of anemias diagnosed by using gold standard criteria in 72 consecutive Thai cirrhotic patients. The diagnosis of cirrhosis was based on the characteristic clinical features and the ultrasonographic findings. The median age of the patients was 49 years; male:female was 1:1.3. The mean hemoglobin value was 8.3 g/dl and the mean MCV was 96.6 fl. Most patients revealed macrocytosis, normal WBC count and mild thrombocytopenia. Iron deficiency, defined as absent bone marrow iron stores, was the most common anemia found in 40% of the patients while folate deficiency, diagnosed when red cell folate was < 160 ng/ml packed RBC, was documented in 10% of the patients. Megaloblastosis, hemolysis and anemia of chronic disease was found in 4%, 28% and 13% of the patients, respectively. Folate deficiency was significantly more common in the alcoholic patients (P = 0.01). Iron deficiency was thus the most common anemia in Thai patients with cirrhosis. The frequency of folate deficiency was not rare and the rate was comparable to data reported from western countries in spite of the Thai diet being relatively rich in folates.
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PMID:Anemias in Thai patients with cirrhosis. 919 76


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