- Received January 09, 2021
- Accepted March 10, 2021
- Publication June 14, 2021
- Visibility 2 Views
- Downloads 1 Downloads
- DOI 10.18231/j.jdpo.2021.028
-
CrossMark
- Citation
To study and analyze hematological parameters in anaemia in males
- Author Details:
-
Dupinder Kaur *
-
Pooja Agarwal
Introduction
Hemolytic weakness is characterized as abbreviated red platelet endurance because of either inherent deformities in the red platelets or outside factors.[1] By far most of erythrocyte problems that happen in the pediatric age bunch result from anomalies inside the red platelets (intra corpusculardefects).[2] Intra-corpuscular imperfections are quite often hereditarily decided, while, the irregularities inside the plasma are generally obtained. Periodically in G6PD inadequacy, an acquired irregularity of erythrocytes prompts hemolysis just when exceptional conditions exist in the plasma like the presence of specific medications, synthetics or other molecules.[3]
Among hemolytic anaemias Thalassemia major, Hereditary spherocytosis, G6 PD lack and procured causes like diseases and falciparum intestinal sickness can cause extreme anaemia.[4]
The early history of megaloblastic weakness is the historical backdrop of malignant iron deficiency. The principal case was accounted for in 1822. In 1849, Addison depicted a patient with deadly idiopathic sickliness. For a long time, malignant paleness was secretly alluded to as "Addisonian vindictive weakness".[5] Ehlrich presented the expression "megaloblast" to portray the enormous nucleated erythroid antecedents found in vindictive anaemia.[6]
Megaloblastic morphology might be found in various conditions. In guys, it results from a lack of folic corrosive or nutrient B12 or both. Vit. B12 and folic corrosive are the cofactors which are fundamental for the union of nucleoproteins and consequently, their lack brings about damaged union of DNA and RNA which prompts incapable erythropoiesis and diminished life expectancy of RBCs [7].
Materials and Methods
Our study is a hospital based study done in a tertiary care health center. Study duration 2014 Study was conducted at 2016 Hematological parameters like Hb (haemoglobin), TC (total count), DC (differential count), PCV (packed cell volume), MCV (mean red cell corpuscular volume) done in the automated cell counter and peripheral smear findings were studied.
Inclusion criteria
Below 15 years male
WHO criteria for anaemia
Males with hemoglobin < 11gm/dl
Exclusion criteria
Males above 15 year of age
Hemoglobin above 11 gm/dl
Hb Electrophoresis, wherever applicable
Results
|
Morphological Types |
Number |
Percentage |
|
Microcytic Hypochromic Anaemia |
192 |
76.8 |
|
Normocytic Hypochromic Anaemia |
30 |
12 |
|
Normocytic Normochromic Anaemia |
27 |
10.6 |
|
Dimorphic Anemia |
2 |
0.6 |
[Table 1] Out of 250 cases, 192 i.e. 76.8% cases showed microcytic hypochromic anaemia, 30 cases i.e. 12% had normocytic hypochromic anaemia, 27 cases i.e. 10.6% had normocytic normochromic anaemia and dimorphic anaemia was seen in 02 cases i.e. 0.6% cases.
|
Peripheral Smear (RBC Chromasia) Finding |
Age Group |
Total |
P Value |
||||||
|
0-5 years |
6-10 years |
11-15 years |
|||||||
|
No. |
% |
No. |
% |
No. |
% |
No. |
% |
||
|
Dimorphic |
02 |
1.55 |
0 |
0.00 |
01 |
1.80 |
02 |
0.80 |
p-value= 0.396, Pearson Chi-Square = 3.146 |
|
Hypochromic |
114 |
87.69 |
61 |
92.42 |
46 |
83.63 |
222 |
88.80 |
|
|
Normochromic |
14 |
10.76 |
5 |
7.58 |
08 |
14.57 |
26 |
10.40 |
|
|
Total |
130 |
100 |
66 |
100 |
55 |
100 |
250 |
100 |
[Table 2] The distribution of peripheral smear (RBC chromasia) with age did not differ significantly as p value >0.05.
|
Peripheral Smear (RBC Size) Finding |
Age Group |
Total |
P Value |
||||||
|
0-5 years |
6-10 years |
11-15 years |
|||||||
|
No. |
% |
No. |
% |
No. |
% |
No. |
% |
||
|
Microcytic |
104 |
80.62 |
51 |
78.46 |
37 |
67.72 |
193 |
77.20 |
P-Value = 0.047, Pearson Chi-Square = 8.166 |
|
Normocytic |
26 |
19.37 |
15 |
21.53 |
18 |
32.72 |
57 |
22.80 |
|
|
Total |
130 |
100 |
66 |
100 |
55 |
100 |
250 |
100 |
[Table 3] Out of 250 cases, 193 i.e. 77.2% cases showed microcytosis maximally in 0-5 years age group and 57 cases i.e. 22.8% had normocytic picture. The distribution of peripheral smear (RBC size) finding with age varied significantly (p value <0.05).
Discussion
In the current investigation, all the cases having MCV <59fl showed 100% microcytic RBCs, none was normocytic on fringe smear assessment. MCV between 59-80fl showed microcytic cells in 79% cases and normocytic cells in 21% cases.[8] MCV >80 fl showed 96% cases with normocytic cells and 4% cases with microcytic cells.
MCH <20 pg showed 100% cases having hypochromasia. MCH between 20-27 pg showed 90% cases having hypochromic cells alongside 9.47% cases having normochromic cells and 0.38% cases had dimorphic populace which was independently included as far as hypochromasia.[9] MCH>27pg showed 84.85% cases having normochromic cells followed by 9.09% cases having hypochromic cells and 6.06% cases had dimorphic population.[10] The p-esteem for this relationship between's MCH finding with chromasia was 0.000 for example p-esteem <0.005.
From both the examinations it was noticed that RBC records are identified with size and chromasia of RBC.[11] This importance is credited to acceptable quality control of the cell counter in our instituition and normal adjustment of the same. [12] Be that as it may, the MCV is an incredibly helpful incentive in arrangement of anaemias[13] however the MCH regularly don't add critical and clinically important data. Since MCH assume a significant part in research center quality control on the grounds that the qualities will stay stable for a given example over time. [14]
Conclusion
Iron deficiency is almost universal when dealing with this magnitude of anaemia. However, clinically speaking, many technical experts believe that to differentiate severe anaemia, a screening for other causes is desirable, all males are recommended to be screened. In the present study of pediatric cases 0-5 year’s age group males were most affected and prevalence was more in males as compared to females and the predominant morphological pattern was microcytic hypochromic anaemia.
Source of Funding
No financial support was received for the work within this manuscript.
Conflicts of Interest
There are no conflicts of interest.
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