Get Permission Kaur and Agarwal: To study and analyze hematological parameters in anaemia in males


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

  1. Below 15 years male

  2. WHO criteria for anaemia

  3. Males with hemoglobin < 11gm/dl

Exclusion criteria

  1. Males above 15 year of age

  2. Hemoglobin above 11 gm/dl

  3. Hb Electrophoresis, wherever applicable

Results

Table 1

Distribution of the various morphological types of anaemia

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.

Table 2

Age wise distribution of cases according to peripheral smear (RBC Chromasia) finding

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.

Table 3

Age wise distribution of cases according to peripheral smear (RBC size) finding

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 anaemias13 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.

References

1 

B Sharada Iron deficiency and iron deficiency anaemia Recent Adv Maless1995520533

2 

H Saloojee JM Pettifor Iron deficiency and impaired child developmentBMJ200132373261377810.1136/bmj.323.7326.1377

3 

MCG Israels The pathological significance of the megaloblastJ Pathol193949123140

4 

D Watkins V M Whitehead D S Rosenblatt DG Nathan S Horkin D Ginsburg TA Look D Fisber Megaloblastic Anaemia 7th Edn.. In: Nathan and Oski’s Hematology of infancy and childhoodPhiladelphia: Elsevier200846878

5 

G Bourner J Dhaliwal J Sumner Performance Evaluation of the Latest Fully Automated Hematology Analyzers in a Large, Commercial Laboratory Setting:A 4-Way, Side-by-Side StudyLab Hematol 20051142859710.1532/lh96.05036

6 

A Tefferi CA Hanson DJ Inwards How to Interpret and Pursue an Abnormal Complete Blood Cell Count in AdultsMayo Clin Proc 20058079233610.4065/80.7.923

7 

CLSI. validation, verification and quality assurance of automated hematology analyzers2nd Edn. Approved Standard. CLSI document H26-A2Wayne, PA: Clinical and Laboratory Standards Institute2010

8 

F Firkin C Chesterman D Penington B Rush de Gruchy’s clinical haematology in medical practice5th Edn.2011245

9 

H Rehema E Simbauranga A Kamugish BR Hokororo J Kidenya Makani Prevalence and factors associated with severe anaemia amongst under-five males hospitalized atBugando Med Centre20151513

10 

A Pandey M Pandey VD Dombale GK Sawke N Sawke Haematological Profile of Anaemia in Males of Age 1-12 Years in Southern Rural India; People’sJ Scientific Res2016914852

11 

M Muthuraman M Sintha A cross sectional analysis of Anaemia in males population in a tertiary care hospital MaduraiMed Pulse Int J Pathol201712427

12 

S Rathna J Venkatraman AS Govindaraj P Patil Study of Morphological Pattern of Anaemia in MalesJ Evol Med Dent Sci201432775403

13 

W Gao H Yan D Wang S Dang L Pei Severity of Anaemia among males under 36 months old in rural Western ChinaJ Pone20138416

14 

S Poornima PAR Balaji SRR Varne K Jayashree F Saba Anemia among hospitalized children at a multispecialty hospital, Bangalore (Karnataka), IndiaJ Family Med Prim Care201431485310.4103/2249-4863.130275



jats-html.xsl


This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

  • Article highlights
  • Article tables
  • Article images

Article History

Received : 09-01-2021

Accepted : 10-03-2021


View Article

PDF File   Full Text Article


Copyright permission

Get article permission for commercial use

Downlaod

PDF File   XML File   ePub File


Digital Object Identifier (DOI)

Article DOI

https://doi.org/ 10.18231/j.jdpo.2021.028


Article Metrics






Article Access statistics

Viewed: 974

PDF Downloaded: 424