Diagnosis of Megaloblastic Anemia

Carmel, Ralph

doi:10.1007/978-3-642-74364-1_2

Cited by 5 publications

(5 citation statements)

References 100 publications

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“…A number of workers [36], most recently Thompson et al [37], have confirmed our finding [ 171 (first made with Louis W. Sullivan [38]), that, when DNA synthesis is slowed by deficiency of B,, or folate, an elevated lobe average precedes macrocytosis, which in turn precedes an elevated MCV.…”

Section: Discussionsupporting

confidence: 89%

Low holotranscobalamin II is the earliest serum marker for subnormal vitamin B₁₂ (cobalamin) absorption in patients with AIDS

et al. 1990

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In AIDS, as previously found in pernicious anemia (PA), the earliest serum marker of subnormal vitamin B12 (cobalamin) absorption, and therefore of negative B12 balance, is low serum holotranscobalamin II (holo-TC II; B12-TC II) despite normal total serum B12 level, normal serum homocysteine, and normal classic (oral free radio-B12) Schilling test. This may be accompanied by subtle and insidious damage to hematopoietic, immunologic, neuropsychiatric, nutritional and alimentary systems, confirmed by correction on therapeutic trial with B12 therapy. Our studies suggest such selective B12 deficiency occurs in about half of the HIV-1 infected, in part due to frequent depression of B12 absorption by HIV-1 attack on the gastric mucosa and/or opportunistic infection attack on the small bowel, and in part due to a telescoping of the continuum of the stages of negative B12 balance in relation to damage to B12 delivery by the infective and/or systemic disease process. In AIDS, when total serum B12 is normal despite tissue depletion of B12, if the classic Schilling test does not reveal subnormal food B12 absorption, the food Schilling test does. We hypothesize that DNA-synthesizing cells of the hematopoietic, immunologic, neurologic and other systems which have surface receptors solely for holo-TC II, and which have low B12 stores, rapidly become dysfunctional due to B12 deficiency when holo-TC II is low, while cells (such as liver cells) which also have surface receptors for holohaptocorrin (B12-haptocorrin) remain B12-replete. We believe this to be another example of the concept of selective nutrient deficiency in one cell line but not another.

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Section: Discussionsupporting

confidence: 89%

Low holotranscobalamin II is the earliest serum marker for subnormal vitamin B₁₂ (cobalamin) absorption in patients with AIDS

et al. 1990

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“…There is no simple, commonly avail able and accurate test for vitamin and folate deficiency. Low levels of serum vitamin B ] 2 or folate in red blood cells cannot be equated with deficiency and additional inves tigations are required to demonstrate a causal relationship [37][38][39]. Our findings confirm those of other series but the incidence of 5% contrasts strikingly with the 51 % incidence of megaloblastic anaemia (mostly in combina tion with iron deficiency) reported in a pre vious study [1], Aplastic anaemia, myelofi brosis and haemolytic anaemia are classical though rather uncommon causes of anaemia.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Causes of Anaemia in a Geriatric Hospitalized Population

et al. 1992

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Of 732 consecutive patients admitted to an acute geriatric ward, 178 (24%) were found to be anaemic (haemoglobin of 115 g/l or below). An appropriate cause responsible for anaemia was identified in 83 %. The anaemia of chronic disorders (ACD) (35%) and iron deficiency anaemia (15%) were the commonest causes. The spectrum of disorders associated with ACD is much broader than the classical category of infectious, inflammatory and malignant disorders. The relatively high prevalence of the myelodysplastic syndrome (5%) is striking and this syndrome as a cause of anaemia in geriatric patients deserves more attention than it has so far received. No obvious cause was found in 17 %. The clinical significance of this finding remains unclear.

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“…PMNs are characterized by segmented nuclei connected by thin strands of chromatin. While PMN nuclei normally have 3–5 lobes, neutrophil hypersegmentation has been observed where 6 or more segments are present and is one of the earliest signs of megaloblastic anemia 9 . On the contrary, PMN hypersegmentation can also be seen under other situations that are not as well understood 10,11 .…”

Section: Introductionmentioning

confidence: 99%

“…While PMN nuclei normally have 3-5 lobes, neutrophil hypersegmentation has been observed where 6 or more segments are present and is one of the earliest signs of megaloblastic anemia. 9 On the contrary, PMN hypersegmentation can also be seen under other situations that are not as well understood. 10,11 Throughout the course of granulopoiesis, additional changes in surface marker expression, cytoskeletal elements, and granule contents also occur.…”

mentioning

confidence: 99%

Microbes and the fate of neutrophils

Kobayashi

DeLeo

Quinn

2022

Immunological Reviews

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Summary Neutrophils or polymorphonuclear neutrophils (PMNs) are an important component of innate host defense. These phagocytic leukocytes are recruited to infected tissues and kill invading microbes. There are several general characteristics of neutrophils that make them highly effective as antimicrobial cells. First, there is tremendous daily production and turnover of granulocytes in healthy adults—typically 1011 per day. The vast majority (~95%) of these cells are neutrophils. In addition, neutrophils are mobilized rapidly in response to chemotactic factors and are among the first leukocytes recruited to infected tissues. Most notably, neutrophils contain and/or produce an abundance of antimicrobial molecules. Many of these antimicrobial molecules are toxic to host cells and can destroy host tissues. Thus, neutrophil activation and turnover are highly regulated processes. To that end, aged neutrophils undergo apoptosis constitutively, a process that contains antimicrobial function and proinflammatory capacity. Importantly, apoptosis facilitates nonphlogistic turnover of neutrophils and removal by macrophages. This homeostatic process is altered by interaction with microbes and their products, as well as host proinflammatory molecules. Microbial pathogens can delay neutrophil apoptosis, accelerate apoptosis following phagocytosis, or cause neutrophil cytolysis. Here, we review these processes and provide perspective on recent studies that have potential to impact this paradigm.

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Diagnosis of Megaloblastic Anemia

Cited by 5 publications

References 100 publications

Low holotranscobalamin II is the earliest serum marker for subnormal vitamin B₁₂ (cobalamin) absorption in patients with AIDS

Low holotranscobalamin II is the earliest serum marker for subnormal vitamin B₁₂ (cobalamin) absorption in patients with AIDS

Prevalence and Causes of Anaemia in a Geriatric Hospitalized Population

Microbes and the fate of neutrophils

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Diagnosis of Megaloblastic Anemia

Cited by 5 publications

References 100 publications

Low holotranscobalamin II is the earliest serum marker for subnormal vitamin B12 (cobalamin) absorption in patients with AIDS

Low holotranscobalamin II is the earliest serum marker for subnormal vitamin B12 (cobalamin) absorption in patients with AIDS

Prevalence and Causes of Anaemia in a Geriatric Hospitalized Population

Microbes and the fate of neutrophils

Contact Info

Product

Resources

About

Low holotranscobalamin II is the earliest serum marker for subnormal vitamin B₁₂ (cobalamin) absorption in patients with AIDS

Low holotranscobalamin II is the earliest serum marker for subnormal vitamin B₁₂ (cobalamin) absorption in patients with AIDS