Importance of Perls’ stain as a routine test in anaemia in adults

Abstract

Background: Anaemia is one of the frequent finding in patients of all age. Proper diagnosis is of utmost important to avoid fatal morbidity in untreated chronic cases. Aims: This study is meant to observe the role of Perls' stain in routine practice in etiological evaluation of anaemia in adults. Methods:Prospective cross sectional study from June 2007 to July 2010. 128 cases of anaemia, alone or as a part of bicytopenia and pancytopenia, in 20-80 years of age, who were recommended by clinicians for bone marrow aspiration analysis after initial routine haematological investigation, were collected as samples. Perls' stain was done on bone marrow smears to estimate marrow iron store in fragments and ring sideroblasts in all the smears.Result: Anaemia was most common haematological presentation(49%), mainly in males (62%) and majority in 20-30 years of age (31.3%). Iron deficiency anaemia was most common cause of anaemia(59.6%) with 0 to1+ iron store. Megaloblastic anaemia, aplastic anaemia, thalassemia and other haemoglobinnopathies, anaemia of chronic disease(AOCD) , myelodysplastic syndrome(MDS) and secondary sideroblastic anaemia(SA) were other causes of anaemia found. 3.2% cases had ring sideroblasts of which 0.78% was MDS and 2.3% was secondary SA. Conclusion:Perls' stain is a cheap and relatively simple test that can be used as a routine test in all bone marrow aspirates to provide provisional diagnosis of some relatively infrequent causes of anaemias which otherwise could be missed when only non invasive methods are relied upon for assessing body iron content.

A study of Iron store in Bone marrow and its correlation in various anemia

“…9 62 (51.23%) were males and 59 (48.77%) were females with male to female ratio of 1.05:1. In present study, 61(87.1%) cases of microcytic anaemia patients have iron grade of 0 and 1 which was observed in Pujara et al, Deka et al and Alexander et al [8][9][10] In present study, other 9 (12.85%) cases of microcytic anaemia have iron grade of 2 and 3, which received parenteral iron therapy before bone marrow examination. Jameson et al studied 4 cases of iron deficiency anemia which received parenteral iron before bone marrow examination and recorded iron storage grade of 2 and 3.…”

“…Deka et al studied 16 (11.76%) cases of thalassemia and other hemoglobinopathies, in which patients have iron storage grade of 3 and 4. 8,9 In our study we observed 1 (0.8%) case of sickle cell anemia was studied in present study, in which iron grade found to be 3. Koduri et al in his review article mentioned that iron deficiency is more common in patients with sickle cell anemia without any blood transfusion.…”

“…Pujara et aland Deka et al found iron grade of 0-2 (3 cases) and 0-1 (2 cases) respectively in their study. 8,9 1 (0.8%) case of thalassemia minor was studied in present study, in which iron store found to be 2.Pujara et al studied 1 (1.36%) case of thalassemia, in which iron storage grade was 3. Deka et al studied 16 (11.76%) cases of thalassemia and other hemoglobinopathies, in which patients have iron storage grade of 3 and 4.…”