Iron Deficiency Anemia Producing Evidence of Marrow Hyperplasia in the Calvarium

Britton, Howard A.; Canby, John P.; Kohler, Colette M.

doi:10.1542/peds.25.4.621

Cited by 35 publications

(2 citation statements)

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“…Even today, they are frequently attributed to anemia due to nutrient deficiency (most commonly iron‐deficiency, but also B 12 , and folic acid deficiency) (Cohen & Armelagos, 1984; El‐Najjar, 1976; El‐Najjar et al, 1976; Fairgrieve & Molto, 2000; Hens et al, 2019; Palkovich, 1987; Walker, 1985; Zaino, 1967). Association of hyperplastic and porous lesions with anemia—without a differential diagnosis—in archeological settings is partly due to the numerous clinical studies which demonstrate changes in the skull in cases of congenital and acquired hemoglobinopathies (Britton et al, 1960; Burko et al, 1961; Caffey, 1937; Cooley et al, 1927; Jelliffe & Blackman, 1962; Moore, 1929; Rose, 1929; Shahidi & Diamond, 1960). As iron deficiency is one of the most common causes of anemia today (Camaschella, 2015, 2019), it has become a commonly cited cause of CO and PH.…”

Section: Introductionmentioning

confidence: 99%

A biological approach to adult sex differences in skeletal indicators of childhood stress

O’Donnell

Hill

Anderson

et al. 2021

American Journal of Biological Anthropology

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Objectives: In previous work examining the etiology of cribra orbitalia (CO) and porotic hyperostosis (PH) in a contemporary juvenile mortality sample, we noted that males had higher odds of having CO lesions than females. Here, we examine potential reasons for this pattern in greater detail. Four non-mutually exclusive mechanisms could explain the observed sex differences: (1) sex-biased mortality; (2) sexual dimorphism in immune responses; (3) sexual dimorphism in bone turnover; or (4) sexual dimorphism in marrow conversion. Subjects and methods:The sample consists of postmortem computed tomography scans and autopsy reports, field reports, and limited medical records of 488 individuals from New Mexico (203 females; 285 males) aged between 0.5 and 15 years. We used Kaplan-Meier survival analysis, predicted probabilities, and odds ratios to test each mechanism.Results: Males do not have lower survival probabilities than females, and we find no indications of sex differences in immune response. Overall, males have a higher probability of having CO or PH lesions than females. Conclusions:All results indicate that lesion formation in juveniles is influenced by some combination of sex differences in the pace of red-yellow conversion of the bone marrow and bone turnover. The preponderance of males with CO and PH likely speaks to the potential for heightened osteoblastic activity in males. We find no support for the hypotheses that sex biases in mortality or immune responses impacted lesion frequency in this sample. Sex differences in biological processes experienced by children may affect lesion formation and lesion expression in later life.

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Section: Introductionmentioning

confidence: 99%

A biological approach to adult sex differences in skeletal indicators of childhood stress

O’Donnell

Hill

Anderson

et al. 2021

American Journal of Biological Anthropology

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“…1 This sign has also been described in iron deficiency anemia, cyanotic heart disease, congenital syphilis, metastatic neuroblastoma, nutritional deficiencies, as well as hematologic malignancies. 4 , 5 Here, we discuss HOE sign in a 9-year old-girl with a previously missed diagnosis of sickle cell disease who presented with acute hemorrhagic stroke. Our discussion will focus on the incidental finding of the HOE sign.…”

Section: Introductionmentioning

confidence: 99%

Hair-on-End Sign in a 9-Year-Old Girl Presenting with Acute Stroke in Sickle Cell Disease

Ogwang¹,

Odongo²,

Namusisi³

et al. 2022

IMCRJ

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Background The hair-on-end (HOE) sign is a rare finding seen in the diploic space on skull radiographs, computed tomography (CT) and magnetic resonance imaging (MRI) with the appearance of long, thin vertical striations of calcified spicules perpendicular to the bone surface that looks like hair standing on end. It is classically seen in children/adolescents with hemolytic anemias, in particular, thalassemia major and sickle cell disease. Here, we present a 9-year-old Ugandan girl who presented with stroke in whom head CT demonstrated cerebral intraparenchymal hemorrhage and multiple infarcts on the left with HOE sign. Hb electrophoresis confirmed the diagnosis of sickle cell anemia. Case Summary We present a 9-year-old Ugandan girl who presented with an unexplained stroke that preceded an episode of acute headache, vomiting, followed by focal convulsions and altered consciousness. Clinical findings revealed severe pallor of the conjunctivae and mild scleral icterus. CT demonstrated right cerebral intraparenchymal hemorrhage, multiple high cerebral infarcts on the right and evidence of extra medullary hematopoiesis with a classical HOE sign. Hemoglobin (Hb) electrophoresis confirmed sickle cell disease (SCD). The child was then initiated on hydroxyurea, antibiotics, analgesics and intravenous fluids. She improved and was discharged 16 days later. Follow-up of the child was uneventful. Conclusion HOE sign is a complication of chronic hemolysis usually seen in patients with thalassemia and sickle cell anemia. It is a rare finding that clinicians should be well conversant with, especially in Africa where sickle cell disease is common.

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Radiological Features of Iron-Deficiency Anemia

Lanzkowsky¹

1968

Arch Pediatr Adolesc Med

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Iron Deficiency Anemia Producing Evidence of Marrow Hyperplasia in the Calvarium

Cited by 35 publications

References 0 publications

A biological approach to adult sex differences in skeletal indicators of childhood stress

A biological approach to adult sex differences in skeletal indicators of childhood stress

Hair-on-End Sign in a 9-Year-Old Girl Presenting with Acute Stroke in Sickle Cell Disease

Radiological Features of Iron-Deficiency Anemia

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