Severe dyserythropoiesis and autoimmune thrombocytopenia associated with ingestion of kelp supplements

Pye, K.; Kelsey, StephenM.; House, I; Ac, Newland

doi:10.1016/0140-6736(92)91305-r

Cited by 26 publications

(10 citation statements)

References 5 publications

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“…congenital dyserythropoietic anemias, thalassemias, congenital dyserythropoietic porphyria 1 or hereditary sideroblastic anemia 2 or acquired MDS, as well as secondary disorders. Secondary myelodysplasia-like changes are found in severe illness, 3 after exposure to drugs, 4 toxins, 5,6 autoimmune diseases, 7 vitamin B12, folate and copper deficiency, 8,9 parvovirus B19 infection 10 or excessive alcohol intake. 11,12 They are neither neoplastic nor pre-leukemic.…”

Section: Introductionmentioning

confidence: 99%

Assessment of dysplastic hematopoiesis: lessons from healthy bone marrow donors

Parmentier¹,

Schetelig²,

Lorenz³

et al. 2011

Haematologica

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BackgroundAccording to WHO 2008 guidelines, the required percentage of cells manifesting dysplasia in the bone marrow to qualify as significant is 10% or over in one or more hematopoietic cell lineages, but this threshold is controversial. No 'normal' values have been established. Therefore, we investigated dyshematopoiesis in bone marrow aspirate squash preparations of 120 healthy bone marrow donors. Design and MethodsBone marrow squash slides of 120 healthy unrelated bone marrow donors were examined independently by 4 experienced morphologists. Samples were taken from the first aspiration during the harvest. Bone marrow preparation and assessment were performed according to WHO recommendations and ICSH guidelines. ResultsMore than 10% dysmyelopoiesis could be detected in 46% of bone marrow aspirate squash preparations with 26% in 2 or more cell lineages and 7% in 3 cell lineages in healthy bone marrow donors. Donors under the age of 30 years exhibited more dysgranulopoietic changes and dysmegakaryopoietic changes (P<0.001) compared to the older donors. Female donors showed more dysgranulopoietic changes than male donors (P=0.025). The concordance rate between the 4 investigators was modest in dysgranulopoiesis but poor in dyserythropoiesis and dysmegakaryopoiesis. ConclusionsThe poor reliability of the 10% cut off was partly related to the proximity of the current criteria to the observed cut-off mean values of the normal population. These findings question the current WHO threshold of the 10% or over necessary for the percentage of cells manifesting dysplasia to be considered significant, and suggest that either a higher threshold would be more appropriate or different thresholds should be set for each lineage.Key words: dysplasia, hematopoiesis, cut off, significant, percentage, bone marrow donors.Citation: Parmentier S, Schetelig J, Lorenz K, Kramer M, Ireland R, Schuler U, Ordemann R, Rall G, Schaich M, Bornhäuser M, Ehninger G, and

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Section: Introductionmentioning

confidence: 99%

Assessment of dysplastic hematopoiesis: lessons from healthy bone marrow donors

Parmentier¹,

Schetelig²,

Lorenz³

et al. 2011

Haematologica

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“…In one patient, a third rechallenge with cow’s milk did not cause recurrent thrombocytopenia even though thrombocytopenia had apparently recurred with two previous exposures to cow’s milk (39). In the other seven patients, platelet count recovery was incomplete or follow‐up platelet counts were not reported (28, 38, 40–42).…”

Section: Resultsmentioning

confidence: 99%

Thrombocytopenia as an adverse effect of complementary and alternative medicines, herbal remedies, nutritional supplements, foods, and beverages*

Royer

George

Terrell

2010

European J of Haematology

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“…Lead poisoning has resulted from Indian and Burmese cosmetics, glazes of ceramic containers, and traditional remedies such as Daw Tway, a digestive remedy associated with lead poisoning in Burma. Arsenic poisoning has resulted from intake of alternative medications [6] including Ayurvedic medicines [7]. Copper deficiency should be suspected when there has been excess intake of oral zinc or following gastric bypass surgery; knowledge that the patient has a peripheral neuropathy may be a clue to the diagnosis.…”

Section: Something Unexpectedly Detectedmentioning

confidence: 99%

The hematopathologist as detective

Bain

2011

J Hematopathol

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The skills required of a physician are akin to those of a detective, fictional or real. The diagnostic process is based on observation, deduction, and inference. We may thus see the hematopathologist as using the same skills as a detective. Sometimes, the hematopathologist is involved, usually inadvertently, in the detection of actual crime or other illicit activity. More often, the skills of a detective are being applied in the normal diagnostic process.

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Severe dyserythropoiesis and autoimmune thrombocytopenia associated with ingestion of kelp supplements

Cited by 26 publications

References 5 publications

Assessment of dysplastic hematopoiesis: lessons from healthy bone marrow donors

Assessment of dysplastic hematopoiesis: lessons from healthy bone marrow donors

Thrombocytopenia as an adverse effect of complementary and alternative medicines, herbal remedies, nutritional supplements, foods, and beverages*

The hematopathologist as detective

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