Study of Morphological Pattern of Anaemia at a Tertiary Care Centre

Abstract

BACKGROUND Anaemia is a disease of low erythrocyte count and haemoglobin (Hb) concentration less than the normal range. The main causes of anaemia are a decrease in RBCs, their destruction and decrease of Hb synthesis. A useful method for diagnosis and classification of anaemias is based on the morphological appearance of RBCs on an ideal stained blood smear. The main terms used in such classification are normocytic normochromic, microcytic hypochromic and macrocytic anaemia. In general, microcytic hypochromic anaemias are caused by reduced haemoglobin synthesis (most commonly because of iron deficiency), while macrocytic anaemias caused by reduced DNA synthesis that impair the maturation of erythroid precursors in the bone marrow. Normocytic normochromic anaemias have diverse aetiologies; in some of these anaemias, specific abnormalities of red cell size and shape which is best appreciated through visual inspection of peripheral smears provide an important clue as to cause. METHODS Retrospectively and prospectively we evaluated the results of complete blood count (CBC) and peripheral blood picture (PBP) of all anaemic patients attending during the year 2018 (from 1st January to 31st December), in the Department of Pathology, Gandhi Medical College, Bhopal (M.P.). RESULTS Out of a total of 500 patients, 220 were males and 280 were females. Results of CBC and PBP showed that 145 (29%), 275 (55%) and 80 (18%) of the patients had normocytic normochromic, microcytic hypochromic and macrocytic pattern of anaemia respectively. CONCLUSIONS The microcytic hypochromic pattern of anaemia is highly frequent among this sample of patients while the macrocytic pattern of anaemia is the lowest. According to gender groups, microcytic hypochromic pattern of anaemia is more common among females; malnutrition, increase of blood loss due to pregnancy or menstruation, and lack of iron absorption are the main causes, while the normocytic normochromic anaemia is highly prevalent among males, which is mainly due to blood loss or chronic diseases.

Prevalence of Anemia and Admission Outcome Among Anemic Compared to Non-anemic Patients Admitted in Internal Medicine at University Teaching Hospital of Kigali: a Non Randomized Comparative Study.

“…Most of anemic participants in our study had Normocytic anemia at 80% with 14.7% and 5.3% representing microcytic and Macrocytic respectively. The distribution of the types of anemia in current study were not in alignment of consulted studies as most of the studies reviewed , Microcytic anemia was predominant followed by Normocytic and macrocytic respectively (23)(24)(25)(26). The explanation of this discordance might be the fact that most of our participants were male who aren't at risk of iron de ciency anemia but also most of our participants had chronic diseases which can explain Normocytic anemia predominance in our study.…”

Severe Megaloblastic Anemia & Thrombocytopenia in Pregnancy: A Case Report

“…Red blood cell development, brain processes, and DNA synthesis all rely on vitamin B 12. Vitamin B 12 deficiency is most often caused by a lack of the nutrient in one's diet, although other factors, such as surgical procedures and malnutrition, may also contribute [11]. Megaloblastic anemia may have resulted from a lack of folate and vitamin B12 in this patient, who discovered her pregnancy at week 4.…”

“…It occurs when cells continue to grow without dividing [10]. Megaloblastic anemia is a kind of nutritional anemia that may be acquired and is one that might be troublesome during pregnancy [11]. This patient has an MCV and Hb value of 119.9 respectively.…”

“…Megaloblastic anemia is most often caused by vitamin deficiencies, particularly folic acid and vitamin B12 deficiencies, which may arise from poor dietary intake, impaired absorption, or abnormal metabolism [13]. When the body's requirement for folate is elevated because to the enhanced cell replication occurring in the fetus, uterus, and bone marrow, yet dietary intake or absorption of folate is insufficient, or when the body excretes more folate than normal, a deficit of folate may result [11]. Red blood cell development, brain processes, and DNA synthesis all rely on vitamin B 12.…”

“…During pregnancy, women should take 400 micrograms (g) of folic acid daily [12]. When pregnant again, women who have already given birth to a child with a neural tube abnormality should take 5 mg of folic acid daily [11].…”