Study of sideroblasts and iron stores in bone marrow aspirates using Perls′ stain

Dharwadkar, Arpana; Vimal, Shruti; Panicker, N K; Chandanwale, Shirish S; Viswanathan, Vidya; Kumar, Harsh

doi:10.4103/0975-2870.177655

Cited by 4 publications

(6 citation statements)

References 2 publications

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“…While Pujara et al found increased store , Dharwadkar et al found normal (1+to 3+) iron store in bone marrow fragments. [5,6] This dissimilarity with Pujara et al may be due to the grading followed by them who considered 1+ to 2+ iron as normal store while grades above that was recorded as increased store.…”

Section: Discussionmentioning

confidence: 92%

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

Deka

Saikia

Kakati

et al. 2017

APALM

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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.

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Section: Discussionmentioning

confidence: 92%

“…Dharwadkar et al found 1.8% cases of refractory anaemia with 10% marrow sideroblast. [6] This difference may be due to their study sample which included cases of neoplasia also. Andrew et al found 3.4% cases of MDS which included 2(1.14% ) cases of RARS.…”

Section: Discussionmentioning

confidence: 97%

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

Deka

Saikia

Kakati

et al. 2017

APALM

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“…A proportion of normal erythroblasts exhibit few (1–5) iron-containing granules randomly distributed around the cytoplasm. Such erythroblasts are designated as sideroblasts and stand for 20–50% of the erythroblasts in a normal bone marrow [ 8 ]. Sideroblasts are visible in bone marrow aspirate smears but not in bone marrow biopsy sections since erythroblastic iron is lost in bone marrow biopsy processing [ 7 ].…”

Section: Ring Sideroblast Definitionmentioning

confidence: 99%

“…Signs of dyserythropoiesis, such as megaloblastic changes and multinuclearity, are also seen in MDS-RS [ 10 ]. Cytoplasmic vacuolization of myeloid precursors and immature erythroid forms is common in Pearson’s syndrome [ 58 ], MLASA, and copper deficiency [ 8 , 9 , 10 ].…”

Section: Diagnosis Of Sideroblastic Anemiasmentioning

confidence: 99%

Causes and Pathophysiology of Acquired Sideroblastic Anemia

Rodríguez‐Sevilla

Calvo

Arenillas

2022

Genes

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The sideroblastic anemias are a heterogeneous group of inherited and acquired disorders characterized by anemia and the presence of ring sideroblasts in the bone marrow. Ring sideroblasts are abnormal erythroblasts with iron-loaded mitochondria that are visualized by Prussian blue staining as a perinuclear ring of green-blue granules. The mechanisms that lead to the ring sideroblast formation are heterogeneous, but in all of them, there is an abnormal deposition of iron in the mitochondria of erythroblasts. Congenital sideroblastic anemias include nonsyndromic and syndromic disorders. Acquired sideroblastic anemias include conditions that range from clonal disorders (myeloid neoplasms as myelodysplastic syndromes and myelodysplastic/myeloproliferative neoplasms with ring sideroblasts) to toxic or metabolic reversible sideroblastic anemia. In the last 30 years, due to the advances in genomic techniques, a deep knowledge of the pathophysiological mechanisms has been accomplished and the bases for possible targeted treatments have been established. The distinction between the different forms of sideroblastic anemia is based on the study of the characteristics of the anemia, age of diagnosis, clinical manifestations, and the performance of laboratory analysis involving genetic testing in many cases. This review focuses on the differential diagnosis of acquired disorders associated with ring sideroblasts.

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“…Perl's staining on bone marrow aspirate is the gold standard for assessing tissue iron storage. The test, in addition to being invasive, has limited diagnostic advantage [15].…”

Section: A Functional Iron Deficiency and Absolute Iron Deficiencymentioning

confidence: 99%

Main Pathophysiological, Diagnostic and Therapeutic Aspects in Anemia of Chronic Inflammation

D’Angelo¹

2022

CLINICMED

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In chronic inflammation, iron deficiency over time causes a developmental clinical condition ranging from non-anemia to evident microcytic and hypochromic anemia. Pathophysiologically, the iron imbalance in chronic inflammation is mediated by the increase in hepcidin. Its dosage, not yet used routinely, represent an important diagnostic parameter in the setting of anemia, particularly in Anemia of Chronic Deficiency or in the Anemia of Chronic Deficiency/Iron Deficiency Anemia combination. Immunologically, B and T lymphocytes for their activation process need iron to proliferate; in infections, the interaction of myeloid cells, T and B cells, results in inflammatory cytokines secretion which modify iron homeostasis. In chronic inflammation, the rational approach to restore the proper iron flow from the cell to the blood, is to treat the underlying disease, at the same time, adequate iron therapy should be considered. The diagnosis, as well as the correct therapeutic approach to anemia of chronic disease are both increasingly a challenge.

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Study of sideroblasts and iron stores in bone marrow aspirates using Perls′ stain

Cited by 4 publications

References 2 publications

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

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

Causes and Pathophysiology of Acquired Sideroblastic Anemia

Main Pathophysiological, Diagnostic and Therapeutic Aspects in Anemia of Chronic Inflammation

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