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Introduction: Hypertension has emerged as a significant public health concern, ranking among the leading causes of mortality in low- and middle-income countries. Moreover, it is closely associated with structural and functional alterations in hematopoietic cells. Therefore, this study aimed to evaluate the hematological parameters of hypertensive patients in Northeast Ethiopia. Methods: A comparative cross-sectional study was conducted from January to March 2023, involving 248 participants. This included 124 hypertensive patients and 124 apparently healthy controls selected using a systematic random sampling technique. Socio-demographic and clinical data were collected through a structured questionnaire, and anthropometric measurements were obtained following established guidelines. Ethical approval was obtained from the Ethical Review Committee of the College of Medicine and Health Sciences at Wollo University. After obtaining informed consent, approximately 5 ml of venous blood was drawn from each participant for complete blood count and fasting blood glucose analysis, performed using the Mindray BC-3000 Plus hematology analyzer and the DIRUI CS-T240 automated clinical chemistry analyzer, respectively. Data analysis involved independent t-tests, Mann-Whitney U-tests, correlation tests, and logistic regression. A p-value of <0.05 was considered statistically significant. Results: The study found that white blood cell count, platelet count, platelet distribution width, red cell distribution width, and mean platelet volume were significantly higher in hypertensive patients compared to the control group (p < 0.05). Conversely, red blood cell count, hematocrit, and hemoglobin levels were significantly higher in the control group than in hypertensive patients (p < 0.05). Additionally, white blood cells and platelets exhibited a positive correlation with systolic and diastolic blood pressure (p < 0.05), while red blood cell count, hematocrit, and hemoglobin demonstrated a negative correlation with blood pressure indices and body mass index. Anemia was observed in 20.2 % of hypertensive patients. Notably, an abnormal body mass index (AOR: 3.5, 95 % CI: 1.3-9.6, p = 0.011) and high systolic blood pressure (AOR: 4.6, 95 % CI: 1.3-15.5, p = 0.013) were significantly associated with anemia among hypertensive patients. Conclusion: This study identified significant differences in various hematological parameters between hypertensive patients and the control group. Routine assessments of hematological parameters should be considered to effectively manage hypertension-related complications in hypertensive patients.

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Splenic hematoma secondary to snake bite is a potential complication due to snake envenomation and poses a significant risk to the health of the patients. Although relatively rare, this complication once diagnosed, should be initiated with timely anti-venom administration and supportive care. Clinicians must be aware of any signs of hematological abnormalities in snakebite patients, as the development of splenic hematoma can have serious implications for patient outcomes. Awareness of this potential complication and multidisciplinary collaboration among medical teams are crucial to ensuring effective management and optimal patient care in these clinical scenarios. Understanding this concern can improve patient prognosis and advance the overall approach to snakebite management in healthcare settings.

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Objective: Abnormalities in blood cells are frequently associated with thyroid hormone disorders as a result of their involvement in the proliferation and production of blood cells. This study aimed to determine the magnitude and associated factors of hematological abnormalities in patients with hypothyroidism. Methods: A cross-sectional study was conducted from January 1 to June 30, 2023, at the University of Gondar Comprehensive Specialized Hospital. The present study included a total of 300 patients with hypothyroidism prospectively using the systematic random sampling technique. The hematological parameter data were collected using data extraction sheets, whereas the associated factor data were collected using both structured questionnaires and data extraction sheets. For complete blood cell counts, 4 mL of anticoagulated venous blood was collected and analyzed. The data were entered into Epi-data version 3.1 and analyzed with Stata version 14. Both bivariate and multivariate logistic regressions were performed to identify factors associated with hematological abnormalities. A P value < 0.05 was considered to indicate statistical significance. Results: The median value of red blood cell, hemoglobin, mean cell volume, white blood cell, and platelet were 4.63 x1012/µL, 14 g/dL, 84.3fl, 5.3 x103/µL, and 228, respectively. The overall incidences of anemia, leucopoenia, and thrombocytopenia in patients with hypothyroidism were 26.3% (95% confidence interval (CI): 21-32), 15.7% (95% CI: 14.2-17.2), and 9% (95% CI: 7.5-10.5), respectively. Lymphopenia was detected in 9% (95% CI: 8.6-10.1) of the patients, and neutropenia was detected in 6% (95% CI: 4.4-7.6) of the patients. Only three factors, female sex (adjusted odds ratio (AOR) =2.1, 95% CI=1.3-3.1), alcohol consumption (AOR= 3.8, CI=1.7-8.9), and febrile illness (AOR=2.7, 95% CI=1.3-5.4), were found to be significantly associated factors for anemia. Conclusion: The present study revealed heterogeneous hematological abnormalities in patients with hypothyroidism. Thus, early diagnosis and monitoring strategies are required to minimize complications in patients.

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Malaria remains a major public health issue worldwide, with high rates of morbidity and mortality. The resistance of Plasmodium parasites to commonly used antimalarial drugs has necessitated the development of novel drugs and targets for malaria treatment. Lycopene is a natural compound present in tomatoes and other red fruits and vegetables. This study aimed to evaluate the antimalarial activity of lycopene and its co-administration with chloroquine against chloroquine-resistant malaria, as well as to assess its impact on hematological abnormalities associated with malaria infection. The experimental animals for this study were infected with 10 7 NK65 Plasmodium berghei-infected red blood cells via intraperitoneal injection. The animals were then treated with artemether-lumefantrine, chloroquine, and varying doses of lycopene. The study evaluated percentage parasitemia, mean survival time, and various hematological parameters, including red blood cell count, hematocrit, hemoglobin concentration, mean corpuscular volume, mean corpuscular hemoglobin, red blood cell distribution width - coefficient of variation, red blood cell distribution width - standard deviation, white blood cell count, granulocyte count, lymphocyte count, monocyte count, and procalcitonin level. The study revealed that lycopene demonstrated significant (p < 0.05) antimalarial activity and the ability to ameliorate hematological abnormalities associated with acute malaria infection. The findings of this study highlight the potential of lycopene as a novel antimalarial agent. The results of this study may contribute to the development of new drugs for malaria treatment, particularly in low- and middle-income countries.

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Antimaláricos , Cloroquina , Licopeno , Malaria , Plasmodium berghei , Licopeno/farmacología , Licopeno/administración & dosificación , Animales , Antimaláricos/farmacología , Antimaláricos/uso terapéutico , Cloroquina/farmacología , Cloroquina/uso terapéutico , Ratones , Malaria/tratamiento farmacológico , Plasmodium berghei/efectos de los fármacos , Resistencia a Medicamentos , Modelos Animales de Enfermedad , Parasitemia/tratamiento farmacológico , Masculino , Combinación Arteméter y Lumefantrina/uso terapéutico , Combinación Arteméter y Lumefantrina/farmacología

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Purpose: The hematological changes in COVID-19 patients continue to receive great attention, especially in the field of public health. To our knowledge, coronavirus disease may be identified based on the severity of illness, and the study of peripheral blood smears may offer important information to facilitate the identification. Thus, we evaluated the morphological abnormalities (atypical and immature lymphocytes, lymphocytes with micronuclei, various nuclear abnormalities among erythrocytes) and quantitative changes in peripheral blood cells among 48 individuals with COVID-19 disease. Methods: The present study is a retrospective analysis of 48 individuals, including 24 hospitalized patients diagnosed with COVID-19 disease. The blood smears of all patients were subjected to a hematological examination to identify various morphological abnormalities in white and red blood cells. In addition, a micronucleus test was conducted to assess the incidence of chromosomal damage in lymphocytes. Furthermore, the complete blood count (CBC) was performed to evaluate changes in peripheral blood cells, particularly the differential total leukocyte count, which could indicate the immune response against viral infection in COVID-19 patients. Results: The findings of the hematological study conducted on patients diagnosed with COVID-19 disease revealed neutrophilia, eosinophilia, mild monocytosis, decreased hematocrit level, elevated erythrocyte sedimentation rate (ESR), and immature leukocytes. It was observed that patients who were infected with coronavirus demonstrated mild thrombocytopenia. Furthermore, the micronucleus test indicated the presence of immature cells with micronuclei among lymphocytes and numerous nuclear abnormalities in red blood cells. These results help to shed light on the hematological changes that occur in COVID-19 patients, and could potentially contribute to the development of more effective treatments for the disease. Conclusions: The examination of complete blood counts (CBCs) in conjunction with peripheral blood smears offers a potential means of identifying the impact of SARS-CoV-2 infection on the hematopoietic and immune systems, thereby providing early indications of inflammation. Based on a study, it has been suggested that SARS-CoV-2 may affect red and white blood cells causing morphological alterations thereby establishing a corresponding relationship with disease severity.

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Background: Hematological abnormalities are a common complication of malaria infection. However, there is a paucity of evidence regarding it among malaria-infected adult patients in association with the ABO blood group in Ethiopia, particularly in the Harari Region. Therefore, this study aimed to assess the hematological abnormalities among malaria-infected adult patients in association with ABO blood groups at Jinella Health Center, Harar, Eastern Ethiopia. Methods: An institutional-based cross-sectional study was conducted from July 10, 2022, to January 10, 2023. Four milliliters of venous blood were collected from each study participant. Drops of blood were used for blood film preparation. ABO blood group was determined by agglutination test using monoclonal anti-sera (Agape Diagnostics Ltd., India). A complete blood count was done using the DxH 800 (Beckman Coulter, Inc, Miami, FL) hematology analyzer. The data were analyzed using SPSS version 26. Bivariable and multivariable logistic regression models were fitted. The level of significance was declared at a p-value of <0.05. Results: The study revealed that 47.2% (95% CI: 41.0 53.6) of the participants were anemic. Being female (AOR = 3.18, 95% CI = 1.67, 6.04), having the A blood group (AOR = 2.75, CI = 1.20, 6.31), and being infected with P. falciparum (AOR = 2.64, CI = 1.26, 5.53) were all significantly associated with malaria anemia. The overall prevalence of thrombocytopenia was also 67.7% (95% CI: 61.7-73.4%). It was significantly associated with P. falciparum infection (AOR = 8.03, CI = 3.53, 18.25) and high parasitemia levels (AOR = 4.40, CI = 1.57, 12.32). Conclusion: Patients with malaria who belonged to the "A" blood group in the study area had anemia as a serious health problem. Hence, frequently checking for anemia in patients with malaria who have blood group "A" can help with early detection and better management of anemia.

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Liver cirrhosis remains a major public health issue. Liver fibrosis leading to cirrhosis is the terminal stage of various chronic liver diseases. Inflammatory cytokines are involved in the pathogenesis. Patients with cirrhosis often have hematological abnormalities, such as anemia and thrombocytopenia, which have multifactorial etiologies. Anemia in cirrhosis could be related to bleeding leading to iron deficiency anemia or other nutritional anemia such as vitamin B12 and folate deficiency. The pathophysiology of thrombocytopenia in liver cirrhosis has been postulated to range from splenic sequestration to bone marrow suppression from toxic agents, such as alcohol. It often complicates management due to the risk of bleeding with severely low platelets. This review aimed to highlight pathogenesis of liver cirrhosis, hematological abnormalities in liver cirrhosis, and their clinical significance.

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Background: In neonatal sepsis, anemia, leukocytosis, thrombocytopenia, and a shortened coagulation time are the most common hematologic abnormalities. However, there is inadequate information regarding the hematological abnormalities in neonatal sepsis. Thus, we aimed to determine the magnitude of hematological abnormalities in neonatal sepsis. Methods: This is a cross-sectional study that included 143 neonates with culture proven sepsis aged 1-28 days from September 2020 to November 2021 at the University of Gondar Specialized Referral Hospital. The sociodemographic data was collected using a pre-tested structured questionnaire, and the clinical and laboratory data was collected using a data collection sheet. A total of 2 mL of venous blood was taken using a vacutainer collection device for the complete blood count (CBC) and blood culture analysis. A univariate and multivariate logistic regression model was used to investigate factors associated with hematological abnormalities in neonatal sepsis. Statistical significance was declared when a p-value was less than 0.05. Results: The prevalence of anemia, thrombocytopenia, and leucopenia in neonatal sepsis was 49% (95% CI: 40.89-57.06), 44.7% (95% CI: 36.8-52.9), and 26.6% (95% CI: 22.01-29.40), respectively. On the other hand, leukocytosis and thrombocytosis were found in 7.7% (95% CI: 4.35-13.25) and 11.9% (95% CI: 7.56-18.21), respectively. Being female (AOR: 3.3; 95% CI: 1.20-3.82) and being aged less than 7 days (AOR: 2.44; 95% CI: 1.6-6.9) were found to be significant predictors of anemia. Conclusion: The magnitude of anemia, leucopenia, and thrombocytopenia is high in neonatal sepsis. Furthermore, being female and being younger than 7 days were risk factors for anemia. Thus, the diagnosis and treatment of anemia, leucopenia, and thrombocytopenia prevents further complications in neonatal sepsis.

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BACKGROUND: Asthma is a chronic inflammatory disease that affects the lungs. Variation in whole blood cell lines is caused by the progression and severity of asthma. Common hematological abnormalities encountered during asthma include eosinophilia, neutrophilia, leukocytosis, and increased erythrocyte sedimentation rate. The main aim of this study was to assess the selected hematological abnormalities and their associated factors among asthmatic patients in Northwest Ethiopia from March to May 2021. METHODOLOGY: A hospital-based cross-sectional study was conducted on a total of 320 asthmatic patients in Northwest Ethiopia. A simple random sampling technique was employed to select study participants. A pre-tested structured questionnaire and a checklist were used to collect data. Blood samples were collected from asthmatic patients for complete blood count and erythrocyte sedimentation rate determination. Hematological profiles were analyzed by Unicel DxH 800 (Beckman Coulter, Ireland). The erythrocyte sedimentation rate was determined by using the Westergren method. The data were entered into EpiData version 3.0.4 and analyzed with a statistical package for social science version 20 software. The bi-variable and multi-variable binary logistic regression models were used to assess the factors associated with hematological abnormalities. A p value of less than 0.05 in the multivariable logistic regression analysis was considered statistically significant. RESULTS: The overall prevalence of neutrophilia, eosinophilia, thrombocytopenia, leukocytosis, and basophilia was 35.3%, 20%, 11.9%, 10.3%, and 4.1%, respectively. Neutrophilia was associated with a lack of physical activity (AOR = 3.25; 95% CI 1.43-7.37) and a history of taking non-asthmatic drugs within the previous three months (AOR = 2.63; 95% CI 1.22-5.65). Being admitted to the emergency department (AOR = 0.27; 95% CI 0.11-5.67) was found to be associated with eosinophilia. In addition, being admitted to the emergency department (AOR = 5.44; 95%CI: 2.6-11.3) was associated with thrombocytopenia. CONCLUSION: The current study demonstrated the predominant prevalence of neutrophilia, followed by eosinophilia, among asthma patients. Therefore, hematological abnormalities should be taken into account for proper monitoring and management of asthmatic patients.

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Anemia , Asma , Trombocitopenia , Anemia/epidemiología , Asma/epidemiología , Estudios Transversales , Etiopía/epidemiología , Humanos , Leucocitosis

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Objective: Changes in the blood cell function, metabolism, and the coagulation system were associated with diabetes mellitus. This study aimed to determine the magnitude and associated factors of hematological abnormalities in adults with type 1 diabetes mellitus. Methods: A total of 204 medical charts of adults with type 1 diabetes mellitus who registered for follow-up at the University of Gondar Comprehensive Specialized Hospital were reviewed from June to August 2021. Data were collected using a structured data extraction checklist. To identify factors associated with hematological abnormalities, both bivariate and multivariate logistic regression analyses were done. Statistical significance was defined as a p-value of <0.05. Results: The overall magnitude of leukocytosis and anemia in adults with type 1 diabetes mellitus was 76.0% (95% confidence interval: 70.07-81.89) and 30.90% (95% confidence interval: 24.49-37.28), respectively. Neutrophilia and lymphocytosis were the common white blood cell abnormalities detected in 53.43% (95% confidence interval: 46.53-60.33) and 43.63% (95% confidence interval: 36.76-50.49) of the patients, respectively. Besides, thrombocytosis and thrombocytopenia were observed in 5.4% (95% confidence interval: 2.27-8.52) and 10.3% (95% confidence interval: 6.09-14.5) of the patients, respectively. Only being male (adjusted odds ratio = 2.28 (95% confidence interval: 1.46-5.29)) and duration of diabetes mellitus (⩾3 years) (adjusted odds ratio = 8.41 (95% confidence interval: 2.49-28.29)) were significantly associated with anemia and leukocytosis, respectively. Conclusion: Hematological abnormalities, particularly anemia and leukocytosis, are common in patients with type 1 diabetes mellitus. Therefore, preventive and control strategies for hematological abnormalities are essential in patients with type 1 diabetes mellitus particularly for male and patients with a long duration on diabetes mellitus to reduce the burden and related complications.

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Background: Hematologic abnormalities are common complications of patients infected with HIV associated with accelerated deterioration in CD4+ cell counts, disease progression, poor quality of life and death. Few studies have evaluated the magnitude of cytopenias at the initiation of antiretroviral therapy (ART) in sub-Saharan Africa. The aim of this study was to determine the prevalence and predictors of cytopenias among HIV-infected adults at initiation of ART in a resource-limited setting in Ethiopia. Methods: A cross-sectional study was conducted among HIV-infected adults initiating ART at the HIV care and treatment clinic of Mehal Meda Hospital between September 2008 and June 2019. Demographic, clinical and laboratory data of patients were collected from medical records. Anemia was defined according to WHO guidelines as hemoglobin concentration <12 g/dl for non-pregnant females and <13 g/dl for males. Leucopenia was defined as total white blood cell count <4.0 × 103 cells/µL and thrombocytopenia as platelet count <150 × 103 cells/µL. Logistic regression analysis was used to determine factors associated with the presence of cytopenias. Results: Out of the total 566 patients included, 36.6% (95% CI 32.7-40.6%) had anemia, 17.1% (95% CI 14.2-20.4%) had leucopenia and 14.5% (95% CI 11.8-17.6%) had thrombocytopenia. A total of 53.2% (95% CI 49.1-57.3%) of patients had at least one form of cytopenia, 14.1% (95% CI 11.4-17.2%) had bicytopenia, and only 0.5% had pancytopenia. Factors associated with the presence of any cytopenia in multivariable analysis were male sex, advanced clinical disease stage, low CD4+ cell count, low BMI, and decreased renal function. Conclusion: A substantial burden of cytopenias was detected among HIV-infected adults enrolled for care and treatment services in our setting. Patients with HIV infection should be screened for hematological abnormalities at initiation of ART because of its potential for morbidity and mortality during ART.

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INTRODUCTION: Hematological abnormalities are common in children with down syndrome (DS), mainly during childhood. AREAS COVERED: DS newborns can develop hematological benign conditions that resolve spontaneously within 1 -2 months. However, about 10% of them can present transient abnormal myelopoiesis (TAM), characterized by the presence of circulating blasts. About 80% of DS neonates with TAM undergo spontaneous resolution of both clinical and laboratory abnormalities within 3-6 months after birth. However, some newborns with TAM may develop acute myeloid leukemia associated with DS (ML-DS), usually after an interval without signs of leukemia. GATA1 mutations are stable molecular markers that may monitor the presence of minimal residual disease (MRD) after TAM resolution. Moreover, DS children have a 10-20-fold increased risk of developing acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). The predisposition to develop leukemia occurs both in children with complete trisomy 21 and in those with mosaic trisomy, suggesting an important role of chromosome 21 in leukemogenesis. EXPERT OPINION: In contrast to the excellent prognosis of ML-DS obtained likewise with low doses of chemotherapy, DS-ALL patients show worse outcomes than non-DS children, therefore advances and risk-stratified treatment adjustments are mandatory for this particular set of patients.

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Síndrome de Down , Enfermedades Hematológicas , Leucemia Mieloide Aguda , Enfermedad Aguda , Niño , Síndrome de Down/complicaciones , Síndrome de Down/genética , Factor de Transcripción GATA1/genética , Enfermedades Hematológicas/complicaciones , Enfermedades Hematológicas/diagnóstico , Humanos , Recién Nacido , Leucemia Mieloide Aguda/genética , Reacción Leucemoide , Mutación , Trisomía

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Objective This study evaluated the importance of bone marrow aspiration and trephine biopsy (BM) for the diagnosis of underlying hematological abnormalities in renal patients. Methods This cross-sectional study on BM was carried out between August 2010 and April 2019, in our specialist renal center for various unexplained hematological abnormalities in patients with renal diseases [chronic kidney disease (CKD), end-stage renal disease (ESRD) requiring maintenance hemodialysis (MHD), patients with normal renal function but other nephrology and urology issues like stone disease and nephrotic syndrome]. Results Out of 176 reported BM examinations, 48 (27.3%) were done on ESRD patients on MHD (CKD-D), and 69 (39.2%) on CKD patients not on MHD (CKD-nD). Fifty-nine (33.5%) BM were done on patients with normal renal function (n-CKD). The indication for BM was pancytopenia 50 (28.4%), unexplained anemia 39 (22.2%), and unexplained thrombocytopenia 43 (24.4%). In 91 (51.7%) patients BM was normal. In 30 (17%) patients multiple myeloma (MM) was diagnosed on BM, out of which 18 (26.1%), nine (18%), three (5.3%) were CKD-nD, CKD-D, and n-CKD patients, respectively. In 11 (6.3%) patients BM was suggestive of myelodysplasia (MD), out of these 11 patients, five (10%) were CKD-D patients. Conclusion BM is an underutilized method of diagnosis of hematological abnormalities in renal patients. Our study revealed the importance of BM examination, especially in patients with CKD.

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Adalimumab-induced thrombocytopenia is a rarely occurring condition that may present with hemorrhagic manifestations. This report describes a case of a patient who presented with severe, symptomatic thrombocytopenia while on adalimumab for the treatment of hidradenitis suppurativa. The patient responded to treatment with steroids, intravenous immunoglobulin (IVIG), and platelet transfusion, in addition to discontinuation of adalimumab.

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OBJECTIVES: Hematological abnormalities of the major blood cell lines are frequently reported in patients with HIV-1 infection, in patients without antiretroviral therapy, and during the advanced stages of the disease. Chronic immune activation and inflammation results in the progressive depletion of CD4+ T-cells play a significant role in the clinical progression and pathogenesis of this infection. This study was aimed at assessing the prevalence of hematological abnormalities and their associated factors before and after the initiation of antiretroviral therapy in adults with HIV-1 infection in a referral hospital. METHODS: The study was conducted from 1 April to 30 June 2018, at Goba Referral Hospital. A total of 308 HIV-positive adults on treatment were enrolled during the study period. Socio-demographic and clinical data were collected using a structured questionnaire, with pre-highly active antiretroviral therapy data were extracted from medical records while post-treatment immuno-hematological measurements were done on blood samples collected at the time of enrollment. RESULTS: The prevalence of anemia, leukopenia, and thrombocytopenia before initiation of antiretroviral treatment was higher, although anemia and thrombocytopenia decreased correspondingly after initiation of treatment leukopenia increased by 4%. Mean values of immuno-hematological parameters before and after treatment initiation were significant (p < 0.05). CD4+ T-cell count <200 cells/µL was the only independent risk factor for anemia and leukopenia before highly active antiretroviral therapy, while stage IV disease, female sex, zidovudine, lamivudine, and nevirapine treatment, and intestinal parasite infection were predictors of anemia after treatment initiation. CONCLUSION: The study revealed that hematological abnormalities are common in HIV infection, while the occurrence of abnormalities after highly active antiretroviral therapy initiation. Different risk factors are associated with hematological abnormalities at pre- and post-highly active antiretroviral therapy with regular monitoring of risk factors, adherence to the early initiation of highly active antiretroviral therapy, and conduct of further longitudinal studies are recommended.

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BACKGROUND: The present study aimed to examine whether variables including D-dimer, high-sensitivity C-reactive protein (hsCRP), hemoglobin, platelet count, and nutritional status mediate the pathway between cancer and ischemic stroke outcomes. METHODS: We reviewed data from consecutive patients with ischemic stroke admitted to Osaka University Hospital between January 1, 2006, and December 31, 2016. Patients with ischemic stroke were grouped according to the presence of cancer. Nutritional status was assessed using Controlling Nutritional Status (CONUT) scores. Mediation analyses were utilized to address the study aims. RESULTS: Among 1,570 patients with ischemic stroke, 185 (12%) had active cancer. Relative to patients with ischemic stroke in the non-cancer group, those in the cancer group exhibited higher National Institutes of Health Stroke Scale scores on admission, higher D-dimer and hsCRP levels, lower hemoglobin levels and platelet counts, higher CONUT scores, and poorer modified Rankin Scale scores at discharge. Mediation analysis revealed that D-dimer, hsCRP, hemoglobin, platelet count, and CONUT scores acted as mediators of poor prognosis in the cancer group. The association between the exposure and outcome variables was no longer significant in the models containing D-dimer and CONUT scores as mediator variables, suggesting that they were strong mediators. Regarding the association between the mediator and outcome variables, hemoglobin, platelet count, and CONUT exhibited non-linearity (p for non-linearity < 0.001). CONCLUSIONS: D-dimer, hsCRP, hemoglobin, platelet count, and CONUT score act as mediators of poor prognosis in patients with ischemic stroke with comorbid cancer. Such abnormalities can help to predict ischemic stroke outcomes.

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Biomarcadores/sangre , Isquemia Encefálica/diagnóstico , Evaluación de la Discapacidad , Enfermedades Hematológicas/diagnóstico , Pruebas Hematológicas , Desnutrición/diagnóstico , Neoplasias/diagnóstico , Evaluación Nutricional , Estado Nutricional , Accidente Cerebrovascular/diagnóstico , Anciano , Plaquetas , Isquemia Encefálica/epidemiología , Isquemia Encefálica/terapia , Proteína C-Reactiva/análisis , Comorbilidad , Femenino , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Enfermedades Hematológicas/sangre , Enfermedades Hematológicas/epidemiología , Enfermedades Hematológicas/terapia , Hemoglobinas/análisis , Humanos , Japón/epidemiología , Masculino , Desnutrición/epidemiología , Desnutrición/fisiopatología , Desnutrición/terapia , Persona de Mediana Edad , Neoplasias/epidemiología , Neoplasias/terapia , Valor Predictivo de las Pruebas , Pronóstico , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/terapia

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BACKGROUND: Natalizumab, a monoclonal antibody directed against alpha-4-integrin, is an efficacious treatment used in Multiple Sclerosis (MS). Use in early pregnancy is safe but information in the third trimester is limited. Ceasing natalizumab is often associated with an increased risk in MS relapse and in some instances natalizumab continuation during pregnancy may be required. However natalizumab crosses the placenta in late pregnancy and has been associated with hematological abnormalities. We present clinical and hematological outcome data of newborns from a series of MS patients who received natalizumab during their second and third pregnancy trimesters. We describe possible methods to mitigate risks to the fetus. METHODS: Retrospective chart review of 15 births from mothers receiving natalizumab throughout pregnancy. RESULTS: Thirteen mothers with third-trimester exposure to natalizumab were identified. Median age at conception was 34 years (26-40) and median disease duration was 53.5 months (11-204). The 13 mothers gave birth to 15 newborns (2 mothers each with 2 individual births), median (SD) birth weight was 2778 gs (2100 - 3790). Congenital or laboratory abnormalities were identified in 5 which included anemia (n = 2) and thrombocytopenia (n = 3). CONCLUSIONS: Complications following natalizumab administration during the second and third trimester of pregnancy occurred in 33% of newborns. However, did not result in mortality or morbidity. Dose alterations during the third trimester, pre-delivery umbilical cord sampling and IVIG administration may reduce hematological effects on newborns. Prospective studies with larger numbers of patients are required to provide further evidence regarding the safety of Natalizumab use in pregnancy.

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Anomalías Inducidas por Medicamentos/etiología , Anemia/inducido químicamente , Factores Inmunológicos/efectos adversos , Esclerosis Múltiple/tratamiento farmacológico , Natalizumab/efectos adversos , Complicaciones del Embarazo/tratamiento farmacológico , Resultado del Embarazo , Tercer Trimestre del Embarazo/efectos de los fármacos , Trombocitopenia/inducido químicamente , Adulto , Anemia/congénito , Femenino , Humanos , Recién Nacido , Natalizumab/administración & dosificación , Embarazo , Estudios Retrospectivos , Trombocitopenia/congénito

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We report an African infant with Ellis-van Creveld (EVC) syndrome. EVC syndrome is a chondral and ectodermal dysplasia with autosomal recessive transmission. The baby presented with polydactyly, short limbs and atrioventricular septal defect, but was withdrawn from clinical follow up for the first year of life. Initial hematological abnormalities could not be explained and normalized later. EVC syndrome was confirmed by genetic analysis that showed two pathogenic mutations in the EVC2 gene, c.653_654del, p.Val218Glyfs*12 in exon 5, and c.2710C>T, p.Gln904* in exon 16. The variant c.653_654del; p.Val218Glyfs*12 in exon 5 has not been described before. Our review of medical literature suggested this is the first molecularly confirmed case of EVC syndrome in sub-Saharan Africa.

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Síndrome de Ellis-Van Creveld/genética , Síndrome de Ellis-Van Creveld/diagnóstico , Mano/diagnóstico por imagen , Humanos , Lactante , Masculino , Polidactilia/diagnóstico por imagen , Tanzanía , Tibia/diagnóstico por imagen

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Canine hepatozoonosis caused by Hepatozoon canis is widespread in America. In Argentina, since the first finding of the disease in Buenos Aires in 1999, several isolated cases were reported in other six provinces. However, there is no information regarding hematological and epidemiological characterization of the disease in the country. A total of 100,123 canine blood samples obtained during the period 2002-2013 from Southern Greater Buenos Aires were examined by light microscopy. Overall prevalence was 2.3%, with high parasitemia levels (>800gamonts/µl) in 680 samples, mild (100-800) in 1088, and low (<100) in 433 patients. Among parasitemic dogs, anemia (mostly non-regenerative) was present in 56.9%. Inflammatory leukogram, defined as neutrophilia with or without leukocytosis, with or without left shift and left shift with or without neutrophilia, was the main hematological abnormality and was present in 74.1% of positively tested dogs. A clear seasonal tendency was observed, with maximum values in summer and minimal in winter, and an increasing prevalence was recorded during the study decade. Young, male and mixed breed dogs showed higher prevalence values. Our findings strongly suggest that canine hepatozoonosis is endemic and expanding in the region.

RESUMEN

BACKGROUND: HIV infected children experience a range of hematological complications which show marked improvement within 6 months of initiating anti-retroviral therapy. The Objectives of the study was to describe the changes in hematological indices of HIV-1 infected children following 6 months of treatment with first line antiretroviral drugs (ARVs) regimen. METHODS: A retrospective study was conducted between September and November 2008. During this period medical records of children attending Comprehensive Care Clinic at Kenyatta National hospital were reviewed daily. HIV infected children aged 5-144 months were enrolled if they had received antiretroviral drugs for at least 6 months with available and complete laboratory results. RESULTS: Medical records of 337 children meeting enrollment criteria were included in the study. The median age was 63 months with equal male to female ratio. Following 6 months of HAART, prevalence of anemia (Hemoglobin (Hb) <10 g/dl) declined significantly from 35.9 to 16.6 % a nearly 50 % reduction in the risk of anemia RR = 0.56 [(95 % CI 0.44, 0.70) p < 0.001]. There was significant increase in Hb, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and platelets above the baseline measurements (p < 0.0001) and a significant decline in total white blood cell counts >11,000 cell/mm(3) but a none significant decrease in red blood cells (RBC). Pre-HAART, World Health Organization (WHO) stage 3 and 4 was associated with a ten-fold increased likelihood of anemia. Chronic malnutrition was associated with anemia but not wasting and immunologic staging of disease. CONCLUSION: Hematological abnormalities changed significantly within 6 months of antiretroviral therapy with significant increase in hemoglobin level, MCV, MCH and platelet and decrease in WBC and RBC.