GLORIA

GEOMAR Library Ocean Research Information Access

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
Filter
  • American Society of Hematology  (6)
  • 1
    In: Blood, American Society of Hematology, Vol. 136, No. Supplement 1 ( 2020-11-5), p. 19-20
    Abstract: Introduction Iron deficiency anemia (IDA) is a major public health issue, with widespread prevalence and negative impact on health care system. IDA occurs when iron stores diminish to the level that disturbs erythropoiesis and causes anemia. Neutropenia is an abnormal reduction in the number of neutrophils. A little is known about the association between iron deficiency anemia and neutropenia. The aim of this study is to investigate the prevalence of neutropenia in a large cohort of adult patients with IDA and to find possible correlation between neutrophil levels with haemoglobin concentration and iron stores. We studied associated infections in this neutropenic group. Materials and Methods We retrospectively reviewed the electronic medical records of 1567 patients attended haematology clinic with the diagnosis of IDA ((haemoglobin level less than 12 gm/dl for women, less than 13 gm/dl for men) over the past 2 years in Hamad Medical Corporation, Qatar. Other causes of anemia and anemia associated with any systemic or endocrine disease were excluded. The values of complete blood count (CBC) and iron parameters were collected. Neutropenia was defined as neutrophils count to be less than 1.5x 109/L Results Sixty four patients of the 1567 cohort with IDA had neutropenia (4.084%) Their mean neutrophils count = 1.18 +/- 0.28x 109/L before iron replacement. Neutrophil count increased significantly to 2.33 +/- 1x 109/L after iron therapy (p & lt; 0.05) . No significant correlation was detected between neutrophil count on the one hand and iron level, iron saturation, TIBC, Transferrin and ferritin level on the other hand. Eight out of the 64 patients with neutropenia had infection at the time of presentation; 5 upper respiratory tract infections, 1 gastroenteritis, 1 lymphadenitis, 1 urinary tract infections. Five of these patients received antibiotics, with no complications reported. Discussion In our cohort with IDA the prevalence of neutropenia was 4.08%. In all patients, the neutrophil count returned to normal after proper iron therapy. The effect of iron deficiency on neutrophils count is through its effect on haematopoiesis progenitors and bone marrow microenvironment which regulates the production of cell lineages. In addition, the high level of erythropoietin (observed in IDA) has been shown to down-regulate neutrophil production in animal models. In another relatively smaller study on 516 patients with IDA, neutropenia was found in 17.6% However, unlike in our study the neutrophil count was correlated with Hb level. On the other hand in 97 patients with unexplained neutropenia, IDA was found in 2.1% with correction of neutrophil count after correction of the anemia. In addition, the associated infection rate was low and was treated without complications. Our findings support a possible link between IDA and neutropenia evident by the improvement of neutrophils count after iron replacement, (1.18 vs 2.33x 109/). Conclusions: The finding of neutropenia is not uncommon in patients with IDA. This neutropenia markedly improved after iron replacement. Iron is essential for proper development and maintenance of the immune system in general and further studies are required to elaborate further in this unique association. Figure 1 Disclosures No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2020
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 2
    In: Blood, American Society of Hematology, Vol. 136, No. Supplement 1 ( 2020-11-5), p. 18-19
    Abstract: Introduction Iron deficiency anemia (IDA) is the most common cause of anemia in both developed and developing countries, particularly affecting females in the child bearing age and children. The treatment of IDA is a major health goal, it consists of treating the underlying cause and iron supplements. Iron replacement comes in form of oral or intravenous, there are certain side effects of this therapy including constipation and allergy. Leukopenia as a side effect of iron therapy is under reported in the literature as only sporadic cases were prescribed. We conducted a study to clarify this issue and to check for its clinical significance. Objective: To assess the relationship between iron therapy (intravenous) and leukopenia, neutropenia or lymphocytopenia, and its impact on patient's clinical settings. Materials and Methods We retrospectively reviewed the electronic medical records of patients attended Haematology clinic for iron deficiency anemia and treated with intravenous iron (ferric carboxymaltose or iron saccharide) over 2 years in Hamad Medical Corporation, Doha/Qatar. Adult female patients with IDA cases who received IV iron were included. anemia due to other nutrients deficienciesa nd conditions (including other medications) that may alter WBCs count were excluded.Age, Ethnicity, BMI, Complete blood count and iron studies data were collected before and after treatment with IV iron therapy. Infection occurrence at the time of IDA and leukopenia, the use of antibiotics and infection related complications were also collected. Leukopenia was defined as WBCs count to be less than 4000/microlitre, Neutropenia as ANC less than 1500/microlitre and lymphocytopenia as lymphocytes less than 1000/mocrolitre. Statistical analysis was done using mean , SD and t test. Results After iron therapy, out of 1567 case of iron deficiency anemia, 30 cases (1.914%) have leukopenia,15 cases (0.957%) have neutropenia and 12 cases (0.765%) have lymphocytopenia. All had normal readings before treatment. 2 patients (6.66%) had infection, 1 had upper respiratory tract infection and 1 urinary tract infection, the latter was treated with antibiotics, none reported infection related complications Discussion Leukocytopenia is defined as low WBCs circulating in the blood and this can be caused by low neutrophils count, low lymphocytes count, other WBCs components or combined. Some previous reported cases generated the idea of a possible connection between iron supplement therapy and leukopenia, Brito-Babapulle et al reported a case of fatal bone marrow suppression linked to ferric carboxymaltose therapy in a patient with IDA. The pathophysiology is not well understood but thought to be a toxic effect of iron on bone marrow and it can affect all cell lineages. Our findings suggest possible iron replacement side effect as there was significant drop of the WBCs count after treating IDA patients with IV iron, however this association was not common. There was no life threatening or serious infections in the affected patients, which can suggest that most of these cases are mild and transient. More studies are needed to address this issue, particularly on larger scales. Patient education also may be appreciated before treatment with IV iron. Conclusions: Leukopenia in form of neutropenia or lymphocytopenia maybe a side effect of IV iron therapy. Clinical significance is limited in view of current literature further studies needed to elaborate more in this important adverse event. Figure Disclosures No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2020
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 3
    In: Blood, American Society of Hematology, Vol. 136, No. Supplement 1 ( 2020-11-5), p. 16-16
    Abstract: Introduction Severe IDA can cause many complications and impair the quality of life. Iron is an essential micronutrient required for catalysis, DNA synthesis, redox reactions and oxygen transport1. It is important for an early step in embryonic haematopoiesis, which is common for all developing blood cells. The link between IDA and leukopenia is not well recognized in the literature. Objectives To assess the prevalence and clinical significance of leukopenia in patients with IDA and effect of iron replacement and correction of anemia on the WBCs count. Materials and Methods We retrospectively reviewed the electronic medical records of all patients attended haematology clinic with the diagnosis of iron deficiency anemia (IDA) over 2 years in Hamad Medical Corporation, Qatar. All other causes of anemia and patients with systemic or chronic diseases were excluded. Age, nationality, BMI, Complete blood count and iron parameters were collected before and after treatment with IV iron therapy. Associated infections at the time of presentation (IDA and leukopenia) were noted including the course of the infection and response to treatment. Leukopenia was defined as WBCs count below 4000/microlitre. Statistical analysis was done using paired t test to compare variables after versus before iron therapy. Results Out of 1567 case of iron deficiency anemia, 80 case had leukopenia (5.105%) Their mean Leukocytes count was 3.35 +/- 0.48 ×103 before iron replacement. 7 patients had infections; 4 had upper respiratory tract infection, 1 urinary tract infection, 1 gastroenteritis, 1 lymphadenitis. Six of them received antibiotics and they had no complications. After iron therapy and correction of anemia the leukocyte count increased significantly to 4.38 +/- 1.82×103 (P & lt; 0.05). There was no significant correlation between WBC count and iron parameters (Hb, TIBC, serum iron concentration). Discussion High level of erythropoietin in IDA is thought to cause down regulation of neutrophils in animal models. In our study leukopenia occurred in 5.1% of the big cohort with IDA. A previous study on 516 patients with IDA recorded leukopenia in 17.6% of them. Their cases with leukopenia occurred more in patients with severe anemia. The increase of WBC count with correction of anemia suggested a physiologic link between erythropoiesis and leukopoiesis. However, our study did not show correlation between WBC count and Hb or any of the iron parameters. In concert with our finding, a study in healthy children (n = 556) did not find associations between the measured iron markers and WBC In addition, the association between IDA and leukopenia did not significantly increase the risk of infections in our patients. The link between leukopenia and IDA needs to be addressed in more studies. Conclusions: The prevalence of leukopenia in this big cohort with IDA was 5.1%. This leukopenia was not associated with severe or complicated infections. There were no associations between the measured iron markers and white blood cell counts in healthy adults Figure Disclosures No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2020
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 4
    In: Blood, American Society of Hematology, Vol. 136, No. Supplement 1 ( 2020-11-5), p. 39-40
    Abstract: Introduction Iron deficiency anemia (IDA) is the most common cause of anemia in both developed and developing countries, particularly affecting females in the child bearing age and children. The treatment of IDA is a major health goal, it consists of treating the underlying cause and iron supplements. Iron replacement comes in form of oral or intravenous, there are certain side effects of this therapy including constipation and allergy. Leukopenia as a side effect of iron therapy is under reported in the literature as only sporadic cases were prescribed. We conducted a study to clarify this issue and to check for its clinical significance. Objective: To assess the relationship between iron therapy (intravenous) and leukopenia, neutropenia or lymphocytopenia, and its impact on patient's clinical settings. Materials and Methods We retrospectively reviewed the electronic medical records of patients attended Haematology clinic for iron deficiency anemia and treated with intravenous iron (ferric carboxymaltose or iron saccharide) over 2 years in Hamad Medical Corporation, Doha/Qatar. Adult female patients with IDA cases who received IV iron were included. anemia due to other nutrients deficienciesa nd conditions (including other medications) that may alter WBCs count were excluded.Age, Ethnicity, BMI, Complete blood count and iron studies data were collected before and after treatment with IV iron therapy. Infection occurrence at the time of IDA and leukopenia, the use of antibiotics and infection related complications were also collected. Leukopenia was defined as WBCs count to be less than 4000/microlitre, Neutropenia as ANC less than 1500/microlitre and lymphocytopenia as lymphocytes less than 1000/mocrolitre. Statistical analysis was done using mean , SD and t test. Results After iron therapy, out of 1567 case of iron deficiency anemia, 30 cases (1.914%) have leukopenia,15 cases (0.957%) have neutropenia and 12 cases (0.765%) have lymphocytopenia. All had normal readings before treatment. 2 patients (6.66%) had infection, 1 had upper respiratory tract infection and 1 urinary tract infection, the latter was treated with antibiotics, none reported infection related complications Discussion Leukocytopenia is defined as low WBCs circulating in the blood and this can be caused by low neutrophils count, low lymphocytes count, other WBCs components or combined. Some previous reported cases generated the idea of a possible connection between iron supplement therapy and leukopenia, Brito-Babapulle et al reported a case of fatal bone marrow suppression linked to ferric carboxymaltose therapy in a patient with IDA. The pathophysiology is not well understood but thought to be a toxic effect of iron on bone marrow and it can affect all cell lineages. Our findings suggest possible iron replacement side effect as there was significant drop of the WBCs count after treating IDA patients with IV iron, however this association was not common. There was no life threatening or serious infections in the affected patients, which can suggest that most of these cases are mild and transient. More studies are needed to address this issue, particularly on larger scales. Patient education also may be appreciated before treatment with IV iron. Conclusions: Leukopenia in form of neutropenia or lymphocytopenia maybe a side effect of IV iron therapy. Clinical significance is limited in view of current literature further studies needed to elaborate more in this important adverse event. Disclosures No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2020
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 5
    In: Blood, American Society of Hematology, Vol. 138, No. Supplement 1 ( 2021-11-05), p. 4214-4214
    Abstract: Prevalence of Thrombocytopenia among Iron Deficiency Anemia in Arab population in Qatar INTRODUCTION / BACKGROUND Iron deficiency anemia is a common cause of anemia, and account for almost half of the causes of all anemias. It is well known and common that iron deficiency anemia can be with thrombocytosis, A study reviewed 450 patients with a diagnosis of anemia between 2002 and 2006 was performed in which 143 of them were having IDA found that 31% of them were having associated thrombocytosis (4). A retrospective study conducted in Turkey found that Iron deficiency anemia and thrombocytopenia found in 13 from 615 patients (2.1%) (5). IDA and thrombocytopenia are found in certain ethnicity where we don t have data from studies about Arab Population. Materials and Methods We retrospectively reviewed the electronic medical records of patients attended hematology/ IV iron room clinics with the diagnosis of IDA over 2 years from the period between December 2017 to December 2019 in Hamad Medical Corporation, Qatar. Complete blood count and iron parameters were collected and analyzed. Thrombocytopenia was defined as Platelet count of less than 150 × 109/L. Statistical analysis was done using mean and SD and paired t test to compare variables after versus before treatment. Depending on previous studies available in the literature, the prevalence of IDA and thrombocytopenia reported from the study done in Turkey (2.1%), based on this we expect the prevalence estimates in Arab population is 3% (with margin of error +/- %) and confidence level 95%, the required sample size needed would be a total of 1744 participants +- 0.8. The adequate sample size was determined using the following statistical equation: Inclusion Criteria: Arab Female who is diagnosed with iron deficiency anemia or iron depleted and receive iron therapy. Exclusion criteria: Extreme age less than 18 and above 65Any chronic organ dysfunction or failurePrevious bariatric surgery or gastrostomyMalignancy (Known or discovered at any time during study follow up) Results: Out of 1752 cases of IDA, 39 cases had thrombocytopenia, (2.2 %) (table 1) with mean age of 41.38. The mean Platelet count was 108 x 10^9 in patients with thrombocytopenia while it was 325 x 10^9 in non-thrombocytopenia patients. Platelets count mean increased to 179 x 10^9 after iron replacement (p & lt; 0.05). Analysis of thrombocytopenia according to nationalities was obtained which showed 28 cases among Qatari's (2.2%), 4.1 % in Egyptians, 3.8% in Yemenis, 3.1% Sudanese, 2.9%,2.7% in Jordanian and Syrian respectively and 1.1% in other nationalities (table 2). Discussion: Qatar is multinational country with large number of expatriates working in it. In our study thrombocytopenia occurred in 39 cases out of 1752 cases included in the study which represent 2.2% of them. Most of our patients were of Qatari nationality 1327 in which 28 cases of thrombocytopenia were found, with 3.8 % in Egyptian the 2nd most common Arab residents in Qatar. Further analysis according to nationalities revealed 3.1%, 2.9%, 2.7% in Yemenis, Sudanese and Jordanian patients, with 1.1% in other patients from other Arab nationalities. Comparison of blood parameters including platelet count before and after iv iron therapy were obtained which showed mean platelet count was 108 x 10^9 which increased to 179 x 10^9 after iron therapy, The mechanisms for the thrombocytopenia associated with IDA are not well established, although iron plays a critical role both in the synthesis of platelets and in the regulation of thrombopoiesis. Other blood parameters including WBC, ANC, Lymphocyte count showed decremental responses after iron therapy with WBC dropped from 6.3 to 6.1, ANC from 3.5 to 2.7 and lymphocyte count from 1.9 to 1.8 in thrombocytopenic patients. Conclusion: The prevalence of thrombocytopenia among IDA in Qatar was 2.2%, which normalized after iv iron therapy. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2021
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 6
    In: Blood, American Society of Hematology, Vol. 136, No. Supplement 1 ( 2020-11-5), p. 15-16
    Abstract: Introduction Iron deficiency anaemia (IDA) is one of the most common health problems worldwide, its prevalence is up to 1 in 5 of the general population. The diagnosis of absolute iron deficiency is easy unless the condition is masked by inflammatory conditions. All cases of iron deficiency should be assessed for treatment and underlying cause.In developing countries, iron deficiency anemia is nutritional, resulting from reduced intake of bioavailable iron , and often associated with infections causing hemorrhages, such as hookworm infestation . In Western societies, other than in individuals at risk, iron depletion results from chronic bleeding and/or reduced iron absorption, disorders that may be more relevant than anemia itself.The association between IDA and lymphocytopenia is poorly addressed in the literature. Objective: To assess the prevalence of lymphocytopenia in a large cohort with IDA and to study the effect of iron replacement on lymphocytes count. Materials and Methods We retrospectively reviewed the electronic medical records of patients attended haematology clinic with the diagnosis of IDA over 2 years in Hamad Medical Corporation, Qatar. Patients with other forms of anemia were excluded as those with chronic or systemic diseases. Complete blood count and iron parameters were collected and analysed. Lymphocytopenia was defined as lymphocyte count less than 1000/microlitre. Statistical analysis was done using mean and SD and paired t test to compare variables after versus before treatment. Results The mean age of our IDA patients was 37.95 years with a mean BMI = 31.82. Out of 1567 case of IDA, 20 had lymphocytopenia, (1.276%). The mean lymphocytes count mean increased from 0.73 +/- 0.15 x 10^9 before iron replacement, to 1.79 +/- 0.74 x 10^9 after iron treatment (p & lt; 0.05) (iron dose of 1000 mg of IV iron saccharate or ferric carboxymaltose) . Four out of the 20 patients with lymphopenia had mild infections (2 upper respiratory tract infections, 1 urinary tract infection and one gastroenteritis) with no serious complications. These findings suggested that the lymphopenia associated with IDA is correctable and does not increase infection risk in these patients. Discussion Our study showed a possible negative impact of IDA on lymphocytes count in a small number of patients that was corrected with the correction of anemia with iron therapy. Animal studies showed that iron deficiency may lead to impaired T lymphoid differentiation and may negatively affect all cell lineage in haematopoiesis not only on erythroid line. A case control study by Das et al. found significantly lower levels of CD4+ T-cell counts and CD4:CD8 ratios in iron deficient children, however there was no significant effect on immunoglobulin levels. Conclusions: Lymphopenia may occur in a small percentage of patients with IDA. Significant increase in the lymphocyte count occur with iron therapy and correction of the anemia. Lymphopenia was not associated with serious infections. Disclosures No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2020
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...