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Normocytic Anemia

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81. Emergency management of adrenal insufficiency in children: advocating for treatment options in outpatient and field settings

in primary, but not secondary AI, and can be associated with hypercalcemia and metabolic acidosis. Hypoglycemia is more frequent in neonates and infants regardless of the type of AI. Other findings include normocytic anemia, lymphocytosis and eosinophilia. Hormonal measurements and provocative testing The diagnosis of primary AI is suggested by blood tests pref- erably performed at 8:00 AM that show an ACTH level greater than 100 pg/mL and a cortisol level less than 10 mcg/dL 1 or by an ACTH level

2019 Pediatric Endocrine Society

82. Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association Full Text available with Trip Pro

and mature granulocytes. Leukopenia and lymphocyte predominance suggest an alternative diagnosis. Anemia occurs commonly, is normochromic and normocytic, and resolves with resolution of inflammation. Elevation of acute-phase reactants such as ESR and CRP is nearly universal; the degree of elevation of ESR and CRP may be discrepant. The CRP normalizes more quickly than the ESR during resolution of inflammation. Moreover, the ESR is elevated by IVIG therapy, and therefore, a decreased ESR during follow-up

2017 American Heart Association

83. Blood Transfusions in Obstetrics

is defined as first trimester haemoglobin (Hb) less than 110 g/l, second/third trimester Hb less than 105 g/l, and postpartum Hb less than 100 g/l, in line with British Committee for Standards in Haematology (BCSH) guidance. For normocytic or microcytic anaemia, a trial of oral iron should be considered as the first step and further tests should be undertaken if there is no demonstrable rise in Hb at 2 weeks and compliance has been checked. Pregnant women should be offered screening for anaemia (...) of clinical trials. Is there a role for antifibrinolytics? For those centres not participating in clinical trials, consideration should be given to using tranexamic acid during major obstetric haemorrhage. How should intrapartum anaemia be managed? In addition to major haemorrhage guidelines, obstetric units should have guidelines on criteria for red cell transfusion in anaemic women who are not actively bleeding. If the Hb is less than 70 g/l in labour or in the immediate postpartum period, the decision

2015 Royal College of Obstetricians and Gynaecologists

84. More Than A Medical Note

; irregularly irregular S1/S2 with a grade 4/6 harsh systolic murmur at the second right intercostal space with radiation toward the right carotid artery and a 3/6 systolic ejection murmur at the apex; and melena. Labs are significant for low hemoglobin (10.3) and hematocrit (31.3), normocytic anemia, and a positive fecal occult blood test indicating active bleeding. Transthoracic echocardiogram is consistent with severe aortic stenosis and mild aortic regurgitation as well as severe mitral annular

2016 Clinical Correlations

85. Hematological responses to iron-folate supplementation and its determinants in pregnant women attending antenatal cares in Mekelle City, Ethiopia. Full Text available with Trip Pro

, respectively). Normocytic hypochromic anemia was the commonest form of anemia found in this study followed by normocytic normochromic anemia. There was no statistically significant association between poor hemoglobin responses and all studied factors such as educational level, household size, parity, recent illness, stage of pregnancy, coffee consumption, and duration of iron treatment.Our study revealed poor hemoglobin responses in nearly half of the study participants and a high proportion of anemias (...) Hematological responses to iron-folate supplementation and its determinants in pregnant women attending antenatal cares in Mekelle City, Ethiopia. To characterize anemia and evaluate hematological responses to universal iron-folic acid (IFA) supplementation in Ethiopian pregnant women.A hospital- based prospective follow up study was done between December 2016 and June 2017. Hematological profiles were measured in pregnant women before and after a minimum of one-month IFA supplementation. Mean

2018 PLoS ONE

86. Laboratory diagnosis of non-immune hereditary red cell membrane disorders

of Laboratory Medicine and Pathology, Mayo Clinic Rochester, Rochester, MN, USA Department of Molecular Medicine & Medical Biotechnologies, University Federico II of Naples, Naples, Italy Hématologie Biologique, Bicêtre et Faculté de Pharmacie, AP‐HP Hôpital, Université Paris‐Sud, Le Kremlin Bicêtre, France Division of Medicine, University College London, London, UK Hematology Unit, Physiopathology of Anemias Unit, Foundation IRCCS Cá Granada Ospedale Maggiore Policlinico, Milan, Italy Haematology (...) Department, St. George Hospital, SEALS Central, Sydney, NSW, Australia ICSH Representative. Hematology Unit, Physiopathology of Anemias Unit, Foundation IRCCS Cá Granada Ospedale Maggiore Policlinico, Milan, Italy for Corresponding Author Membrane Biochemistry, NHS Blood and Transplant, Bristol, UK Correspondence : May‐Jean King, Membrane Biochemistry, NHS Blood and Transplant, 500 North Bristol Park, Northway, Filton, Bristol BS34 7QH, UK. Tel.: +44 (0) 117 921 7601; Fax: +44 (0) 117 912 5782; E‐mail

2015 British Committee for Standards in Haematology

87. Spotlight Case Part 2: Hypergammaglobulinemia and defective humoral immunity in HIV-infected patients

or cardiac exam. The white blood cell count was 21,000/mm3 with 86% neutrophils. The erythrocyte sedimentation rate and C-reactive protein were elevated to 126 mm/hr and 261 mg/L, respectively. Labs were otherwise significant for a normocytic anemia (hemoglobin 9.5 g/dL) and serum protein-albumin gap of 5. A polyclonal hypergammaglobulinemia with IgG predominance was noted. A chest radiograph showed bilateral pleural effusions, greater on the right than on the left. Arthrocentesis of the right knee

2015 Clinical Correlations

88. Spotlight Case Part 1: Oligoarticular Septic Arthritis-A Case of Disseminated Pneumococcal Disease

or cardiac exam. The white blood cell count was 21,000/mm3 with 86% neutrophils. The erythrocyte sedimentation rate and C-reactive protein were elevated to 126 mm/hr and 261 mg/L, respectively. Labs were otherwise significant for a normocytic anemia (hemoglobin 9.5 g/dL) and serum protein-albumin gap of 5. A polyclonal hypergammaglobulinemia with IgG predominance was noted. A chest radiograph showed bilateral pleural effusions, greater on the right than on the left. Arthrocentesis of the right knee

2015 Clinical Correlations

89. Quantitative data on red cell measures of iron status and their relation to the magnitude of the systemic inflammatory response and survival in patients with colorectal cancer. Full Text available with Trip Pro

, at a single centre between 2008 and 2017 were included (n = 824). Blood samples taken for C-reactive protein (CRP), albumin, and full blood count (FBC) allowed patients to be grouped by modified Glasgow Prognostic Score (mGPS), and anaemia subtype (haemoglobin (Hb) M < 130 mg/L and F < 120 mg/L, with microcytic anaemia being mean corpuscular volume (MCV) < 80 f/L, and normocytic anaemia with MCV 80-100 f/L). Relationships between these groupings and red cell measures iron status including Hb, MCV, mean (...) corpuscular haemoglobin (MCH) and red cell distribution width (RDW) were examined.The combination of increasing T stage and increasing mGPS was associated with lower Hb, lower MCV, lower MCH, higher RDW, and higher prevalence of both microcytic and normocytic anaemia (all p < 0.001). The combination of CRP >10 mg/L and albumin <35  g/L was associated with lower Hb, lower MCV, lower MCH, higher RDW, and higher prevalence of both microcytic and normocytic anaemia (all p < 0.010). At multivariate Cox

2019 European Journal of Surgical Oncology

90. Prospective evaluation of pregnancy outcome in an Italian woman with late-onset combined homocystinuria and methylmalonic aciduria. Full Text available with Trip Pro

function and normocytic anaemia. At the age of 34, when her first pregnancy resulted in an intrauterine death of a morphologically normal growth-restricted foetus, she was diagnosed with homocystinuria and methylmalonic aciduria due to cyanocobalamin C (cblC) defect, which was confirmed by molecular investigation. Consequently, hydroxocobalamin was administered to correct homocysteine plasma levels. This treatment was efficacious in lowering homocysteine plasma levels and restored anaemia and renal (...) Prospective evaluation of pregnancy outcome in an Italian woman with late-onset combined homocystinuria and methylmalonic aciduria. Cobalamin metabolism disorders are rare, inherited diseases which cause megaloblastic anaemia and other clinical manifestations. Early diagnosis of these conditions is essential, in order to allow appropriate treatment as early as possible.Here we report the case of a patient who was apparently healthy until the age of 20, when she presented with impaired renal

2019 BMC Pregnancy and Childbirth

91. Abnormal red blood cell morphological changes in thalassaemia associated with iron overload and oxidative stress. (Abstract)

with thalassaemia are commonly known as microcytic hypochromic anaemia with poikilocytosis. However, iron and ROS accumulation in RBCs as related to RBC morphological changes in patients with thalassaemia has not been reported.Twenty-one patients with thalassaemia, including HbH, HbH with Hb Constant Spring and β-thalassaemia/HbE (splenectomy and non-splenectomy) genotypes, and five normal subjects were recruited. RBC morphology was analysed by light and scanning electron microscopy. Systemic and RBC iron (...) status and oxidative stress were examined.Decreased normocytes were observed in the samples of patients with thalassaemia, with RBC morphological abnormality being related to the type of disease (α-thalassaemia or β-thalassaemia) and splenic status. Target cells and crenated cells were mainly found in splenectomised patients with β-thalassaemia/HbE, while target cells and teardrop cells were found in non-splenectomised patients. Patients with thalassaemia had high levels of serum ferritin, red cell

2019 Journal of Clinical Pathology

92. Transient Erythroblastopenia of Childhood: A Review for the Pediatric Emergency Medicine Physician. (Abstract)

children who present with normocytic anemia and lack of reticulocytosis without evidence of blood loss, hemolysis, or other causes of bone marrow suppression. Evaluation should be targeted at ruling out other causes of anemia. Management is mainly supportive, although some children may require blood transfusions for symptomatic anemia. Most patients demonstrate a return of hematopoiesis within two weeks of diagnosis and normalization of blood counts within two months.

2019 Pediatric Emergency Care

93. Myelodysplastic/ Myeloproliferative Neoplasms Treatment (PDQ®): Health Professional Version

with an unremarkable morphology, can exhibit abnormal granulation, unusual nuclear lobation, or finely dispersed nuclear chromatin.[ ] Fewer than 20% blasts are seen in the blood or bone marrow. Neutrophilia occurs in nearly 50% of patients with neutrophil precursors (e.g., promyelocytes and myelocytes) accounting for more than 10% of the white blood cells.[ ] Mild normocytic anemia is common. (Refer to the PDQ summary on for more information on anemia.) Moderate thrombocytopenia is often present. Bone marrow (...) or complex abnormalities), and anemia.[ ][ ] The nucleoside azacitidine is an inhibitor of DNA methyltransferase that has been approved for the treatment of MDS and CMML, largely based on a Cancer and Leukemia Group B randomized trial and a randomized trial conducted in Europe.[ , ] Azacitidine may improve both the dysplastic and proliferative features of CMML. Erythropoietic growth factors may help to reduce transfusion requirements when anemia supervenes. This trial, in which patients were randomized

2017 PDQ - NCI's Comprehensive Cancer Database

94. Tacrolimus Treatment for Refractory PRCA

-effect of tacrolimus for refractory PRCA. Condition or disease Intervention/treatment Phase Pure Red Cell Aplasia Drug: tacrolimus Phase 4 Detailed Description: Pure red cell aplasia (PRCA) is a rare normocytic normochromic anemia with reticulocytopenia, characterized by a reduction of erythroid precursors from the bone marrow, could be divided into congenital and acquired PRCA according to pathogenesis. Congenital PRCA, also known as Diamond-Blackfan syndrome, has been associated with pathogenic (...) Union Medical College Hospital Study Details Study Description Go to Brief Summary: Pure red cell aplasia (PRCA) is a kind of anemia characterized by severe reticulocytopenia and obvious bone marrow erythroblastic cells decreased. Cyclosporine and /or steroids are the first line therapy but some patients were refractory or intolerance to the treatment. The effects of the second line therapy are also not satisfactory and sometimes not available. The investigators aim to explore the efficacy and side

2018 Clinical Trials

95. Rare and unusual case of anti-factor XI antibodies in patient with plasma cell leukemia. Full Text available with Trip Pro

by the addition of the control plasma confirming the presence of anti-factor XI autoantibodies. In addition, the blood count showed bicytopenia with non-regenerative normocytic normochromic anemia and thrombocytopenia. The blood smear demonstrated a plasma cell count of 49% (2842/mm3) evoking PCL. The bone marrow was invaded up to 90% by dystrophic plasma cells. The biochemical assessment suggested downstream renal and electrolyte disturbances from exuberant light chain production with abnormalities including (...) Rare and unusual case of anti-factor XI antibodies in patient with plasma cell leukemia. The acquired inhibitors of coagulation have been observed in very rare cases of monoclonal gammopathies. We report a very rare case of anti-factor XI antibodies in patient with plasma cell leukemia (PCL).This is a 59-year-old male patient without pathological history, admitted to the nephrology department for management of renal insufficiency and anemia syndrome. The history and physical examination

2018 BMC Hematology

96. Aggressive Systemic Mastocytosis in Association with Pure Red Cell Aplasia Full Text available with Trip Pro

Aggressive Systemic Mastocytosis in Association with Pure Red Cell Aplasia Aggressive systemic mastocytosis (ASM) is characterized by mast cell accumulation in systemic organs. Though ASM may be associated with other hematological disorders, the association with pure red cell aplasia (PRCA) is rare and has not been reported. Pure red cell aplasia (PRCA) is a syndrome, characterized by normochromic normocytic anemia, reticulocytopenia, and severe erythroid hypoplasia. The myeloid

2018 Case reports in hematology

97. Acute Lymphoblastic Leukemia Presenting with Liver Infiltration and Severe Lactic Acidosis Full Text available with Trip Pro

patient who presented with severe chest pain, dyspnea, systemic symptoms, leukopenia, normocytic anemia, and severe lactic acidosis. He was admitted with a possible diagnosis of acute pericarditis and lactic acidosis. Sodium bicarbonate replacement did not improve the lactic acidosis. Liver biopsy was performed because of persistently elevated alkaline phosphatase and gamma-glutamyl transferase; the biopsy showed atypical lymphoblasts and bone marrow biopsy confirmed the diagnosis of precursor B acute

2018 The American journal of case reports

98. Abnormal folate metabolism causes age‐, sex‐ and parent‐of‐origin‐specific haematological defects in mice Full Text available with Trip Pro

upon the sex of the parent. For instance, wildtype daughters of Mtrr+/gt females displayed normocytic anaemia. In contrast, wildtype daughters of Mtrr+/gt males exhibited erythrocytic microcytosis not associated with anaemia. Therefore, abnormal folate metabolism affects adult haematopoiesis in an age-, sex- and parent-specific manner.© 2018 The Authors. The Journal of Physiology published by John Wiley & Sons Ltd on behalf of The Physiological Society. (...) Abnormal folate metabolism causes age‐, sex‐ and parent‐of‐origin‐specific haematological defects in mice Folate (folic acid) deficiency and mutations in folate-related genes in humans result in megaloblastic anaemia. Folate metabolism, which requires the enzyme methionine synthase reductase (MTRR), is necessary for DNA synthesis and the transmission of one-carbon methyl groups for cellular methylation. In this study, we show that the hypomorphic Mtrrgt/gt mutation in mice results

2018 The Journal of physiology

99. Evaluation of hepatocyte-derived microRNA-122 for diagnosis of acute and chronic hepatitis of dogs Full Text available with Trip Pro

hepatitis manifested anorexia, abdominal distension, weight loss, and melena. Hematological parameters showed normocytic normochromic anemia and thrombocytopenia in both acute and chronic hepatitis groups. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and total bilirubin were significantly higher than control values in acute hepatitis. In chronic hepatitis, total protein and albumin were significantly lower than control values with normal ALT, AST, ALP

2018 Veterinary world

100. Acute coumaphos organophosphate exposure in the domestic dogs: Its implication on haematology and liver functions Full Text available with Trip Pro

urea and decreased low density lipoprotein (LDL) values were observed at 8 h post exposure, which worsened with time. At 24 and 36 hrs post exposure, normochromic normocytic anaemia, pan leucopenia, bloody diarrhoea, retching, vomiting and paddling were observed in affected animals. Post mortem examination revealed severe lungs, liver and stomach congestion. Multifocal areas of necrosis in the liver and kidney, serosal and mucosal haemorrhages and haemorrhagic meningitis were also observed. The use

2018 International Journal of Veterinary Science and Medicine

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