Background: Anemia in patients with diabetes mellitus (DM) is often associated with anemia of chronic disease caused by inflammation or iron metabolism disorders. Hepcidin is known to function in initiating the internalization and degradation of ferroportin. It can inhibit the release of iron from cells where an increase in hepcidin levels will reduce iron absorption in the intestine, resulting in a decrease in serum iron levels. This study aims to determine the relationship between serum hepcidin levels and anemia in patients with Type-2 Diabetes Mellitus (T2DM). Methods: This cross-sectional study was conducted on 77 consecutive T2DM patients who met the inclusion and exclusion criteria and received health services at Sanglah Hospital, Bali, Indonesia, during the study period. The variables assessed in this study included T2DM status (controlled and uncontrolled), anemia, hemoglobin, HbA1c, erythrocyte sedimentation rate, and hepcidin. Data were analyzed with SPSS version 20 for Mac. Results: There was no significant difference in age, sex, disease duration, SGOT, SGPT, leukocytes, platelets, and ESR between controlled and uncontrolled T2DM groups (p>0.05). However, there was a significant difference in eGFR and hemoglobin levels between controlled and uncontrolled T2DM groups (p<0.05). Mann-Whitney U test found a significant difference in hepcidin levels between controlled and uncontrolled T2DM groups (MD=138.14; 95%CI=10. 65-286.94; p=0.046). A weak significant negative correlation was found between hemoglobin and hepcidin levels by the Spearman correlation test (r=-0.259; p=0.043). Conclusion:There was a significant difference between the mean hemoglobin and hepcidin levels in the controlled T2DM group compared to uncontrolled T2DM group patients. A weak statistically significant negative correlation was found between hepcidin levels and anemia in T2DM patients.

Background: ABO and Rhesus blood groups are clinically important, especially in blood transfusion. Blood groups are determined by the antigens found on the erythrocyte membrane. In patients with hematologic malignancies, especially from the myeloid lineage, changes in blood group can occur in the ABO system mainly due to weakness or loss of some ABO antigens. Case Description: A nine-year-old girl was admitted to the hospital with a chief complaint of high fever three days before admission. The patient had been diagnosed with acute non-lymphoblastic leukemia three months ago. From medical history, the patient had undergone chemotherapy and received 22 bags of PRC transfusion with blood group O (+) from February 27th until May 28th 2018. On July 21st 2018, the transfusion procedure was repeated, and the blood group showed B (+). The procedure was repeated using a new sample but the result remained the same. The crossmatch was performed with five blood groups O (+) and two blood groups B (+) showed mayor: negative, minor:+weak, AC:+weak, mayor: negative, minor:+weak, AC:+weak, respectively. Conclusion: Changes in blood group antigens in hematologic malignancies that experience ABO antigen alternation and return to the original blood group reflect the remission from the disease. The expression of H antigen in blood groups A and B may revert to normal with an improvement from the underlying disease.

Patients with CKD usually have chronic inflammation and impaired antioxidant systems, which worsen with the degree of renal impairment. Anemia is one of the major complications in pre-dialysis CKD patients Examination of iron status that is commonly done today such as serum iron parameters, ferritin, and transferrin saturation is still influenced by the inflammatory process. As an alternative to assessing iron status, the soluble transferrin receptor (sTfR) is not affected by chronic disease or inflammation. The purpose of this study was to determine the correlation of sTfR, hemoglobin, serum iron, and estimation of glomerular filtration rate (eGFR) in pre-dialysis CKD patients. This research was conducted from February to June 2022 at the Nephrology Outpatient Clinic and Clinical Pathology Laboratory of Sanglah Hospital, Denpasar. This research is an observational analytic study with a cross-sectional study design. The research subjects involved were 61 pre-dialysis CKD patients who met the inclusion and exclusion criteria. The results showed that the research subjects consisted of 54.1% male and 45.9% female. The results of the Spearman correlation test showed a weak significant negative correlation between sTfR levels and serum iron in pre-dialysis CKD patients (r = -0.264; p=0.040), but no significant correlation with hemoglobin (r = -0.116; p=0.372) and eGFR ((r = 0.134; p=0.302). This study showed a significant correlation indicating that an increase in serum sTfR levels would affect a decrease in serum iron, so it could be considered as a marker for the management of iron deficiency anemia in CKD.