Clinico-Haematological and Biochemical Profile of Dimorphic Anaemia With Bone Marrow Study

Abstract

BACKGROUND Dimorphic anaemia is very common in India. Dimorphism indicates the presence of two distinct populations of red cells. The term is most often applied when there is one population of hypochromic, microcytic cells and another population of normochromic cells, either normocytic or macrocytic. Aims and Objectives-1. Dimorphic anaemia has been studied, because treatment may be ineffective if the dual deficiency is not diagnosed. 2. To correlate and compare the clinico-haematological, biochemical parameters with bone marrow study. 3. To find out the clinical and haematological features of severe anaemia with bone marrow study. MATERIALS AND METHODS This descriptive study included 51 cases of dimorphic anaemia to evaluate association of biochemical profile of dimorphic anaemia with bone marrow study. Data collected from case files, patient history, clinical profile, peripheral blood findings, haematological parameters, bone marrow aspiration and biochemical parameters. RESULTS In our study, dimorphic anaemia (DA) was mostly found in 15-30 years of age. The male-to-female ratio was 1.5: 1 in our study. The most common clinical presentation was pallor and generalised weakness (100%) followed by easy fatigability (72.5%), fever (54.90%), altered behaviour (19.6%) and tingling (8%) are found. Bleeding (13.7%), itching and red spots (13.7%) are found in patients having thrombocytopenia. DA was found mostly in vegetarians (62.7%). The mean haemoglobin was 6.6 gm/dL. Splenomegaly and hepatomegaly were present in 35.2% and 23.5% respectively. There was complete correlation between three parameters in 8/51 (15.68%) cases only. CONCLUSION Bone marrow examination provides rapid and cost-effective investigation for confirming the diagnosis of dimorphic anaemia by reliably assessing the iron stores. Serum ferritin is more specific in predicting the iron deficiency. Serum vitamin B12 and serum folate are also specific, but not sensitive.

To evaluate clinical spectrum of megaloblastic anemia in a tertiary care hospital central India

“…Pallor was present in all the patients in our study, and this was comparable to the survey by Gayathri BN et al [23], Rathwa SS et al [24]. In present study splenomegaly was seen in 40.2% cases, accordance with the Rawat S, et al [25], observed splenomegaly in 35.3% of megaloblastic anaemia cases. In this study, observed the common clinical signs were pallor, glossitis, edema, jaundice, hepatomegaly, splenomegaly and hyper pigmentation, comparable with the Deepankar P, et al [26], B.R.…”

“…Folate deficiency is also another important cause of megaloblastic anemia. In this study, the most common age of presentation of megaloblastic anemia was in the subjects aged 16-30 years, our finding was comparable with the Kaur et al [10] and Khanduri et al [11], which suggest that MA is more prevalent in young age Present study observed slight male predominance (56.1%) over the female (43.9%) of the megaloblastic anaemia patients, Our result was similar to Ratre BK, et al [12], Rawat S et al [13] and Gupta M et al [14] In present study most of the (54.5%) megaloblastic anemia patients were moderate in nature (Hb 7-10%), our finding was concordance with the Choudhary P et al [15] and Mishra R et al [16] Current study observed megaloblastic anaemia was higher among pure vegetarian persons, similar finding also found by Gupta RK et al [17] and KK Magnani, et al [18].…”