Clinicohematological profile of hemolytic anaemia in tertiary care hospital in rural Andhra Pradesh

Abstract

Introduction: Hemolytic anaemias are a group of disorders that cause significant morbidity in children. Method: A cross sectional study was conducted at NRI Medical College for a period of 1 year. All cases of newly diagnosed and old cases of hemolytic anaemia on follow up were included. Results: The study showed beta thalassemia as the most common hemolytic anaemia; followed by malaria, sickle beta thalassemia, thalassemia intermedia, beta thalassemia minor, Sickle cell disease, sickle cell trait, auto immune hemolytic anaemia, and hereditary spherocytosis. The mean hemoglobin at presentation was 5.39 gm/dl. Anthropometric measurements in 32 cases of congenital hemolytic anaemias revealed height < 3 rd centile in 9 cases. Weight less than 3 rd centile was seen in 11 cases. 13 children had hemolytic facies. Massive splenomegaly causing discomfort, gall stones, heart failure were seen in 2 cases each. In thalassemia major, 10 cases required frequent transfusions, [10-12 per year]. 9 came for less frequent transfusions [6 per year]. Sickle thalassemia, thalassemia intermedia, required one transfusion every 1-2 years. Occasional transfusions were given in sickle cell anaemia, hereditary spherocytosis. Serum ferritin levels varied between 220-1427. Conclusion: Hemoglobin electrophoresis remains the main investigation of choice in diagnosis of hemolytic anaemia. Thalassemia major is the most severe among other hemolytic anaemias encountered in this series. The study emphasizes the need to improve awareness regarding hemoglobinopathies among population, prenatal screening, blood transfusion policies, chelation policies to prevent complications in transfusion dependent patients.

Clinico-hematological profile of hemolytic anaemia at the SAMS medical college hospital

“…4 Present study observed the male to female ratio as 1.45 (59% male and 41% female), similar sex ratio of 1.51 (179 male and 118 female) is reported by to Chatopadhyay et al 5 Another study by Anusha R et al, reported 0.9 as male to female which could be due the study setup and sample section. 6 Current study noted the common HA's as beta thalassemia trait in 39.33%, followed by sickle cell anemia in 18.7% and beta thalassemia 16.67% subjects, similar observation were made in the study by Venkateshwary et al, they recorded thalassemia trait in 28.26% and thalassemia major in 16.45%. 7 Another study by Ambekar SS et al also found similar results where beta thalassemia trait was the most common HA.…”

“…7 Beta thalassemia had 16.7% cases with mean hemoglobin and HbF of 5.25gm/dl and 91% similar observation were made by Preethi et al, where the Hb ranged from 3-8.2 gm/dl, and HbF mean was 75.2%. Total serum bilirubin in the study was 3.75mg/dl which is higher than 2.7mg/dl recorded by Anusha R et al 6 In present study sickle cell trait cases were 2% of with mean Hb of 9.1 gm/dl. In Venkataswamy et al, sickle cell trait comprised of 1.55% of all cases with mean values of Hb as 10.8gm/dl.…”

“…Almost similar observations were made by Anusha R et al, where 21.9% patients were reported with malaria and the mean hemoglobin of these patients was 6.3gm/dl. 6…”