Correlation of peripheral blood film, red cell indices, bone marrow study and serum iron studies in the differential diagnosis of microcytic hypochromic anemia in children

Murali Prasath, S R (2016) Correlation of peripheral blood film, red cell indices, bone marrow study and serum iron studies in the differential diagnosis of microcytic hypochromic anemia in children. Masters thesis, Thanjavur Medical College, Thanjavur.

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Abstract

Microcytic hypochromic anemia is the most common type of anemia in childhood. The differential diagnosis includes Iron deficiency anemia, anemia of chronic disease, thalassemia and sideroblastic anemia .Iron deficiency anemia is a major global health problem as it causes anemia as well as impaired coginitive and motor development along with behavioural abnormalities. In developing countries 39 % children below 5 years and 48 % children between 5 -14 years suffer from anemia. Children present in the hospital either with symptoms and signs of anemia or with manifestations of other diseases during which screening reveals anemia. In the current study, 50 children in the age group between 6 months to 12 years, with microcytic hypochromic anemia, identified in the peripheral smear report as well as complete blood hemogram, were randomly selected and their red cell indices were correlated with serum iron profile assuming them to be sensitive and specific for the differential diagnosis. The predominant age group involved was between 6 months to 5 years. Male to female ratio was 1.7:1. Mean age was 5.6 years. Out of 50 cases, 41(82%) were IDA cases, 8(16%) were anemia of chronic disease cases and only 1 (2%) was thalassemia major. In the differential diagnosis of microcytic hypochromic anemia, the correlative study revealed red cell distribution width (RDW) to be most sensitive in the diagnosis of iron deficiency anemia. There was also a statistically significant correlation between the RDW and serum iron profile. Of the various red cell formulas, Sirdah, RBC count, England &Fraser together were 100 % sensitive followed by RDWI and Mentzer’s index, in the diagnosis of IDA. For the ACD cases, the cost effective approach is to correlate the clinical features and perform a CRP level to confirm the underlying chronic disease. After the treatment of underlying disease if the anemia is not corrected, then serum iron can be performed. In our study, all ACD cases had elevated CRP levels along with the clinical features of underlying diseases. Also the RDW was normal in 6 out of 8 cases of ACD. For thalassemia major, owing to life long transfusion necessity, costly investigations like Hb electrophoresis are needed for confirmation.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Microcytic Hypochromic anemia ; Iron Deficiency Anemia ; Anemia of Chronic Disease ; Thalassemia major ; Red Cell Distribution Width ; Red Cell Formulas ; Serum Iron Profile.
Subjects: MEDICAL > Pathology
Depositing User: Punitha K
Date Deposited: 07 Jul 2017 12:06
Last Modified: 26 Nov 2018 17:23
URI: http://repository-tnmgrmu.ac.in/id/eprint/1242

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