scholarly journals THE UTILITY OF BLOOD AND BONE MARROW FILMS AND TREPHINE BIOPSY SECTIONS IN THE DIAGNOSIS OF PARASITIC INFECTIONS

2015 ◽  
Vol 7 ◽  
pp. e2015039 ◽  
Author(s):  
Clare Miller ◽  
Barbara Bain
Keyword(s):  
Bone Marrow ◽  
Iron Deficiency Anaemia ◽  
Parasitic Infection ◽  
Clinical History ◽  
Bone Marrow Examination ◽  
Accurate Diagnosis ◽  
Parasitic Infections ◽  
Trephine Biopsy ◽  
Deficiency Anaemia ◽  
Blood Examination

The laboratory haematologist has a role in the diagnosis of parasitic infections. Peripheral blood examination is critical in the diagnosis of malaria, babesiosis, filariasis and trypanosomiasis. Bone marrow examination is important in the diagnosis of leishmaniasis and occasionally leads to the diagnosis of other parasitic infections. The detection of eosinophilia or iron deficiency anaemia can alert the laboratory haematologist or physician to the possibility of parasitic infection. In addition to morphological skills, an adequate clinical history is important for speedy and accurate diagnosis, particularly in non-endemic areas.

scholarly journals BONE MARROW STUDY IN CASES OF HAEMATOLOGICAL DISORDERS

2019 ◽  
Vol 3 (11) ◽  
Author(s):  
Dr. Atul C. Mujumdar ◽  
Dr. Akash C Chhabra
Keyword(s):  
Bone Marrow ◽  
Peripheral Blood ◽  
Bone Marrow Aspiration ◽  
Bone Marrow Examination ◽  
Parasitic Infections ◽  
Trephine Biopsy ◽  
Blood Picture ◽  
Hematological Disorders ◽  
Tissue Paper ◽  
Haematological Disorders

Introduction: There are various disorders in formation of blood in body. Bone marrow is one of them which involved variety of hematological and nonhematological disorders. Hematological disorders include myeloproliferative neoplasm (MPN), acute leukemia, hemato-lymphoid neoplasm and nutritional deficiency diseases whereas nonhematological disorders include infectious diseases infiltrating the bone marrow such as parasitic infections, tuberculosis and metastatic deposits. Bone marrows present various diseases with various clinical symptoms with the involvement of blood but peripheral blood picture alone does not reflect the nature of disease process. Depending upon the suspected diagnosis from clinical features and peripheral blood examination, that indication for bone marrow examination can be done. Examination of Bone marrow is useful in the diagnosis of both hematological and non-hematological disorders. The most important techniques used for the diagnosis of hematological disorders are trephine biopsy and bone marrow aspiration. For the interpretation of the disorder of bone marrow history, clinical finding, peripheral blood picture and other laboratory findings are required. Usually Bone marrow aspiration (BMA) alone is sufficient for the diagnosis of nutritional anaemias, most of the acute leukaemias and Immune thrombocytopenias. Diagnosis such as Trephine biopsy provides important diagnostic information myelofibrosis, granulomatous disease and bone marrow infiltration. Bone marrow aspiration is useful in making out better individual cell morphology whereas biopsy is useful in bone marrow architectural pattern and distribution. Bone marrow is nor mocellular or hypercellula resulting from ineffective hematopoiesis, increased peripheral destruction and bone marrow invasion. Therefore, bone marrow examination is extremely helpful to identify the cause of pancytopenia. Aim: The main aim of this study is to evaluate the cytological and histological pattern of various hematological disorders in bone marrow aspiration and trephine biopsy respectively. Material and Methods: During the period of 1 year 100 patient with the cases of haematological disorders were included in this study. Routinely stain like Leishman stain is used for bone marrow aspiration. Haematoxylin and eosin stain is also used for trephine biopsy. For all the cases reticulocyte count, peripheral smears, sickling test and complete hemogram were done. Special stains PAS Stain (Periodic acid schiff) was done for all ALL, AML and gauchers disease. In ALL cases Block positivity is shown. In gauchers disease, a gaucher cell shows wrinkled tissue paper appearance with PAS positivity. Reticulin stain was done in myelofibrosis and metastatic deposits. In myelofibrosis, trephine biopsy shows increase in reticulin network with coarse fibrils. Result: In all the cases bone marrow aspiration was done and among them 40 cases trephine biopsy were done. Out of total patients 57 were male and 43 were female.  And the mean age was found as 32.6 years. The findings of the bone marrow were examination. At the time of study period 50% of the study have anemias and they are predominantly megaloblastic followed by aplastic/ hypoplastic anemias. Other three cases include two metastatic deposits and one storage disorder (Gaucher’s Disease). Conclusion: Bone marrow examination is important to diagnosis, prognosis or evaluate therapeutic response for a variety of hematologic and non-hematologic problems. Nowadays, Bone marrow aspiration & bone marrow biopsy are used routinely as diagnostic procedures because it is easier and does not require advance equipments. Therefore both the procedures are complementary to each other which are helpful in further investigation and management. Keywords: Bone marrow aspiration, Trephine biopsy, Pancytopenia, Megaloblastic Anemia

Pancytopenia: A Challenging Problem for Treating Physician

2018 ◽  
Vol 2 (01) ◽  
pp. 22-28
Author(s):  
Md. Rezaul Karim Chowdhury ◽  
Amina Begum ◽  
Md. Haroon Ur Rashid ◽  
Md. Kamrul Hasan
Keyword(s):  
Bone Marrow ◽  
Physical Examination ◽  
Blood Smear ◽  
Peripheral Blood Smear ◽  
Bone Marrow Examination ◽  
Challenging Problem ◽  
Trephine Biopsy ◽  
Life Threatening ◽  
Underlying Pathology ◽  
Careful History

Pancytopenia is an important clinico-haematological entity and striking feature of many serious and life-threatening illnesses. Many haematological and non-haematological diseases involve the bone marrow primarily or secondarily and cause pancytopenia. Decrease in haemopoietic cell production, ineffective haemopoiesis and peripheral sequestration or destruction of the cells are the main pathophysiology of pancytopenia. The cause of pancytopenia thus may be lying in the bone marrow or in the periphery or both. Careful history, physical examination, simple blood work, review of the peripheral blood smear, sometimes bone marrow examination and trephine biopsy are required for diagnosis. Treatment and prognosis depend on the severity of pancytopenia and underlying pathology.

scholarly journals Parasitic Infections Associated with Unfavourable Outcomes in Transplant Recipients

Medicina ◽  
2018 ◽  
Vol 54 (2) ◽  
pp. 27 ◽  
Author(s):  
Wojciech Wołyniec ◽  
Małgorzata Sulima ◽  
Marcin Renke ◽  
Alicja Dębska-Ślizień
Keyword(s):  
Bone Marrow ◽  
Opportunistic Infections ◽  
Immunosuppressive Treatment ◽  
Parasitic Infection ◽  
Parasitic Infections ◽  
Solid Organ ◽  
Tropical Countries ◽  
Real Risk ◽  
Increased Risk ◽  
Disseminated Disease

Introduction. The immunosuppression used after transplantation (Tx) is associated with an increased risk of opportunistic infections. In Europe, parasitic infections after Tx are much less common than viral, bacterial and fungal ones. However, diseases caused by parasites are very common in tropical countries. In the last years the number of travellers with immunosuppression visiting tropical countries has increased. Methods. We performed a literature review to evaluate a risk of parasitic infections after Tx in Europe. Results. There is a real risk of parasitic infection in patients after Tx travelling to tropical countries. Malaria, leishmaniasis, strongyloidiasis and schistosomiasis are the most dangerous and relatively common. Although the incidence of these tropical infections after Tx has not increased, the course of disease could be fatal. There are also some cosmopolitan parasitic infections dangerous for patients after Tx. The greatest threat in Europe is toxoplasmosis, especially in heart and bone marrow recipients. The most severe manifestations of toxoplasmosis are myocarditis, encephalitis and disseminated disease. Diarrhoea is one of the most common symptoms of parasitic infection. In Europe the most prevalent pathogens causing diarrhoea are Giardia duodenalis and Cryptosporidium. Conclusions. Solid organ and bone marrow transplantations, blood transfusions and immunosuppressive treatment are associated with a small but real risk of parasitic infections in European citizens. In patients with severe parasitic infection, i.e., those with lung or brain involvement or a disseminated disease, the progression is very rapid and the prognosis is bad. Establishing a diagnosis before the patient’s death is challenging.

Reticulocyte Parameters in Microcytic Hypochromic Anaemias Using Beckman Coulter DxH800 – A Study from Kerala, India

2021 ◽  
Vol 8 (14) ◽  
pp. 888-892
Author(s):  
Blessy Mary Thomas ◽  
Sheila Das ◽  
Sunil Antony ◽  
Alice David
Keyword(s):  
Bone Marrow ◽  
Iron Deficiency ◽  
Iron Deficiency Anaemia ◽  
Response To Therapy ◽  
Control Group ◽  
Blood Samples ◽  
Deficiency Anaemia ◽  
Chronic Disorder ◽  
Microcytic Hypochromic Anaemia ◽  
Hypochromic Anaemia

BACKGROUND Microcytic hypochromic anaemia is commonly due to iron deficiency, anaemia of chronic disorder [ACD] and thalassaemic syndromes. Reticulocyte count reflects the erythropoietic activity of bone marrow and is thus useful in both diagnosing anaemias and monitoring bone marrow response to therapy METHODS All samples were selected from routine blood counts, and sent for investigation of anaemia, over a period of two years. These samples were run on the DxH800 (Beckman Coulter). 385 cases were selected for the study. Blood analysis for all these cases had been requested by general practitioners to investigate anaemia. These blood samples had been collected in ethylenediaminetetraacetic acid (EDTA) anticoagulant vacutainers and processed within 2 hours of collection. Determination of red cell and reticulocyte parameters in all blood samples, was performed using the Beckman Coulter 7-part analyser [Unicell DxH 800]. RESULTS Of the 156 cases of microcytic hypochromic anaemia studied, iron deficiency anaemia (IDA) was present in 91 cases, anaemia of chronic disorder (ACD) in 50 cases, beta thalassemia trait (BTT) in 15 cases. Of the 50 ACD cases, 37 were associated with IDA. The control group comprised of 229 adult medical students (143 women and 103 men) with a median age of 18.84 ± 0.98 years. We also had 4 cases of other haemoglobinopathies, which were microcytic hypochromic, but were not included in our study as the number of cases was too less to be analysed. CONCLUSIONS New reticulocyte parameters are useful for evaluation of iron status and diagnosing iron deficiency anaemias. They also are reliable parameters for recognising subsets of anaemic patients thereby improving the management of anaemia. KEYWORDS Reticulocyte, Microcytic, Hypochromic, Anaemia, Beckman Coulter

A comparative study of bone marrow aspirate with trephine biopsy in pancytopenia disorders

2021 ◽  
Vol 6 (3) ◽  
pp. 201-206
Author(s):  
Kavya J ◽  
Kalpana Kumari MK
Keyword(s):  
Bone Marrow ◽  
Sensitivity And Specificity ◽  
Megaloblastic Anemia ◽  
Tertiary Care ◽  
Bone Marrow Aspiration ◽  
Bone Marrow Examination ◽  
Care Hospital ◽  
Trephine Biopsy ◽  
Hematological Disorders ◽  
Hematoxylin And Eosin

Pancytopenia is commonly reported in clinical hematology practice. Due to its varied marrow pathology and underlying ailments, diagnosis is often misleading and delayed. Bone marrow examination would provide a comprehensive diagnosis of both blood and bone marrow, since aspirate investigates the cytological morphology and biopsy evaluates the cellularity, architecture, and compact marrows.To compare bone marrow aspiration and trephine biopsy results in the diagnosis of pancytopenia, and to determine the sensitivity and specificity of aspirate examination in pancytopenia diagnosis.This prospective study was conducted at a tertiary care hospital from July 2014 to June 2016. A total of 320 samples were received at the department of pathology for bone marrow examination (aspirate and biopsy). Romanowsky (Leishman) stain was used to investigate aspirate samples. All biopsy samples were processed into 3-5 μ blocks and stained using hematoxylin and eosin after decalcification with 5.5% EDTA. Data analysis was performed using SPSS19.Pancytopenia constituted 56 (18.7%) cases with the mean age of 41.79 years. Of the total pancytopenia cases, hematological disorders constituted 50 (89.3%) cases and 6 (10.7%) were non-hematological cases. Aspirate and biopsy diagnosis positively correlated in 76.79% of cases. A 100% sensitivity and specificity of aspirate diagnosis was observed in, acute myeloid leukemia, hypersplenism, myelodysplastic syndrome, megaloblastic anemia, hematological malignancy in remission and negative for lymphoma infiltrate. Aspirate had no role in diagnosis of uremic osteodystrophy and myelofibrosis, whereas leishmaniasis was diagnosed on aspirate alone.Pancytopenia includes multiple underlying ailments which requires a differential diagnosis approach. Combining both aspirate and biopsy for diagnosis would benefit the patient in prognosis as they are complementary to each other.

scholarly journals Comparison of bone marrow aspiration cytology with bone marrow trephine biopsy histopathology: An observational study

2017 ◽  
Vol 9 (03) ◽  
pp. 182-189
Author(s):  
Meenu Gilotra ◽  
Monika Gupta ◽  
Sunita Singh ◽  
Rajeev Sen
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Aspiration ◽  
Bone Marrow Examination ◽  
Final Diagnosis ◽  
Trephine Biopsy ◽  
Additional Advantage ◽  
Hematological Disorders ◽  
Bone Marrow Trephine ◽  
Bone Marrow Trephine Biopsy ◽  
Underlying Disorder

Abstract INTRODUCTION: Bone marrow examination is a useful investigative tool for the diagnosis of many hematological and nonhematological disorders. Bone marrow aspiration (BMA) provides information about the numerical and cytological features of marrow cells, whereas bone marrow trephine biopsies (BMB) provide excellent appreciation of spatial relationships between cells and of overall bone marrow structure. We conducted this study with the objective of comparing the accuracy of BMA with BMB in the diagnosis of various hematological disorders. MATERIALS AND METHODS: Both BMA and BMB were performed on a total of 130 cases and a comparative evaluation was performed in 100 cases to see the complementary role of both the procedures. However, 30 cases were excluded due to inadequate BMA, BMB, or both. Immunohistochemistry (IHC) was employed whenever required. RESULTS: In our study of 100 cases, 87% of cases were confirmed on bone marrow biopsy and in remaining 13% of cases final diagnosis was achieved with the help of other ancillary investigations. These cases were excluded for calculation of concordance rate between BMA and BMB. The concordance and disconcordance rate between BMA and BMB was 72.4% and 27.6%, respectively. CONCLUSION: BMA cytology and trephine biopsy histopathology complement each other and the superiority of one method over the other depended on the underlying disorder. Furthermore, application of ancillary techniques such as flow cytometery and IHC proved to be an additional advantage in further typing of various diseases.

scholarly journals Ascaris lumbricoides infection: Still a threat for iron deficiency anaemia in 2-year-old Bangladeshi slum-dwelling children

2019 ◽  
Vol 13 (10) ◽  
pp. 933-938
Author(s):  
Md. Shabab Hossain ◽  
Subhasish Das ◽  
Md. Amran Gazi ◽  
Mustafa Mahfuz ◽  
Tahmeed Ahmed
Keyword(s):  
Logistic Regression ◽  
Iron Deficiency ◽  
Ascaris Lumbricoides ◽  
Transferrin Receptor ◽  
Iron Deficiency Anaemia ◽  
Strong Association ◽  
Parasitic Infections ◽  
Soluble Transferrin Receptor ◽  
Intestinal Parasitic Infections ◽  
Deficiency Anaemia

Introduction: Although parasitic infections lead to extracorporeal iron loss resulting in iron deficiency anaemia (IDA), data associating IDA with parasitic infections in the first two years of life are limited. We sought to evaluate the prevalence and severity of anaemia and IDA during this period and to investigate the association between intestinal parasitic infections and IDA. Methodology: Data was collected under MAL-ED study protocol in Bauniabadh slum of Dhaka, Bangladesh. The presence of parasites in stool was detected using wet preparation microscopy at 7, 15, and 24 months. Anaemia was defined as serum haemoglobin < 11 g/dL and IDA was defined by serum haemoglobin < 11 g/dL, serum ferritin < 12 g/L and soluble transferrin receptor > 8.3 mg/L. Logistic regression was done to quantify the relation between stool parasite and IDA separately on samples collected at 7, 15 and 24 months. Results: 265 children were enrolled after birth and samples were collected at 7, 15 and 24 months. Anaemia was detected at 7, 15 and 24 months in 117 (48.8%), 106 (44.2%) and 67 (27.9%) cases whereas IDA was found in 15 (6.3%), 47 (19.6%) and 39 (16.3%) cases, respectively. Iron deficiency anaemia at 24 months was significantly associated with Ascaris lumbricoides infection (OR 3.76; 95 % CI, 1.08-13.11). Conclusions: The prevalence of anaemia and IDA in slum dwelling children of Dhaka is high and Ascaris lumbricoides infection was found to have a strong association with IDA at 24 months of age.

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