The sensitivity and nonspecificity of parameters for the detection of iron deficiency: mean corpuscular volume (MCV); mean corpuscular hemoglobin (MCH); serum iron (SI); total iron binding capacity (TIBC); transferrin saturation (TS); free erythrocyte protoporphyrin (Epp) and serum ferritin (SF) were studied in 78 children from 0.2-3.9 years old and in 165 mothers. In children, MCH and TS were the parameters that showed the highest sensitivity and lowest nonspecificity: 97% of the anemic and non-anemic children were identified as iron deficient by MCH less than 25 pg and/or TS less than 17.5% and 0 and 6% of the children without iron deficiency showed MCH and TS below these values. MCH, SF and TS in the group of mothers were the tests with the highest sensitivity (97%, 88% and 79% respectively), and the nonspecificity of these parameters were 2.2%, 30% and 0.7% respectively. MCH seems to be a sensible and specific screening test for detecting possible cases of iron deficiency in both maternal and infant populations. The best tests to establish the deficiency appear to be TS of Epp tests in children, and TS plus SF in mothers.

Adult↗

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Clinical usefulness of mean corpuscular volume and red cell distribution width in iron deficient blood donors.

The clinical efficacy of the red cell distribution width (RDW > 14.2%) and the mean corpuscular volume (MCV < 83.5 fL) in detecting iron deficiency was evaluated in female blood donors. Employing transferrin saturation < 17%, the prevalence of iron deficiency in 296 female donors was 23%, and in 635 male donors 1.1%. In the total female population, the sensitivity and specificity of the indices were 78% and 92%, respectively, but they were higher in anemic females (sensitivity 90% and positive predictive value 92%) than in non anemic females (sensitivity 58% and positive predictive value 50%). Our results confirm that there is an overlap in the levels of RDW and MCV between the iron and non iron deficient subjects, and these overlap seems to be more remarkable in the non anemic individuals. We conclude that these erythrocyte indices could be useful to identify iron deficiency in anemic female blood donors, but not in non anemic ones.

Adolescent↗

PubMedDate not supplied

Peripheral blood lymphocyte subsets and serum immunoglobulins in Sheehan's syndrome and in normal women during the menstrual cycle.

OBJECTIVE: There has been increasing evidence on the mechanisms underlying the interactions between the neuroendocrine and the immune systems, particularly in animal models with relatively few information in the human. In this study, we evaluate the cellular and humoral immunity in female patients with hypopituitarism and in normal women throughout the menstrual cycle in an attempt to determine the role of pituitary and gonadal hormones on the immune system. DESIGN: Serum immunoglobulins, peripheral blood lymphocyte subsets, and serum hormones were measured in eight patients with postpartum pituitary necrosis (Sheehan's syndrome) and in six normal women along different phases of the menstrual cycle, taking advantage of the lack of pituitary function and the cyclic variations in serum hormones, respectively. RESULTS: Patients with Sheehan's syndrome had higher T lymphocytes (CD2), including helper (CD4) and suppressor (CD8) cell subpopulations and B lymphocytes (CD19) when compared with normal menstruating women. An increase of serum IgA concentrations was also observed. Normal women showed little non-statistically different changes along the menstrual cycle in peripheral blood cell parameters and in serum immunoglobulin levels. CONCLUSIONS: a) Hypopituitarism in humans, in contrast with the animal model, may associate with immune up-regulation at both cellular and humoral levels; and b) hormonal changes along the normal menstrual cycle probably do not influence in great extent the immune system.

Adult↗

PubMedDate not supplied

Immunophenotypic characteristics of the blast crisis in chronic myeloid leukemia.

OBJECTIVE: To characterize the immunophenotype of blast crisis (BC) in Mexican patients with chronic myeloid leukemia (CML). MATERIAL AND METHODS: Mononuclear cells of 17 patients with CML in BC were immunophenotyped employing a panel of 18 monoclonal antibodies: CD5, CD10, CD14, CD22, and anti-HLA-DR used in all patients; CD2, CD15, CD19, CD34, and CD41 in 13 to 16 patients; and CD3, CD7, CD13, CD20, CD21, CD33, CD42b, and CD61 in less than 10 patients. RESULTS: Myeloid was the most frequent type (9/17 cases) followed by lymphoid (6/17) and hybrid or mixed lineage (2/17). Four of the myeloid BC expressed megakaryocyte/platelet associated antigens; 5 of 6 cases with lymphoid BC showed an early precursor B cell immunophenotype (HLA-DR+, CD10+), and the other was an uncommon case of lymphoid B/T transformation (CD19+, CD5+). The CD34 antigen was present in 6 out of 15 cases: 4 patients with lymphoid BC, 1 with myeloid transformation, and 1 with megakaryoblastic BC. CONCLUSIONS: Our findings are comparable to those found in the literature comprising 192 patients. The present study confirms the lineage heterogeneity of CML BC and suggests that extensive immunophenotyping may allow insight for a more precise recognition of normal and leukemic ontogenesis.

Antigens, CD↗

PubMedDate not supplied

[Cellular immunophenotypes in 97 adults with acute leukemia].

OBJECTIVE: To analyze hematopoietic cell surface antigen reactivity in acute leukemia (AL) by flow cytometry and identify acute mixed-lineage leukemias (AMLL) employing the most widely accepted criteria. MATERIAL AND METHODS: Ninety seven patients with de novo AL were studied. Cell surface antigens were investigated with monoclonal antibodies directed to: B lymphoid (CD10, CD19, CD20, CD21, CD22); T lymphoid (CD2, CD3, CD5, CD7); and myeloid (CD13, CD14, CD15, CD33, CD41) cell lineages. Maturation cell-associated antigens (CD34, HLA-DR and TdT) were also studied. RESULTS: Twelve patients unclassified by cytomorphology could be classified by immunophenotype. Using cytomorphologic, cytochemical and immunophenotypic data, 54 cases corresponded to acute lymphoblastic leukemia (ALL) and 43 were acute myeloblastic leukemia (AML). In All there were 63% B lineage, 15% T, 7% T/B, 6% undifferentiated and 9% mixed-lineage (coexpression of two or more myeloid-associated antigens). In AML, myeloid immunophenotype was observed in 86% undifferentiated in 2%, and mixed-lineage in 12% (coexpression of two or more lymphoid-associated antigens). In addition, 26% of ALL cases and 12% of AML cases expressed a single myeloid and lymphoid antigen respectively. The most common aberrant antigens in ALL and AML were CD13 and CD7 respectively. The highest frequency of CD34 antigen expression (90%) was detected in patients with AMLL. CONCLUSIONS: Flow cytometric immunophenotypic analysis allowed to: a) establish diagnosis in cytomorphologically unclassified cases; b) identify AMLL with a frequency similar to that reported in other series; and c) confirm the heterogeneity of AL.

Acute Disease↗

PubMedDate not supplied

[Anemia and iron deficiency in 490 Mexican pregnant women].

OBJECTIVE: To explore correlations of sociobiological variables with levels of blood hemoglobin (HB) in 490 pregnant women. SETTING: Women attending private practice and two public hospitals in the city of Leon, State of Guanajuato (1800 m above sea level). MATERIAL AND METHODS: Demographic, obstetric, nutritional and socioeconomic data were obtained together with an EDTA-blood sample for CBC, and serum for metabolite assays. The women had a mean gestation of 25 weeks (range 4-40) and 65% were multiparous with a mean parity of 2.1. By Mexican standards they had fairly high social, nutritional and intergenesic lapse. Associations were explored by step-wise multiple ANOVA. RESULTS: On the basis of HB < 12 g/dL (equivalent aprox to 11 at sea level), 37% of the women were considered anemic. The MANOVA (excluding iron deficiency) showed associations of HB with gestation (p < 0.001) and parity (p = 0.024). Iron deficiency was present in 76% of the anemics (136/180) and 31% of the non-anemics (97/310). Folate and vitamin B12 assays in women with anemia and no iron deficiency showed folate or B12 deficiency in only 33% (14/43) leaving 29 cases with anemia of unknown etiology. CONCLUSIONS: 1. Gestation age was the factor most strongly associated to anemia and iron deficiency in our sample. 2. Anemia and iron deficiency were seen in 37% (N = 180) and 48% (N = 233) of the women respectively. 3. Of the 180 anemic women, 76% (N = 136) were iron deficient but only 14/43 anemic without iron deficiency were folate or B12 deficient leaving 6% (29/490) with anemia of unknown etiology. 4. The prevalence of anemia and iron deficiency were high in our population in spite of its fairly good sociodemographic and nutritional conditions.

Adolescent↗