Original Research Article
Dec. 3, 2020
Microcytosis: Etiological Discussion about 280 Cases
Khayati S, Bahri R, El Farssani F, Yahyaoui H, Ait Ameur M, Chakour M
SAS J Med | 232-234
DOI : 10.36347/sasjm.2020.v06i12.001
Introduction: Anemia is defined by: a decrease in hemoglobin (Hb) level based on normal values for age. We talk about microcytosis for an average globular volume (MCV); whose reference value is between 80 and 100 fl in adults; less than 80 fl. Material and method: We conducted a prospective study over a period of two months in the hematology laboratory of the Avicenne hospital in Marrakech. Complete blood counts (CBCs) were performed on samples. A blood smear, stained with the May-Gründwald-Giemsa stain, was performed for all patients. Were included in our study, all CBCs including MCV <80 fL in adults and <71 fL in children. Results: During the study period, 3682 NFS were performed. 280 microcytoses were detected. The average VGM was 73.8 fl. In the blood smear, the most common blood cell abnormalities were anisopoikilocytosis (97%), microcytosis (90%) and hypochromia (85%). Exploration of these microcytoses revealed a predominance of iron deficiency, found in 48% of cases, 21% of pseudopolyglobulie, 18% of inflammation, 3% of hemoglobinopathy, and in 10% of cases, no etiology was found. Conclusion: This study confirmed the value of a complementary assessment when detecting microcytosis. In particular, it can detect iron deficiencies and hemoglobin abnormalities. In the event of a difficult etiological diagnosis, cooperation between clinician and biologist is essential.
Original Research Article
Nov. 25, 2020
Cardio-Respiratory Manifestations and Its Correlation with Clinical Disease Activity Index in Rheumatoid Arthritis
Preeti Yadav, Sushama Jotkar
SAS J Med | 228-231
DOI : 10.36347/sasjm.2020.v06i11.005
Background: In Rheumatoid arthritis (RA), disease activity helps to achieve remission with appropriate treatment, also known as treat-to-target strategy. This strategy is controversial as composite indexes assessing disease activity clinically may be affected by comorbidities or other patient-related factors. Thus they may not truly be a representation of disease activity. The study aimed to assess the cardio-respiratory manifestation and its correlation with clinical disease activity index (CDAI) in RA patients. Methodology: The cross-sectional study was performed on 100 RA patients. Severity of RA was assessed using CDAI. Cardiovascular manifestations were investigated using Electrocardiogram (ECG), 2D Echocardiography (M-mode). Chest X-ray, high resolution computed tomography of the chest, and pulmonary function tests were performed to assess respiratory manifestations. Data were analysed using R-Studio V1.2.5001 software. Chi-square test was used to find the association between variables. Results: Abnormal ECG findings were observed in 17 patients whereas, cardiovascular and respiratory abnormality was observed in 78 and 44 patients respectively. High and moderate diseases activity was found in 42 and 58 patients respectively. A significant association was observed between duration of disease and, cardiac and respiratory manifestation (P=0.0009, P=0.0004). A significant difference was observed in CDAI of patients with or without respiratory abnormalities (P=0.044). No significant association was found between CDAI and cardiorespiratory abnormality. Conclusion: Most RA patients had cardiorespiratory manifestations with high and moderate CDAI. For early identification and treatment, screening of cardiorespiratory manifestation is required.
Atypical Infantile Familial Chylomicronemia Syndrome: A Milky Mess
Mir Inzamam Ali, Malay Jhancy, Joel Thomas, Mohammed Rahim, Abdullah Qabille
SAS J Med | 224-227
DOI : 10.36347/sasjm.2020.v06i11.004
Familial Chylomicronemia was formerly known as type 1 hyperlipoproteinemia, it is a type of severe hypertriglyceridemia characterized by the accumulation of chylomicrons in fasting plasma. Chylomicrons in a patient with health are responsible for carrying the absorbed Triglycerides (TG) into tissues via the activation of Lipoprotein Lipase (LPL) by Apo CII, thus causing the TG to be stored. In cases of Chylomicronemia, the TG is not carried into the tissue and stored thus increasing the level of Chylomicron carrying TG in plasma. This disease has a prevalence of 1 in 1 million for homozygotes and 1 in 500 for heterozygote. The most common mutations are found in the genes LPL, ApoA5, GPIHBP1, and ApoC2 among others. Loss-of-function mutation in these genes renders the LPL-dependent pathway inefficient .