Anemia case study

Systemic Effects. Diseases of the hematopoietic tissues have been reported in patients given repeated injections of radium-224. Anemia, panmyelophthisis, and chronic myeloid leukemia were seen in excess of the control levels in these cases (compared with a higher incidence of acute leukemia in the control group) (Wick et al. 1986). Anemia has also been reported in case studies of the radium dial painters (Martland 1931), but the disease patterns have not been clearly established (Sharpe 1974). 

The same group reported that between 1979 and 1981, Chinese workers using benzene or benzene-containing mixtures were examined. Nine cases of leukemia were found out of4,602 exposed workers. Presumably, some of these may have been included in the study discussed above. Although one worker was exposed for only 2 years, the others were exposed for between 7 and 25 years. No estimate of exposure levels was given for the leukemia cases, but exposure estimates for aplastic anemia cases found in the same study were 29-362 ppm (Yin et al. 1987c). 

Raj Krishnaraj, DVM, MSc, PhD, Study Director, Toxicology/Pathology Scientific Services—Madison, Covance Eaboratories Inc., 3301 Kinsman Blvd., Madison, WI 53704-2523, E-mail raj.krishnaraj covance.com Chapter 2.4 Case Study in Immunotoxicology Practice Immune-Mediated Hemolytic Anemia in Dogs... 

Rare cases of hemolytic anemia, including fatalities, have been reported with the administration of the cephalosporins. The patient should be monitored for anemia If a patient experiences anemia within 2 to 3 weeks after the start of cephalosporin therapy, drug-induced anemia should be considered. If hemolytic anemia is suspected, the primary health care provider will discontinue the drug therapy. The patient may require blood transfusions to correct tire anemia. Frequent hematological studies may be required. 

Hereditary deficiency of phosphoglycerate kinase (PGK) is associated with hereditary hemolytic anemia and often with central nervous system dysfunction and/or myopathy. The first case, reported by Kraus et al. (K24), is a heterozygous female, and the results are not so clear. The second family, reported by Valentine et al. (V3), is a large Chinese family, whose pedigree study indicates that PGK deficiency is compatible with X-linked inheritance. To date, 22 families have been reported (04, T25, Y3). Nine of these have manifested both symptoms five have shown only hemolysis seven have shown the central nervous system dysfunction and/or myopathy but without hemolysis and one case, PGK Munchen, is without clinical symptoms (F5). PGK II is an electrophoretic variant found in New Guinea populations (Y2). Red blood cell enzyme activity, specific activity, and the kinetic properties of this polymorphic variant are normal. 

P7. Pdrignon, J.-L., Hamet, M., Buc, H. A., Cartier, P. H., and Derycke, M., Biochemical study of a case of hemolytic anemia with increased (85-fold) red cell adenosine deaminase. Clin. Chim. Acta 124,205-212(1982). 

In humans, severe cases of acrylonitrile poisoning have resulted in low grade anemia (Wilson 1944 Wilson et al. 1948), but complete recovery was reported. Chronic occupational exposure to low levels of acrylonitrile has not resulted in detectable effects on the hematological system (Sakurai et al. 1978). In intermediate and chronic studies in animals, decreased red cell count, hemoglobin concentration and hematocyte were observed (Bio/dynamics 1980a, 1980b, 1980c Quast et al. 

In an attempt further to elucidate the anhaptoglobinemia in patients with anemia, Nyman (N7) studied the plasma Hp in 335 cases of anemia (Hb less than 11 g/lOOml) mainly from a department of internal medicine. The partition she found (Table 2) is instructive from a pathophysiological point of view. The frequency of subnormal Hp values found within the different diagnostic groups may fairly well reflect the hemolytic trait in tire different types of anemia. Subnormal Hp possibly secondary to the increased red cell destruction is a common finding also in polycythemia. 

Szeinberg, A., Sheba, C., Hirshom, N., and Bodonyi, E., Studies on erythrocytes in cases with past history of favism and drug induced hemolytic anemia. Blood 12, 603-613 (1957). 

Study of plasma catalase activity on an individual basis has been limited in scope. For 50 adults the range was found to be from 4.2 to 9.5 per ml. of plasma. 19 One of the normal individuals was studied for five days, and the following values were obtained 9.5, 8.5, 9.5, 7.0, 9.5. Further study is required before one could conclude definitely that there are significant inter-individual differences. The available evidence points in that direction. In various anemias the values may be 50 or more. In one "diagnostic problem case" the value was 42. It seems highly probable that "normal" differences have physiological significance. 

Wang HH, Grufferman S. 1981. Aplastic anemia and occupational pesticide exposure A case-control study. J Occup Med 23(5) 364-366. 

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