Importance of Perls’ stain as a routine test in anaemia in adults
Keywords:
Anaemia in adults, Bone marrow aspirate, Myelodysplastic syndrome, Perls’ stain, Sideroblastic anaemia.
Abstract
Background: Anaemia is one of the frequent finding in patients of all age. Proper diagnosis is of utmost important to avoid fatal morbidity in untreated chronic cases. Aims: This study is meant to observe the role of Perls’ stain in routine practice in etiological evaluation of anaemia in adults.Methods: Prospective cross sectional study from June 2007 to July 2010. 128 cases of anaemia, alone or as a part of bicytopenia and pancytopenia, in 20-80 years of age, who were recommended by clinicians for bone marrow aspiration analysis after initial routine haematological investigation, were collected as samples. Perls’ stain was done on bone marrow smears to estimate marrow iron store in fragments and ring sideroblasts in all the smears.Result: Anaemia was most common haematological presentation(49%), mainly in males (62%) and majority in 20-30 years of age (31.3%) .Iron deficiency anaemia was most common cause of anaemia(59.6%) with 0 to1+ iron store. Megaloblastic anaemia, aplastic anaemia, thalassemia and other haemoglobinnopathies, anaemia of chronic disease(AOCD) , myelodysplastic syndrome(MDS) and secondary sideroblastic anaemia(SA) were other causes of anaemia found. 3.2% cases had ring sideroblasts of which 0.78% was MDS and 2.3% was secondary SA. Conclusion: Perls’ stain is a cheap and relatively simple test that can be used as a routine test in all bone marrow aspirates to provide provisional diagnosis of some relatively infrequent causes of anaemias which otherwise could be missed when only non invasive methods are relied upon for assessing body iron content. DOI: 10.21276/APALM.1067Conclusion: Perls’ stain is a cheap and relatively simple test that can be used as a routine test in all bone marrow aspirates to provide provisional diagnosis of some relatively infrequent causes of anaemias which otherwise could be missed when only non invasive methods are relied upon for assessing body iron content.References
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6. Dharwadkar A,Vimal S, Panicker Narayanan K, Chandanwale Shirish S, Vishwanathan V, Kumar H. Study of sideroblast and iron stores in bone marrow aspirates using Perls’s stain. Medical journal of Dr. D.Y. Patil university 2016;9:181-85.
7. Haldar B, Partha PP, Sarkar TK, Sharma S, Goswami KB, Aikat A. Aplastic Anemia:A Common Hematological Abnormality Among Peripheral Pancytopenia. N Am J Med Sci 2012;4:384–88.
8. Kaduri P. R. Iron in Sickel cell disease: A review why less is better. Am. J Haemtol 2003;73:59-63.
9. Oluboyede OA, Ajayi OA, Adeyokunnu AA. Iron studies in patients with sickle cell disease. Afr J Med Med Sci 1981;10:1-7.
10. Edwars CQ, Skolnick MH, Kushnew JP. Coincidental nontransfusional iron overload and thalassemia minor: Association with HLA-Linked Haemochromatosis. Blood 1981;58:844-48.
11. Pereira M R M, Veloso E R P, Menezes Y, Gualandro S, Vassalo J Yosinaria. Bone Marrow Finding In Systemic Lupus Erythematosus Patients With Peripheral Cytopenias. Clinical Rheumatol 1998;17:219-22.
12. Artz AS, Thirman MJ. Unexplained Anemia Predominates Despite an Intensive Evaluation in a Racially Diverse Cohort of Older Adults From a Referral Anemia Clinic. J Gerontol A Biol Sci Med Sci 2011;66:925–32.
13. Aul C, Gattermann N, Schneider W. Age related incidence and other epidemiological aspect of myelodysplastic syndromes. British journal of Haemtol 1992;8:358-67.
2. Gale E, Torrance J, Bothwell T. The Quantitative Estimation of Total Iron Stores in Human Bone Marrow. Journal of clinical investigation 1963;42:1076.
3. Burns E, Goldberg SN, Lawrence C, Wenz B. Clinical utility of serum tests for iron deficiency in hospitalized patients. Am J Clin Pathol 1990;93:240-45.
4. Koca E, Cetiner DA, Buyukasik Y, et al. Bone Marrow Iron staining is a Reliable Test for Elimination of Iron Deficiency Anaemia Rather than its Diagnosis. Int J Haematol oncol 2013;23:260-63.
5. Pujara KM, Bhalara RV, Dhruva GA. A study of bone marrow iron storage in haematological disorders. Int J Health Allied Sci 2014;3:221-24.
6. Dharwadkar A,Vimal S, Panicker Narayanan K, Chandanwale Shirish S, Vishwanathan V, Kumar H. Study of sideroblast and iron stores in bone marrow aspirates using Perls’s stain. Medical journal of Dr. D.Y. Patil university 2016;9:181-85.
7. Haldar B, Partha PP, Sarkar TK, Sharma S, Goswami KB, Aikat A. Aplastic Anemia:A Common Hematological Abnormality Among Peripheral Pancytopenia. N Am J Med Sci 2012;4:384–88.
8. Kaduri P. R. Iron in Sickel cell disease: A review why less is better. Am. J Haemtol 2003;73:59-63.
9. Oluboyede OA, Ajayi OA, Adeyokunnu AA. Iron studies in patients with sickle cell disease. Afr J Med Med Sci 1981;10:1-7.
10. Edwars CQ, Skolnick MH, Kushnew JP. Coincidental nontransfusional iron overload and thalassemia minor: Association with HLA-Linked Haemochromatosis. Blood 1981;58:844-48.
11. Pereira M R M, Veloso E R P, Menezes Y, Gualandro S, Vassalo J Yosinaria. Bone Marrow Finding In Systemic Lupus Erythematosus Patients With Peripheral Cytopenias. Clinical Rheumatol 1998;17:219-22.
12. Artz AS, Thirman MJ. Unexplained Anemia Predominates Despite an Intensive Evaluation in a Racially Diverse Cohort of Older Adults From a Referral Anemia Clinic. J Gerontol A Biol Sci Med Sci 2011;66:925–32.
13. Aul C, Gattermann N, Schneider W. Age related incidence and other epidemiological aspect of myelodysplastic syndromes. British journal of Haemtol 1992;8:358-67.
Published
2017-08-31
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