Journal of Blood & Lymph

Problem statement: Diabetes mellitus is a global public health problem with increasing prevalence. The purpose of this study was to investigate changes in some haematological parameters in patients with type 1 diabetes (T1D) in Sokoto, North Western Nigeria and to compare the results with non-diabetics.

Material and methods: A total of 100 consecutively recruited confirmed T1D patients constituted the subjects for this case-control study. Subjects included 52 males (52%) and 48 females (48%). The age range and mean range was 25-60 years and 42.45 years ± 12.23 years respectively. Forty age and gender-matched non-diabetics were monitored as controls. The packed cell volume, platelet and total white cell count and blood glucose level was determined using standard methods and results were compared statistically with values obtained from non-diabetic controls.

Results: The mean PCV was significantly lower among subjects with (T1D) (36.93 ± 2.19) compared to the non-diabetic controls (39.80 ± 2.24), p=0.003. Diabetics with poor glycaemic control had lower packed cell volume compared to those with lower blood sugar level. The mean platelet and total white cell count was significantly higher among diabetics compared to non-diabetic controls (464.76 ± 158.66 and 8.48 ± 3.27) compared to (297.13 ± 94.25 and 6.48 ± 2.12) p=0.0001 and 0.001 respectively. Platelet and total white cell count increased with increasing hyperglycaemia (t=7.66 and 6.33, p-value=0.001). We observed a significant positive correlation between high platelet and total white cell count count and raised blood sugar level among the diabetic subjects studied (r=0.52 and 0.45) respectively. There were no statistically significant differences between haematological values based on the gender of diabetic subjects.

Conclusion: The packed cell volume is lower among diabetic patients compared to non-diabetics. Platelet and total white cell count are significantly higher among diabetic subjects compared to non-diabetic controls. Anaemia, thrombocytosis and leucocytosis were associated with raised blood sugar levels among patients with type 1 diabetes. We recommend the routine haematological monitoring of patients with type 1 diabetes to prevent complications associated with deranged haematological values in this patient group.

Hemopoietic stem cells (HSCs) can be harvested from the bone marrow, peripheral blood or umbilical cord blood. HSC transplantation is used to treat hematologic and lymphoid cancers and other disorders. Some reports have indicated that Bone Marrow Transplantation (BMT) might cure these intractable diseases--including hematological disorders, autoimmune diseases and age-associated diseases. Intra bone marrow- BMT (IBM-BMT) has been proven to be a powerful strategy for allogeneic BMT due to the rapid hemopoietic recovery and the complete restoration of T cell functions. In this review, we summarize the findings of our studies of IBM-BMT to treat some intractable diseases, including cancers such as leukemia, autoimmune diseases such as rheumatoid arthritis and autoimmune pancreatitis, age-related diseases such as osteoporosis and Alzheimer’s disease in mouse models.

Background and objectives: Intrauterine blood transfusion (IUT) performed for fetal anemia may be associated with adverse neonatal outcomes. This study aimed to describe the clinical outcome of surviving neonates treated with IUT in an area where detailed outcome on neonatal data is limited.

Patients and methods: This prospective study included all living newborns treated with IUT at our institution between March 2004 and February 2011. During this period, 30 newborns with a mean gestation age of 35 weeks (range: 25-37 weeks) were admitted with various respiratory, hematological and gastrointestinal morbidities.

Results: The survival rate on discharge was 93%. Severe fetal anemia (72.2%) was significantly associated with a low reticulocyte count at birth and the need for respiratory support after birth (P<0.05). The number of IUTs was significantly correlated with the duration of admission (P=0.034) and the presence of hyporegenerative late anemia (P=0.007), but not with other neonatal outcomes or with a low reticulocyte count at birth. Use of intravenous immunoglobulin was significantly associated with an increased rate of top-up transfusion for late anemia and a decreased duration of admission, with no additional positive effects.

Conclusion: This study provides evidence on the types of potential neonatal morbidities after IUT therapy and their risk factors, and could be useful to clinicians treating fetuses with intrauterine transfusions and also for counseling parents.

Background: Children diagnosed with the hereditary form of retinoblastoma (Rb) have excellent survival, but face an increased risk of bone and soft tissue sarcomas. This predisposition to sarcomas has been attributed to genetic susceptibility due to inactivation of the RB1 gene as well as past radiotherapy for Rb.

Objectives: To report the case of a child with hereditary form of bilateral RB, who developed Ewing’s sarcoma of the right femur 10 years after the Enucleation of the both eyes.

Methods: The child was diagnosed as a case of bilateral RB at the age of 3 months. He was fully investigated and found to have locally advanced RB. Enucleation was done. The patient received chemotherapy and radiotherapy. At 14 years, he was investigated for a small swelling in his right lower leg. After extensive investigations, it was reported as Ewing’s sarcoma. He is treated with chemotherapy.

Results: This report confirms that patients suffering from RB are at an increased risk of developing Second Malignant Neoplasms (SMNs). Conclusions: This case confirms the increased risk of a SMN in children with hereditary RB. These children need a very close follow-up for the early diagnosis of SMNs.

Primary immunodeficiencies are characterized by recurrent or prolonged infections associated with growth retardation, infections by specific microorganisms or by low virulence germs, inappropriate response to the antibiotics used, a high risk of complications and hospitalization and severe vaccine complications. The evaluation of immunological status is essential for the diagnosis of these diseases.
Immunoglobulin replacement therapy is the best option for most antibody deficiencies and for some diseases that do not belong to this group, like hyper IgM syndrome, immunodeficiency with thymoma and severe combined immunodeficiency. This therapy is a safe procedure that induces dramatic positive changes in the clinical outcome of patients who carry antibody defects.
An early diagnosis of primary immunodeficiencies is essential so that therapeutic measures may be taken quickly, such as the use of immunoglobulin when properly indicated, reducing the risks of death and complications.