EVALUATION OF MICROCYTIC HYPOCHROMIC ANEMIA BY ELECTROPHORESIS FOR HEMOGLOBINOPATHIES IN YOUNG POPULATION

Authors

  • UTKARSHA SINGH Department of Pathology, Index Medical College, Hospital and Research Centre, Indore, Madhya Pradesh, India.
  • PRIYANKA SAXENA Department of Pathology, Index Medical College, Hospital and Research Centre, Indore, Madhya Pradesh, India.
  • ATUL KUMAR BIDWAI Department of Pathologist, Mahatma Gandhi District Hospital, Dewas, Madhya Pradesh, India.
  • MADHURIMA SINGH Department of Pathology, Peoples Medical College and Research Centre, Bhopal, Madhya Pradesh, India.

DOI:

https://doi.org/10.22159/ajpcr.2023.v16i3.47370

Keywords:

Microcytic, Hypochromic, Anemia, Hemoglobinopathies, Electrophoresis

Abstract

Objectives: Hemoglobinopathies are serious genetic blood disorders requiring lifelong blood transfusions and treatment in its most severe and chronic form. If undiagnosed or untreated, these disorders ultimately lead to death. South Asia especially India, Pakistan, and Bangladesh has high populations of hemoglobinopathies. In India, there are an estimated 100,000 thalassemia majors patients and nearly 3.5 to 4 million carriers of this genetic disorder. Tribal populations in India have a range of 5–40% sickle cell anemia (SCA) sufferers. The aim of the study was to detect hemoglobinopathies by electrophoresis in microcytic hypochromic anemia in young population in the area covered by tertiary care center at Index Medical College and Hospital.

Methods: A cross-sectional study was carried out in a hospital in rural area of Indore on young patients (10–30 years age group) who attended outpatient department from June 2018 to March 2020. Total 517 cases of moderate to severe anemia were included in the study. All cases were subjected to a series of hematological investigations, which include complete hemogram, peripheral blood smear, and some standard procedures. Sysmex XS800i fully automated Cell counter was used for complete blood count. It is the 5-part differential instrument. It reports on all the five subpopulations, namely, neutrophils, eosinophils, basophils, monocytes, and lymphocytes. A blood smear is a blood test used to look for abnormalities in blood cells.

Results: In the study, out of 517 cases 34.4% cases were positive on Hb electrophoresis and 65.6% were negative. On electrophoresis, the number of sickle cell anemia cases was 34.3%, sickle cell trait – 20.8%, sickle beta-thalassemia – 29.8% and beta-thalassemia major – 29.8% was observed. In hemoglobinopathies, of the 73 females, 28.8% were having beta-thalassemia trait, 27.4% were having SCA 23.3% were having sickle beta-thalassemia, and 20.5% were having sickle cell trait. Of the 105 males, 30.5% were having beta-thalassemia trait, 9.5% were having sickle beta-thalassemia, 39.0% were having SCA, and 21.0% were having sickle cell trait.

Conclusion: The ANMs, ASHA, and Anganwadis should be taught about the importance of screening of hemoglobinopathies. So that they can explain the purpose of screening to the female during pregnancy and to the families in the rural areas. At primary level, the CHCs and PHCs should be equipped with instruments for basic testing of hemoglobinopathies.

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References

Madan N, Sharma S, Sood SK, Colah R, Bhatia LH. Frequency of ȕ-thalassemia trait and other hemoglobinopathies in Northern and Western India. Indian J Hum Genet 2010;16:16-25. doi: 10.4103/0971- 6866.64941, PMID 20838487

Sinha S, Black ML, Agarwal S, Colah R, Das R, Ryan K, et al. Profiling ȕ-thalassaemia mutations in India at state and regional levels: Implications for genetic education, screening and counseling programmes. Hugo J 2009;3:51-62. doi: 10.1007/s11568-010-9132-3, PMID 21119755

Mohanty D, Colah RB, Gorakshakar AC, Patel RZ, Master DC, Mahanta J, et al. Prevalence of beta-thalassemia and other hemoglobinopathies in six cities in India: A multicentre study. J Community Genet 2013;4:33-42. doi: 10.1007/s12687-012-0114-0, PMID 23086467

Balgir RS. Genetic epidemiology of the three predominant abnormal hemoglobins in India. J Assoc Physicians India 1996;44:25-8. PMID 8773089

Chatterjea JB, Saha AK, Ray RN, Ghosh SK. Hemoglobin E-thalassemia disease. Indian J Med Sci 1957;11:553-64. PMID 13474769

Nail SK, Kothari BV, Jhaveri CL, Sukumaran PK, Sanghvi LD. Fatal hemolytic anemia presumably due to the combination of sickle cell and thalassemia gene; case report. Indian J Med Sci 1957;11:244-9. PMID 13428325

Swarup S, Ghosh SK, Chatterjea JB. Haemoglobins E and K and thalassemia in an Indian family with evidence of interaction between haemoglobin E and thalassaemia. J Indian Med Assoc 1966;46:587-90. PMID 5943619

Sukumaran PK, Merchant SM, Desai MP, Wiltshire BG, Lehmann H. Haemoglobin Q India (alpha 64(E13) aspartic acid histidine) associated with beta-thalassemia observed in three Sindhi families. J Med Genet 1972;9:436-42. doi: 10.1136/jmg.9.4.436, PMID 4646552

Ajmani M, Sharma A, Talukder G, Bhattacharyya DK. Genetic interaction of beta-thalassaemia (Hb betaT-) & haemoglobin E (Hb betaE) in populations of Eastern India. Indian J Exp Biol 1977;15:455- 7. PMID 598876

Kumar S, Rana M, Handoo A, Saxena R, Verma IC, Bhargava M, et al. Case report of HbC/β-thalassemia from India. Int J Lab Hematol 2007;29:381-5. doi: 10.1111/j.1365-2257.2006.00850.x, PMID 17824920

Chatterjea JB. Haemoglobinopathies, glucose-6-phosphate dehydrogenase deficiency and allied problems in the Indian subcontinent. Bull World Health Organ 1966;35:837-56. PMID 5338376

Lehmann H, Cutbush M. Sickle-cell trait in Southern India. Br Med J 1952;1:404-5. doi: 10.1136/bmj.1.4755.404, PMID 14896162

Colah R, Mukherjee M, Ghosh K. Sickle cell disease in India. Curr Opin Hematol 2014;21:215-23. doi: 10.1097/MOH.0000000000000029, PMID 24714525

Rao VR. Genetics and epidemiology of sickle cell anemia in India. ICMR Bull 1988;9:87-90.

Turgeon ML. Principles and practice of clinical hematology. In: Linné & Ringsrud’s Clinical Laboratory Science: Concepts, Procedures, and Clinical Applications. 7th ed., Ch. 11. United States: Elsevier Mosby; 2015. p. 321-3.

Neal M. Component of tetrachrome stain (MacNeal) for differentiating leucocytes. JAMA 1922;78:1122.

Lillie RD, Stotz EH, Emmel VM. Conn’s Biological Stains Revised: H J Conns Biological Stains. 9th ed. Baltimore: Williams and Wilkins Co.; 1977. p. 423-4.

Bain BJ. Dacie, Lewis. Practical hematology. 11th ed. London: Churchill Livingstone; 2012. p. 33-5.

International Committee of Standardization in Hematology. Recommendation for neonatal screening for hemoglobinopathies. Clin Lab Haematol 1988;10:335-45.

International Committee of Standardization. Hmeatology. Simple electrophoretic system for presumptive identification of abnormal hemoglobin. Blood 1978;52:1058-64, PMID 698390

International Committee of Standardization. Hmeatology. Recommendation for a system for identifying abnormal hemoglobin. Blood 1978;52:1065-7. PMID 698391

Narang S, Singh A, Nema SK. Spectrum of haemoglobinopathies in a suburb of Indore (India)-A two year study. Indian J Pathol Res Pract 2017;6:378-82.

Patel U, Shrivastav A, Joshi JR, Agnihotri AS, Kaur A, Thakkar B. Detection of hemoglobinopathies and thalassemias in population of Gujarat State using HPLC: Analysis of 2022 cases. Pathol Lab Med 2012;4:80-4.

Chopra GS, Nair V, Gupta PK, Mishra DK, Sharma A, Mathew OP. Spectrum of haemoglobinopathies in a tertiary care hospital of armed forces. Med J Armed Forces India 2008;64:311-4. doi: 10.1016/S0377- 1237(08)80005-6, PMID 27688564

Nema SK, Gupta M, Singh A, Jaiswal SS, Kucheria M, Raipurkar S. Prevalence and spectrum of hemoglobinopathies in tertiary care centre in a rural area of Madhya Pradesh. Int J Res Med Sci 2013;1:482-6. doi: 10.5455/2320-6012.ijrms20131133

Gupta M, Gupta P, Singh A, Saxena A, Raipurkar SP. Spectrum of hemoglobinopathies in the state of Madhya Pradesh, India. Asian Pac J Health Sci 2018;5:195-201.

Urade BP. Incidence of sickle cell anemia and thalassemia in Central India. Open J Blood Dis 2012;2:71-80. doi: 10.4236/ojbd.2012.24014

Shivashankara AR, Jailkhani R, Kini A. Hemoglobinopathies in Dharwad North Karnataka a hospital-based study. J Diagn Clin Res 2008;2:593-9.

Published

07-03-2023

How to Cite

SINGH, U., P. SAXENA, A. K. BIDWAI, and M. SINGH. “EVALUATION OF MICROCYTIC HYPOCHROMIC ANEMIA BY ELECTROPHORESIS FOR HEMOGLOBINOPATHIES IN YOUNG POPULATION”. Asian Journal of Pharmaceutical and Clinical Research, vol. 16, no. 3, Mar. 2023, pp. 84-88, doi:10.22159/ajpcr.2023.v16i3.47370.

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