International Journal of Hematology

International Journal of Hematology | Vol. 1, No. 7, July 2010 | pp. 49–56
DOI: 10.46882/2010/IJH/000007

Original Article

Title: Prevalence and phenotypic characterization of beta-thalassemia traits among microcytic hypochromic anemia cases in a tertiary care center

Names of Authors: E. F. Adeyemi¹, F. G. Sanusi², G. H. Ojo³

Authors’ Affiliations: ¹Department of Pathology, University of Ilorin, Ilorin, Nigeria; ²Department of Haematology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria; ³Department of Paediatrics, Bowen University Teaching Hospital, Ogbomoso, Nigeria

Abstract: Distinguishing iron deficiency from beta-thalassemia trait in microcytic hypochromic anemias remains crucial to avoid inappropriate iron overload therapy. We analyzed 215 consecutive patients presenting with microcytic hypochromic profiles (MCV < 80 fl, MCH < 27 pg) refractory to empirical oral iron supplementation over a 6-month window. High-performance liquid chromatography quantified hemoglobin fractions, while serum iron indices excluded concomitant iron deficiency. Beta-thalassemia trait was confirmed in 18.1% (39 of 215) of patients, characterized by elevated hemoglobin A2 values (> 3.5% up to 5.8%). The mean corpuscular volume in confirmed thalassemia trait cases averaged 68.2 ± 4.1 fl, with red blood cell distribution width values often within a narrower range than pure iron deficiency. Mentzer index calculation (MCV/RBC) yielded values below 13 in 92% of thalassemia trait patients. Screening algorithms utilizing automated cell counter parameters coupled with confirmatory high-performance liquid chromatography prove highly cost-effective for diagnosing hemoglobinopathies in high-prevalence settings.

Keywords: Beta-thalassemia trait, microcytic anemia, high-performance liquid chromatography, hemoglobin A2, Mentzer index

Manuscript Timeline: Received: April 12, 2010; Revised: May 20, 2010; Accepted: June 08, 2010; Published: July 14, 2010

International Journal of Hematology | Vol. 1, No. 12, December 2010 | pp. 89–96
DOI: 10.46882/2010/IJH/000012

Original Article

Title: Screening for Factor V Leiden and Prothrombin G20210A mutations in patients with unprovoked venous thromboembolism

Names of Authors: S. I. Effiong¹, K. U. Haruna², Y. A. Bello³

Authors’ Affiliations: ¹Department of Haematology, University of Uyo, Uyo, Nigeria; ²Department of Pathology, Bayero University, Kano, Nigeria; ³Department of Medical Laboratory Science, Rivers State University, Port Harcourt, Nigeria

Abstract: Inherited thrombophilias contribute significantly to the pathogenesis of venous thromboembolism, yet genetic screening protocols vary widely by region. This cross-sectional study investigated the prevalence of Factor V Leiden (G1691A) and Prothrombin (G20210A) gene mutations among 120 indigenous patients presenting with objectively confirmed, unprovoked deep vein thrombosis or pulmonary embolism. Genomic DNA was extracted from peripheral blood leucocytes, followed by polymerase chain reaction-restriction fragment length polymorphism analysis. Among the 120 patients evaluated, Factor V Leiden mutation was detected in only 1 patient (0.83% heterozygosity), while the Prothrombin G20210A mutation was entirely absent (0.0%). In contrast, baseline functional assays revealed that protein C deficiency was present in 8.3% of cases, protein S deficiency in 10.0%, and antithrombin deficiency in 5.0%. These results confirm that classical European genetic thrombophilia mutations are rare in the West African population. Consequently, routine diagnostic algorithms for unprovoked venous thromboembolism in this region should prioritize functional natural anticoagulant assays over expensive genetic screening for Factor V Leiden and Prothrombin mutations.

Keywords: Venous thromboembolism, Factor V Leiden, Prothrombin mutation, thrombophilia, polymerase chain reaction

Manuscript Timeline: Received: September 05, 2010; Revised: October 14, 2010; Accepted: November 02, 2010; Published: December 10, 2010

International Journal of Hematology | Vol. 1, No. 3, March 2010 | pp. 17–24
DOI: 10.46882/2010/IJH/000003

Review Article

Title: Emerging paradigms in the management of immune thrombocytopenia refractory to first-line therapies

Names of Authors: M. N. Salami¹, O. P. Danladi²

Authors’ Affiliations: ¹Division of Hematology and Blood Transfusion, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria; ²Department of Haematology, University of Benin, Benin City, Nigeria

Abstract: Immune thrombocytopenia presents complex therapeutic dilemmas when standard corticosteroid and intravenous immunoglobulin regimens fail. This comprehensive review synthesizes recent clinical trial evidence regarding thrombopoietin receptor agonists, rituximab protocols, and targeted splenic tyrosine kinase inhibitors. Mechanism-based evaluations show that romiplostim and eltrombopag achieve sustained platelet elevation (> 50 × 10⁹/L) in 60% to 80% of refractory cases, tapering the necessity for chronic immunosuppression or splenectomy. Combination approaches incorporating low-dose rituximab with cyclosporine demonstrate promising remission durability, though long-term infection risks warrant rigorous monitoring. Furthermore, evolving biomarkers regarding platelet autoantibody specificity help predict therapeutic responsiveness before transitioning to second-line and third-line interventions. Management algorithms now favor individualized risk-benefit stratification, balancing bleeding scores against adverse drug profiles. Ongoing trials investigating neonatal Fc receptor antagonists represent the next frontier in minimizing pathogenic autoantibody recycling. This review outlines a practical decision-making framework for hematologists handling treatment-refractory immune thrombocytopenia in diverse clinical environments.

Keywords: Immune thrombocytopenia, refractory, thrombopoietin receptor agonists, splenectomy, rituximab

Manuscript Timeline: Received: December 01, 2009; Revised: January 11, 2010; Accepted: February 02, 2010; Published: March 15, 2010

International Journal of Hematology | Vol. 1, No. 2, February 2010 | pp. 9–16
DOI: 10.46882/2010/IJH/000002

Original Article

Title: Prevalence of iron deficiency anemia and its correlation with cognitive function in primary school children

Names of Authors: G. H. Adeleke¹, I. J. Nwosu², K. L. Balogun³

Authors’ Affiliations: ¹Department of Paediatrics, University of Lagos, Lagos, Nigeria; ²Department of Psychology, University of Nigeria, Nsukka, Nigeria; ³Department of Community Health, Obafemi Awolowo University, Ile-Ife, Nigeria

Abstract: Iron deficiency anemia remains a major public health concern affecting childhood neurodevelopmental outcomes. A cross-sectional survey was conducted among 320 primary school children aged 6 to 11 years in urban and rural primary schools. Hemoglobin levels, serum ferritin, and transferrin saturation parameters were measured alongside standardized cognitive and psychometric testing using the Wechsler Intelligence Scale for Children. The overall prevalence of iron deficiency anemia was 24.4% (78 of 320 children), with higher vulnerability noted in rural cohorts. Multivariate regression analysis revealed a significant positive correlation between serum ferritin concentrations and aggregate cognitive performance scores (r = 0.42, P < 0.01). Children with established iron deficiency anemia scored significantly lower in working memory and processing speed indices compared to non-anemic counterparts. Supplemental iron intervention modeling indicated potential reversibility of cognitive deficits upon prompt hematologic recovery. The data emphasize routine nutritional screening programs and integrated school health interventions to mitigate cognitive impairment linked to early-life microcytic anemias.

Keywords: Iron deficiency, anemia, cognitive function, school children, ferritin

Manuscript Timeline: Received: November 02, 2009; Revised: December 14, 2009; Accepted: January 04, 2010; Published: February 12, 2010

International Journal of Hematology | Vol. 1, No. 11, November 2010 | pp. 81–88
DOI: 10.46882/2010/IJH/000011

Original Article

Title: Efficacy of low-dose rituximab in the management of refractory warm autoimmune hemolytic anemia

Names of Authors: A. B. Chinedu¹, R. S. Tarfa², O. M. Kolawole³

Authors’ Affiliations: ¹Department of Haematology, University of Nigeria Teaching Hospital, Enugu, Nigeria; ²Department of Internal Medicine, Federal Medical Centre, Azare, Nigeria; ³Department of Immunology, Obafemi Awolowo University, Ile-Ife, Nigeria

Abstract: Refractory warm autoimmune hemolytic anemia presents a severe therapeutic challenge when corticosteroid therapies fail or induce intolerable toxicities. This prospective study evaluated the clinical efficacy and safety of a low-dose rituximab protocol (100 mg weekly for 4 consecutive weeks) in 18 adult patients with corticosteroid-resistant or dependent warm autoimmune hemolytic anemia. Clinical response was defined by stabilization of hemoglobin levels above 10.0 g/dl without red blood cell transfusion support. At day 60 post-treatment, 11 patients (61.1%) achieved complete remission, and 4 patients (22.2%) achieved partial remission. The mean hemoglobin level rose significantly from a baseline of 6.2 ± 1.1 g/dl to 11.4 ± 1.5 g/dl at month 6 (P < 0.001). Reticulocyte counts and serum lactate dehydrogenase concentrations normalized in 77.8% of responsive individuals. Infusion-related adverse events were mild (Grade 1 or 2) and occurred in only 3 patients. Over a 12-month follow-up period, the relapse-free survival rate among responders was 80.0%. Low-dose rituximab exhibits substantial therapeutic efficacy, favorable safety profiles, and cost-effectiveness, offering an excellent second-line alternative for managing refractory immune hemolysis in resource-limited hematology units.

Keywords: Autoimmune hemolytic anemia, rituximab, corticosteroid-resistant, remission, hemolysis

Manuscript Timeline: Received: August 12, 2010; Revised: September 18, 2010; Accepted: October 05, 2010; Published: November 12, 2010

International Journal of Hematology | Vol. 1, No. 6, June 2010 | pp. 41–48
DOI: 10.46882/2010/IJH/000006

Original Article

Title: Evaluation of D-dimer and fibrinogen levels in pre-eclamptic women as predictive markers of disseminated intravascular coagulation

Names of Authors: B. C. Emeka¹, C. D. Nwachukwu², D. E. Okon³

Authors’ Affiliations: ¹Department of Obstetrics and Gynaecology, University of Calabar, Calabar, Nigeria; ²Department of Haematology, University of Calabar Teaching Hospital, Calabar, Nigeria; ³Department of Chemical Pathology, University of Uyo, Uyo, Nigeria

Abstract: Pre-eclampsia frequently disrupts hemostatic balance, precipitating life-threatening consumptive coagulopathies. A case-control study was performed on 110 pregnant women with severe pre-eclampsia and 110 normotensive pregnant controls matched for gestational age. Plasma D-dimer and serum fibrinogen concentrations were quantified using immunoturbidimetric assays. Mean D-dimer levels were significantly elevated in the severe pre-eclampsia group (1.85 ± 0.62 mg/L) compared to normotensive controls (0.42 ± 0.15 mg/L, P < 0.001). Conversely, plasma fibrinogen levels showed a progressive decline corresponding to disease severity, dropping to 2.10 ± 0.45 g/L in pre-eclamptic cases versus 3.50 ± 0.60 g/L in controls. Receiver operating characteristic curve analysis established a D-dimer threshold value above 1.40 mg/L as having 86.4% sensitivity and 81.2% specificity for identifying early prothrombotic transitions toward disseminated intravascular coagulation. Serial monitoring of these parameters provides critical diagnostic utility for obstetricians managing severe hypertensive disorders of pregnancy.

Keywords: Pre-eclampsia, D-dimer, fibrinogen, disseminated intravascular coagulation, hemostasis

Manuscript Timeline: Received: March 14, 2010; Revised: April 25, 2010; Accepted: May 10, 2010; Published: June 16, 2010