ABSTRACT
Anaemia is one of the commonest hematological disorders prevalent in elderly population of either sex. WHO suggested any condition with decline of haemoglobin is considered as anaemia. Ferritin an iron storage compound is considered as a well known marker of iron storage. Therefore the present study was designed to evaluate the role of serum ferritin in differential diagnosis of anaemia along with various indices of anaemia and their haematological profile in geriatric population. Methods: Complete blood count included the following: Hb level; and white cell indices such as total leucocyte count (TLC) and differential leucocyte count, as well as corrected TLC. All investigations were carried out on an automated cell counter. Serum ferritin was estimated by automated analyser. Results: The nutrition deficiency anaemia (47.5%) was most common type of anaemia among elderly population. Further, anaemia due to chronic disease (20.2%), Marrow infiltration (8.3%) and multiple myeloma (7.1%) were recorded in the elderly population. serum ferritin level was significantly low in iron deficiency anaemia (151±88 ng/ml) compare to other types of anaemia dual defficency anaemia (157±98 ng/ml). However, ferritin was significantly high in megaloblastic anaemia (210±101 ng/ml) and anaemia of chronic diseases (204±102 ng/ml). Conclusion: Findings of the current study revealed that ferritin can be an important marker for the differential diagnosis of anaemia in elderly population. Moreover, the diagnostic accuracy may be enhanced when PBF and bone marrow findings are combined with clinical examination and other relevant investigations. Biochemical investigation of serum ferritin along with other findings might be helpful in early diagnosis along with accurate aetiology of anaemia in elderly population.
ABSTRACT
Background: Cutaneous vasculitis presents as a mosaic of clinical and histological findings. Its pathogenic mechanisms and clinical manifestations are varied. Aims: To study the epidemiological spectrum of cutaneous vasculitides as seen in a dermatologic clinic and to determine the clinico-pathological correlation. Methods: A cohort study was conducted on 50 consecutive patients clinically diagnosed as cutaneous vasculitis in the dermatology outdoor; irrespective of age, sex and duration of the disease. Based on the clinical presentation, vasculitis was classified according to modified Gilliam's classification. All patients were subjected to a baseline workup consisting of complete hemogram, serum-creatinine levels, serum-urea, liver function tests, chest X-ray, urine (routine and microscopic) examination besides antistreptolysin O titer, Mantoux test, cryoglobulin levels, antineutrophilic cytoplasmic antibodies and hepatitis B and C. Histopathological examination was done in all patients while immunofluorescence was done in 23 patients. Results: Out of a total of 50 patients diagnosed clinically as cutaneous vasculitis, 41 were classified as leukocytoclastic vasculitis, 2 as Heinoch−Schonlein purpura, 2 as urticarial vasculitis and one each as nodular vasculitis, polyarteritis nodosa and pityriasis lichenoid et varioliforme acuta. Approximately 50% of the patients had a significant drug history, 10% were attributed to infection and 10% had positive collagen workup without any overt manifestations, while 2% each had Wegener granulomatosis and cryoglobulinemia. No cause was found in 26% cases. Histopathology showed features of vasculitis in 42 patients. Only 23 patients could undergo direct immunofluorescence (DIF), out of which 17 (73.9%) were positive for vasculitis. Conclusions: Leukocytoclastic vasculitis was the commonest type of vaculitis presenting to the dermatology outpatient department. The workup of patients with cutaneous vasculitis includes detailed history, clinical examination and investigations to rule out multisystem involvement followed by skin biopsy and DIF at appropriate stage of evolution of lesions. Follow up of these patients is very essential as cutaneous manifestations may be the forme fruste of serious systemic involvement.