Morphological Classification of Anemia in Sudanese Patients with Different Chronic Disease

Background: The morphologic approach to anemia begins with review of the CBC, particularly the mean corpuscular volume (MCV), and the peripheral blood smear. The initial distinction is based on the red cell size: anemias are classified as microcytic, normocytic, or macrocytic. The presence of abnormally shaped erythrocytes (poikilocytes) may suggest a specific disease or cause. A problem with the morphologic approach is that the morphologic changes in early anemia may be subtle and easy to miss. A second problem is that one morphologic abnormality may have several possible causes. Methods: A sample of 100 participants were included in the study. Informed consent was obtained. Venous blood samples were obtained and serum prepared, the hematology analyzer (Sysmex 3000) used to measure the hematology parameters, Cobas e114 used to estimate the serum ferritin. Results: The results showed significant differences between the mean level of male and female in the following parameters RBC’s count, and RBC’s indices MCV, MCH and PLTs count p. value( <0.05) and significant statistical deferens in RBC count , MCV and MCH among study group p .value (0.001 , 0.002 , 0.02) respectively. Platelets count show statistical significant differences among study group p. value (0.03). The correlation studies showed there are significant correlation between age and Hb concentration p. value (0.01), and positive correlation between weight and Hb concentration p. value (0.01). In current study there were Significant association between Age , RBCs, Hemoglobin , HCT, MCH ,MCHC and Platelets Count among patients with liver disease (P. value = 0.00, 0.001, 0.013, 0.000, 0.00,0.000, 0.000) respectively .The mean of hematological parameters, WBCs mean was 8.3 ±3.3 (×109 /l), RBCs 4.5 ± 0.5 (×1012/l) and the mean of Hb was 9.7±1.4 g/l which was low than normal, PLTs Count mean was 284.5 ±98.9 (×109 /l) while the mean was serum ferritin 13.4 ±7.1 mg/l in pregnant women with anemia. Table (7). In this study there was significant statistical difference between RBCs count and age (p. value 0.040) and statistical insignificant different between (WBCs, Hb, PCV, MCV, MCH, MCHC, PLTs count and Serum ferritin among pregnant women (p. value: 0.14, 0.68, 0.52, 0.18, 0.33, 0.7, 0.23 and 0.97) respectively. Positive statistical correlation was observed between serum ferritin and Hb, also positive correlation was observed between serum ferritin and PCV. In the current study significant positive correlation was observed between first and second trimester in Hb concentration P.value (0.000) and between second and third trimester P.value (0.000), Negative correlation between serum ferritin and different stage of trimester P.value ≥ 0.05. and significant statistical difference in Hb and serum ferritin level among patients use iron supplement P.value (0.009 and 0.000) respectively. Conclusion: Majority of the study participants had, followed by Normocytic, and macrocytic anemia. This might have negative health and educational implications. In this study result were represented significant when Comparison of age, counts, red count, hemoglobin, Hematocrit, red cells indices, and insignificant with white cell count among liver disease patients and control. Comparison of age, white cells counts, red cells count, hemoglobin, red cells indices and Platelets Count among gender of liver disease patients the result were represented insignificant. Comparison of age, , red cells count, hemoglobin, red cell ,the result represent significant and white cells counts Platelets Count ,MCH,MCV, represent insignificant among duration of disease. Significantly Decrease in Hb% and S. ferritin was observed in Sudanese pregnant women