12th Congress of the European Hematology ... - Haematologica

12 th Congress of the European Hematology Association
1183
ERYTHROPOIETIN, IRON, AND FOLIC ACID IN CHILDREN WITH NEPHROTIC SYNDROME
AND NORMAL RENAL FUNCTION
C. Donato, E. Antonuccio, M. Grimoldi, M. Rapetti, S. Exeni, C. Laso,
L. Haymes, R. Exeni
Hospital del Niño de San Justo, SAN JUSTO, BUENOS AIRES, Argentina
Backgrounds. Some patients with nephrotic syndrome (NS) and normal
kidney function become anemic. To date, the pathogenesis of anemia
remains elusive. Massive urinary losses and low serum levels of
albumin and other proteins are key findings in NS. Of them, transferrin
(Tf) and erythropoietin (Epo) deficiencies have been suggested as factors
contributing to the anemia. Urinary excretion of these proteins is
believed to be the main mechanism leading to these deficiencies. However,
only a few patients with NS develops anemia. Aims. To investigate
the role of Epo, iron, and folic acid in non-anemic children with NS and
normal kidney function. Methods. Children with nephrotic syndrome
were classified as: Group A: NS without proteinuria, in remission; Group
B: NS with proteinuria, at diagnosis or in relapse. Clinical data were
recorded, and the following laboratory tests were carried out. Blood
samples: complete cells count, urea, creatinine, glucose, cholesterol, total
proteins, albumin, Epo, ferritin (Ft), serum iron (SI), Tf, Tf saturation
(TS), and folic acid. Urine samples: Epo, proteins, glucose, and ?2
microglobulin. Results. Hemoglobin, serum Epo and folic acid were within
normal range in all the patients of both groups. Comparison between
groups (table) showed significantly lower levels of SI, Tf, TS and Ft in
group B; no significant difference could be demonstrated for urinary
Epo, although a trend to reach higher values in group B was evident. Tf
and SI levels under normal limits were seen in 100% and 67% of children,
respectively, in group B, and none in group A. The percentage of
patients with urinary losses of Epo was similar for both groups. A direct
correlation between SI and Tf was observed (r: 0.73; p=0.0002); no correlation
was found between serum or urinary Epo and other analyzed
parameters. Conclusions. Urinary losses of Epo were demonstrated in
children with NS, whether or not they were in remission: percentage of
patients and amount of urinary excretion were similar for both groups.
Levels of Tf and SI were invariably normal in group A and subnormal
in most patients in group B. Since no patient was anemic, our findings
suggest that neither the urinary excretion of Epo nor the low levels of
Tf and SI are the main mechanisms leading to anemia. Other associated
factors, such as a blunted Epo secretion or a misbalance of soluble Tf
receptor, should be present in children with NS developing anemia.
Table 1.
1184
HAEMOSTATIC EVIDENCE OF THROMBOTIC SIGNALLING IN NIGERIAN WOMEN
ON INJECTABLE CONTRACEPTIVES
O. Ajayi, 1 O. Ajayi, 1 E. Obarhua2 1 2 University of Benin, BENIN CITY, Nigeria; Irrua Specialist Teaching Hospital,
IRRUA, Nigeria
Background. Oral contraceptives pills (OCP) have been linked inextricably
with thrombotic tendencies and hypofibrinolysis in African
women while, the role of the long acting injectable contraceptives (IC)
has not been fully elucidated. Aims. This study was designed to assess
the probable effects of IC in thrombogenesis and to compare its use
434 | haematologica/the hematology journal | 2007; 92(s1)
with that of OCP. Methods. Twenty five (25) females on IC for up to one
year and more (from 3 months) attending the out patient clinic at the
Obstetrics and Gynaecology department of Irrua Specialist Teaching
Hospital, Ekpoma who consented to the study were investigated together
with 25 (age-matched; never had any form of contraceptives) controls.
They were grouped into two categories( group A; less than 1 year of use,
group B; 1 year and above).Thrombogenic and Rheologic factors such
as Haematocrit (HCT), Plasma Fibrinogen Concentration (PFC), Platelet
count (PC), Whole blood and Plasma Viscosities (WBV and PV respectively)
and Euglobulin lysis time (ELT) were analyzed with standard
methods. Student t-test was used for the statistical comparison between
controls and the test groups and p