The ratio of hematological parameters and markers of inflammation in patients with iron deficiency and pernicious anemia

Abstract

INTRODUCTION:Pernicious anemia is an autoimmune megaloblastic and macrocytic anemia, characterized by a deficiency of vitamin B12 and the absence of internal factors in gastric juice. In this type of anemia values of red blood cells and hemoglobin are reduced, and it is followed with a slight decrease in the number of leukocytes and platelets, and granulocyte nucleus hypersegmentation. Observations of the peripheral blood smear clearly show: microcytosis, hypochromia, anizocytosis, poikilocytosis. Iron deficiency anemia (IDA) is a condition in which blood lacks adequate healthy red blood cells due to insufficient iron. In the peripheral blood smear of IDA patients, following is clearly observed: microcytosis, hypochromia, anizocytosis, poikilocytosis.The number of red blood cells is reduced, disproportionate in relation to the reduction of hemoglobin, while the values of leukocytes and platelets is usually normal. AIM: The aim of this research is to investigate the association of hematologic parameters and inflammatory markers in patients with these two anemias. MATERIALS AND METHODS:The study used data of laboratory tests of 100 patients with anemia, of which 50 with anemia due to iron deficiency (anemia hypochromic), and 50 with pernicious anemia. The study involved data of adult patients whose hemoglobin level is below 138 g /L, and the value of the red blood cells line- red blood cells, beneath 4,30x1012/L. RESULTS:The value of leukocyte and platelet counts were statistically significant (p<0.001), but only in IDA group of patients. Differences in the number of red blood cells and hemoglobin concentration were not statistically significant in any of the groups. Statistically significant differences have been detected between the two groups of patients (p<0.0005), when it comes to values of neutrophils and lymphocytes. The correlation coefficient between MCH and CRP, and fibrinogen revealed a good negative correlation (MCH and CRP: r = -0.561,p<0.01; MCH and fibrinogen: r = -0.652, p<0.01). CONCLUSION:In the group of patients with IDA concentration of CRP was significantly higher compared to patients with other groups, which confirms the importance of CRP as a marker of inflammation. On the other hand neutrophil to lymphocyte ratio (NLR), had no correlation with either the parameters of anemia, and is generally the worse indicator of disease. NLR compared to CRP is a better biomarker in postoperative inflammation, while CRP may be a marker of decisions with preoperative patients.