BONE MARROW IRON STORE IN PERLS??? STAINED ASPIRATES AND THE RED CELL INDICES

Abstract

Gurumayum Laxmikanta Sharma1, Laishram Deepak Kumar2, Ningthoujam Bhubon Singh3, Laishram Rajesh Singh4, Kaushik Debnath5

BACKGROUND
The National Family Health Survey 3 (NFHS-3) states the prevalence of anaemia in India to be 55.3% in women and 24.2% in men. The evaluation of Bone Marrow (BM) iron is a sensitive and reliable means for the diagnosis of iron deficiency anaemia. BM iron identified by Perls’ Prussian blue reaction is regarded as the gold standard for evaluating BM iron stores. Surrogate serum biochemical markers are routinely employed to assess the BM iron status. Among the automated cell counter parameters, increase in the RDW is the earliest evidence of iron deficiency. Hb level, RBC count, PCV, MCV, MCH and MCHC values fall progressively with time. Our study was commenced with an intent to evaluate the Bone Marrow (BM) iron status in different haematological disorders and to correlate it with the peripheral blood red cell indices.
MATERIALS AND METHODS
BM aspirations of 100 patients were done. The Perls’ stained smears were evaluated and graded for BM iron stores. Using ABX Pentra 60 automatic cell analyser, RBC indices were determined from the peripheral blood samples.
RESULTS
Significant and fair correlations of MCV (rs = 0.317, n=100, p<0.05), MCH (rs = 0.327, n=100, p<0.05), MCHC (rs = 0.343, n=100, p<0.05) and a significant negative, but fair correlation of RDW-CV% (rs= -0.292, n=100, p<0.05) with the BM iron grade were observed in our study, which were comparable with similar other studies. MCV had a significant and very good correlation with MCH (rs = 0.945). 75% of patients with a depleted BM iron store also had simultaneously low MCV and MCH values. Among the RBC indices, MCHC had the strongest correlation (rs = 0.343) with the BM iron store. 75.7% of the patients with a normal MCHC value also had a normal MCV value.

CONCLUSION
The BM iron grade determined on the Perls’ stained aspiration smears and the red cell indices determined by the automatic cell analyser fairly correlated with each other. Therefore, we conclude that the red cell indices may be of use as an affordable, ubiquitous parameter for predicting BM iron stores.

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