Original Research Article
Year: 2016 | Month: November | Volume: 6 | Issue: 11 | Pages: 57-66
Bone Marrow Morphology in Geriatric Patients with Anemia
Srijanaki M1*, Johnsy Merla J1**, Shantaraman K2**, Swaminathan K2**
1Assistant Professor, 2Professor,
*Department of Pathology, Madurai Medical College. **Department of Pathology, Tirunelveli Medical College.
Corresponding Author: Srijanaki M
ABSTRACT
Background Anemia is a common hematological problem in the geriatric age group and its incidence increases with increasing age. Anemia in old age has unique causes, adverse effects and functional outcome. The etiology is often multi-factorial, the most common causes being Anemia of Chronic disease, Nutritional deficiencies, followed by unexplained anemia. Myelodysplastic Syndrome (MDS) is more common in older adults and accounts for a significant number of unexplained anemias in elderly. Bone Marrow Morphology remains the cornerstone in its diagnosis and is an important tool that complements cytogenetic finings for diagnostic and prognostic discrimination in MDS. The present study evaluated the Bone Marrow morphology in Geriatric patients with Anemia and emphasises Myelodysplastic syndrome as one of the important causes of geriatric anemia.
Study Design: prospective descriptive study.
Aim: 1.To evaluate the clinical presenting features and the basic, hematological parameters in Geriatric patients with Anemia. 2. To evaluate the morphological alterations of Bone marrow aspirates in these Geriatric patients with Anemia. 3. To correlate these morphological alterations of Bone marrow aspirates with the clinical and basic hematological parameters in these patients.
Materials and Methods: This prospective study was conducted over a period of two years from September 2010-2012 in a tertiary health care hospital. Geriatric patients of age more than 60 years who are presenting with anemia, fulfilling the WHO criteria of anemia were enrolled in the study. Bone marrow was aspirated from the sternum or the posterior superior iliac crest, using a Salah needle.
Results: The anemia was of severe degree in most patients as per WHO criteria. It was often multifactorial. Bone marrow examination showed a Reactive Erythroid Hyperplasia of marrow with micronormoblastic maturation suggestive of a probable Iron deficiency in 41.54% of patients. The present study identified Myelodysplastic syndrome as a possible cause of Geriatric Anemia in 9.23% of patients.
Conclusion Anemia in elderly patients should never be regarded as a normal physiological response to aging. All Elderly patients with Anemia should always be evaluated for an underlying cause and treated accordingly. Hence a Bone marrow examination is often necessary in all cases of geriatric anemia for establishing a diagnosis, particularly in MDS.
Key words: anemia, geriatric, MDS, bone marrow morphology.