, ineffective erythropoiesis, inflammation, splenic pooling and haemolysis have all been implicated in normocytic anaemia associated with malarial infection (4,5,9).
The World Health Organization classification of MDS, updated in 2008, indicates that the features that define MDS include blood cytopenias, ineffective hematopoiesis, dyserythropoiesis
, dysgranulopoiesis, dysmegakaryopoiesis, and increased myeloblasts (4).
8) Many other studies with small numbers of cases have also reported the findings of necrosis, reticulin fibrosis, (7) increased sea-blue histiocyte numbers, (9) dyserythropoiesis
, gelatinous transformation, and lymphocytosis.
5 Not reported CrCl <50 ml/min Hypoalbuminemia Dehydration Infection 2 59/M 1 15 Digoxin Infection CrCl Furosemide <50 ml/min Dipyridamole Indomethacin 3 71/F 5 10 MTX Diclofenac CrCl <50 Clopidogrel ml/min Old age Hypoalbuminemia Dehydration Infection Daily MTX High MCV value Case Bone marrow Peripheral findings eosinophil increase (days after admission) 1 Relative increase in 4th eosinphil, and dyserythropoiesis
2 Bone marrow 1st eosinophilia (40%), and dyserythropoiesis
3 Bone marrow 5th eosinophilia (50%) Case numbers 1 and 2 show results from the study by Bruyn et al.
In the hypercellular marrow dyserythropoiesis
is recognised by abnormal nuclear lobulation, irregular cytoplasmic haemoglobinisation together with basophilic stippling.
The main aetiologies for HIV-related anaemia are dyserythropoiesis
(anaemia of chronic disease), infections and drugs.
Secondly, malaria-associated anaemia is due, in part, to the anaemia of inflammation, which is characterized by dyserythropoiesis
, shunting of iron to non-bioavailable forms, decreased erythropoietin production and responsiveness, and decreased erythrocyte survival.
5) The absence of BCR-ABL1 or dyserythropoiesis
and dysgranulopoiesis effectively rules out CML and PMF, respectively.
Dysplasia restricted to only one lineage such as dyserythropoiesis
was reported (88).
A biopsy of one of the masses showed hypercellular marrow with erythroid hyperplasia, moderate dyserythropoiesis
, megaloblastic changes and overloaded iron stores which were in keeping with EMH.
The prime candidates for the host factors mediating dyserythropoiesis
have been growth factors and cytokines.
The hepcidin/ferritin ratio is also low in several secondary syndromes of iron overload characterized by ineffective erythropoiesis, including thalassemia and congenital dyserythropoiesis