Landsteiner’s Law

by SHOHEL RANA | Apr 27, 2024 | HAEMATOLOGY

Landsteiner’s Law

Landsteiner’s Law, also known as Landsteiner’s Rule, is a principle in immunohematology formulated by the Austrian biologist and physician Karl Landsteiner, who is renowned for his groundbreaking work on blood groups. Landsteiner discovered the ABO blood group system in 1901, for which he was awarded the Nobel Prize in Physiology or Medicine in 1930. Landsteiner’s Law states that:

“Antibodies in the serum of an individual will react with antigens on red blood cells (RBCs) only if the individual lacks those antigens on their own RBCs.”

In simpler terms, Landsteiner’s Law explains the basis of compatibility and incompatibility reactions in blood transfusions. The presence of specific antigens (e.g., A, B) on the surface of red blood cells determines an individual’s blood group. When blood from a donor with certain antigens is transfused into a recipient lacking those antigens, the recipient’s immune system may recognize the donor’s antigens as foreign and produce antibodies against them. This can lead to an immune reaction, causing the recipient’s antibodies to attack and destroy the donor’s red blood cells, resulting in a transfusion reaction.

Conversely, Landsteiner’s Law also suggests that individuals lacking certain antigens on their own red blood cells will not produce antibodies against those antigens. For example, individuals with blood type O lack A and B antigens on their red blood cells and therefore do not produce anti-A or anti-B antibodies. However, they can produce antibodies against other blood group antigens, such as the Rh factor (anti-D).

Understanding Landsteiner’s Law is crucial for blood banking and transfusion medicine, as it guides the selection of compatible blood donors and recipients to prevent adverse reactions during blood transfusions. Compatibility is determined by matching the donor’s blood type with the recipient’s blood type, considering both the ABO and Rh blood group systems, as well as other minor blood group antigens.

Iron Profile

by SHOHEL RANA | Apr 27, 2024 | HAEMATOLOGY

Serum Iron Profile

An iron profile, also known as an iron panel or iron studies, is a group of blood tests that measure various parameters related to iron metabolism in the body. Iron is an essential mineral required for the formation of hemoglobin, which carries oxygen in the blood, and for various enzymatic reactions involved in energy metabolism and cellular function. Iron profiles help diagnose and monitor conditions related to iron deficiency or iron overload. Here are the components typically included in an iron profile:

Serum Iron:
- Serum iron measures the concentration of iron in the blood plasma. It reflects the amount of iron circulating in the bloodstream and is influenced by dietary intake, iron absorption, and iron utilization by the body.
- Normal range: 60-170 μg/dL (10.7-30.4 μmol/L)
Total Iron-Binding Capacity (TIBC):
- TIBC measures the total capacity of transferrin, a protein that binds to and transports iron in the blood. It reflects the body’s ability to bind and transport iron to tissues for various metabolic processes, including hemoglobin synthesis.
- Normal range: 240-450 μg/dL (42.9-80.6 μmol/L)
Transferrin Saturation:
- Transferrin saturation is calculated as the ratio of serum iron to TIBC and represents the percentage of transferrin saturation with iron.
- Transferrin saturation provides information about the proportion of transferrin molecules that are bound to iron and is used to assess iron status and iron metabolism.
- Normal range: 20-50%
Serum Ferritin:
- Ferritin is a protein that stores iron and releases it in a controlled manner as needed by the body. Serum ferritin levels reflect the body’s iron stores and are considered the most sensitive indicator of iron status.
- Normal range: 12-300 ng/mL (12-300 μg/L)
- Ferritin levels <30 ng/mL (<30 μg/L) are suggestive of iron deficiency, while levels >300 ng/mL (>300 μg/L) may indicate iron overload.
Transferrin Receptor (sTfR):
- Soluble transferrin receptor (sTfR) is a marker of cellular iron uptake and reflects the body’s demand for iron for erythropoiesis (red blood cell production).
- Elevated sTfR levels may indicate iron deficiency or increased erythropoietic activity, while low levels may indicate adequate iron stores.
- sTfR levels are sometimes used in conjunction with ferritin levels to assess iron status more accurately.
Hematologic Parameters:
- Hemoglobin (Hb), hematocrit (Hct), mean corpuscular volume (MCV), and mean corpuscular hemoglobin concentration (MCHC) are often included in an iron profile to assess red blood cell indices and detect anemia.
- Anemia can result from iron deficiency, but it can also be caused by other factors such as vitamin deficiencies, chronic diseases, or hemoglobinopathies.

An iron profile is typically ordered to evaluate iron status, diagnose iron deficiency anemia or iron overload disorders (e.g., hemochromatosis), monitor response to iron therapy, or investigate the underlying causes of abnormal iron metabolism. Interpretation of iron profile results should be done in conjunction with clinical findings, medical history, and other laboratory tests to determine the appropriate diagnosis and management plan.

Iron Deficiency Anaemia

by SHOHEL RANA | Apr 27, 2024 | HAEMATOLOGY

Iron Deficiency Anaemia

Iron deficiency anemia (IDA) is a common type of anemia that occurs when the body doesn’t have enough iron to produce adequate amounts of hemoglobin, the protein in red blood cells that carries oxygen from the lungs to the rest of the body. Iron deficiency can develop gradually over time due to various factors, including insufficient dietary intake of iron, impaired absorption of iron from the diet, increased iron requirements (such as during pregnancy or rapid growth periods), chronic blood loss, or certain medical conditions that interfere with iron metabolism.

Here are the key features and characteristics of iron deficiency anemia:

Signs and Symptoms:
- Fatigue and weakness
- Pale skin (pallor)
- Shortness of breath
- Headaches and dizziness
- Cold hands and feet
- Brittle nails
- Rapid or irregular heartbeat (palpitations)
- Reduced exercise tolerance
- Restless legs syndrome
- Craving for non-food substances (pica), such as ice or dirt
Laboratory Findings:
- Low hemoglobin (Hb) levels: Hemoglobin levels below the reference range for age and sex are characteristic of anemia.
- Low serum ferritin levels: Ferritin is a protein that stores iron in the body. Reduced ferritin levels indicate depleted iron stores.
- Low serum iron levels: Serum iron levels may be decreased in iron deficiency anemia due to insufficient iron supply.
- High total iron-binding capacity (TIBC): TIBC measures the body’s capacity to bind and transport iron. Elevated TIBC levels reflect increased iron-binding capacity due to iron deficiency.
- Low mean corpuscular volume (MCV): MCV measures the average size of red blood cells. In iron deficiency anemia, red blood cells are typically smaller than normal (microcytic), resulting in a low MCV.
Causes:
- Inadequate dietary intake of iron-rich foods, such as meat, poultry, fish, beans, lentils, fortified cereals, and green leafy vegetables.
- Impaired iron absorption due to gastrointestinal disorders (e.g., celiac disease, inflammatory bowel disease), surgical removal of part of the stomach or intestines, or medications that interfere with iron absorption (e.g., proton pump inhibitors, antacids).
- Increased iron requirements during periods of rapid growth (e.g., infancy, adolescence) or pregnancy.
- Chronic blood loss due to gastrointestinal bleeding (e.g., ulcers, hemorrhoids, colon cancer), menstruation, or frequent blood donation.
Treatment:
- Iron supplementation: Oral iron supplements are typically prescribed to replenish iron stores and correct anemia. It’s important to take iron supplements as directed by a healthcare provider to avoid side effects and ensure optimal absorption.
- Dietary changes: Consuming iron-rich foods and vitamin C-rich foods (which enhance iron absorption) can help improve iron levels. Examples include red meat, poultry, fish, beans, lentils, tofu, spinach, broccoli, strawberries, and citrus fruits.
- Treatment of underlying causes: Addressing underlying conditions that contribute to iron deficiency, such as gastrointestinal disorders or chronic blood loss, is essential for long-term management.

Iron deficiency anemia is a treatable condition, and early diagnosis and intervention can help alleviate symptoms, improve quality of life, and prevent complications. It’s important for individuals experiencing symptoms of anemia to seek medical evaluation and appropriate management from a healthcare provider.