No increased mortality risk in older persons with unexplained anaemia

Background: in older persons, anaemia is associated with a number of unfavourable outcomes. In approximately 30% of older persons with anaemia, the cause of the anaemia is unexplained. We assessed the clinical differences between subjects with explained and unexplained anaemia and investigated whether these subjects have different mortality patterns compared with subjects without anaemia.Design: observational prospective follow-up study.Setting: the Leiden 85-plus study.Participants: four hundred and ninety-one persons aged 86 years.Methods: the study population was divided in three groups: (i) no anaemia (reference group, n = 377), (ii) explained anaemia (iron deficiency, folate deficiency, vitamin B12 deficiency, signs of myelodysplastic syndrome or renal failure, n = 74) and (iii) unexplained anaemia, (n = 40). Mortality risks were estimated with Cox-proportional hazard models.Results: haemoglobin levels were significantly lower in subjects with explained anaemia than in subjects with unexplained anaemia (P < 0.01). An increased risk for mortality was observed in subjects with explained anaemia [HR: 1.93 (95% CI: 1.47-2.52), P < 0.001], but not in subjects with unexplained anaemia [HR: 1.19 (95% CI: 0.85-1.69), P = 0.31]. Adjusted analyses (sex, co-morbidity, MMSE, institutionalised and smoking) did not change the observed associations for both explained and unexplained anaemic subjects.Conclusion: older subjects with unexplained anaemia had similar survival compared with non-anaemic subjects. Increased mortality risks were observed in subjects with explained anaemia compared with non-anaemic subjects.Public Health and primary careGeriatrics in primary car

Primary Invasive Aspergillosis of the Digestive Tract: Report of Two Cases and Review of the Literature

BACKGROUND: Disseminated aspergillosis is thought to occur as a result of vascular invasion from the lungs with subsequent bloodstream dissemination, and portals of entry other than sinuses and/or the respiratory tract remain speculative. METHODS: We report two cases of primary aspergillosis in the digestive tract and present a detailed review of eight of the 23 previously-published cases for which detailed data are available. RESULTS AND CONCLUSION: These ten cases presented with symptoms suggestive of typhlitis, with further peritonitis requiring laparotomy and small bowel segmental resection. All cases were characterized by the absence of pulmonary disease at the time of histologically-confirmed gastrointestinal involvement with vascular invasion by branched Aspergillus hyphae. These cases suggest that the digestive tract may represent a portal of entry for Aspergillus species in immunocompromised patients

Loss-of-function ferroportin disease: novel mechanistic insights and unanswered questions

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De waarde van ijzerparameters bij ijzergebreksanemie.

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Een patiënt met ‘high-count’ monoklonale B-cellymfocytose zonder SF3B1-mutatie en een myelodysplastisch syndroom met ringsideroblasten met een SF3B1-mutatie

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Possible role for cytotoxic lymphocytes in the pathogenesis of acute interstitial nephritis after recombinant interleukin-2 treatment for renal cell cancer

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Twenty Years of Ferroportin Disease: A Review or An Update of Published Clinical, Biochemical, Molecular, and Functional Features

Contains fulltext : 208591.pdf (publisher's version ) (Open Access