Introduction:Haemolytic anaemia (HA) is defined as a decrease in haemoglobin (Hb)
levels below baseline due to excessive and premature destruction of red blood
cells (RBCs) in the periphery resulting in a shortened life span of less than
120 days. Haemolysis can be corpuscular or extra-corpuscular. The aim of our
study was to investigate the factors associated with it for optimal management of patients hospitalised in internal
medicine at the Douala General Hospital (DGH).Methodology: We conducted an analytical
cross-sectional study, including all patients admitted to the
internal medicine department of the DGH from 11 February to 20 May 2022, and
excluding patients with non-compliant samples. The search for haemolytic
anaemia was carried out by means of blood count, reticulocyte count, blood
smear, unconjugated bilirubin, lactate dehydrogenase and direct Coombs test.
Sociodemographic, clinical and biological parameters were collected and
analysed. Correlation was defined for a p value < 0.05. Results: This study included 147 patients, 50.34% of whom were men, for a sex
ratio of 1.01. The mean age was 52 ± 17.9 years. The most represented age group
was 56 - 70 years (n = 49; 33%) with extremes from 15 to 90 years. We counted
29.3% cases of haemolytic anaemia (HA) and 13.9% cases of autoimmune haemolytic
anaemia (AIHA). Haemolytic anaemia (HA) was present in 54.14% of men for a sex
ratio of 1.38; the most represented age group was 40 - 55 years, 37.2%. HA was
associated with jaundice (OR: 3.74, CI: [1.70 - 8.22], p = 0.001), HIV - AIDS
(OR: 2.72, CI: [0.98 - 7.53], p = 0.05), thrombocytopaenia (OR: 3.53, CI: [1.58
- 7.89], p = 0.02). LDH was elevated (OR: 2.86, CI: [1.30 - 6.26], p = 0.00) as
well as elevated reticulocyte count (OR: 3.84, CI: [1.75
References
[1]
Breton-Gorius, J., Reyes, F., Rochant, H., Rosa, J. and Vernant, J.P. (1992) L’héma- tologie de Bernard Dreyfus. Medecine-Sciences Flammation. 1474 p
[2]
World Health Organization (1968) Nutritional Anaemias Report of a WHO Scientific Group. Geneva, WHO Technical Report Series, No. 405.
[3]
McLean, E., Cogswell, M., Egli, I., Wojdyla, D. and de Benoist, B. (2009) Worldwide Prevalence of Anaemia, Who Vitamin and Mineral Nutrition Information System, 1993-2005. Public Health Nutrition, 12, 444-454. https://doi.org/10.1017/S1368980008002401
[4]
Zinebi, A., Eddou, H., Moudden, K.M. and Elbaaj, M. (2017) Etiological Profile of Anaemias in an Internal Medicine Department. The Pan African Medical Journal, 26, Article No. 10. https://doi.org/10.11604/pamj.2017.26.10.11368
[5]
Tchente, C.N., Tsakeu, E.N.D., Nguea, A.G., Njamen, T.N., Ekane, G.H. and Priso, E.B. (2016) Prevalence and Factors Associated with Anaemia in Pregnancy at Douala General Hospital. The Pan African Medical Journal, 25, Article No. 133. https://doi.org/10.11604/pamj.2016.25.133.10610
[6]
Hioui, M.E., Aboussaleh, Y., Ahami, A.O.T. and Farsi, M. (2009) Contribution to the Study of the Prevalence of Anaemia in Preschool Children in the Kenitra Region, Morocco. Antropo, 19, 1-5. www.didac.ehu.es/antropo
[7]
Faye, A., Diagne, N., Ndao, A.C., Bourgi, L., Sow, M., Dieng, M., et al. (2020) Les anémies du sujet agé en médecine interne: Aspects épidémiologiques, cliniques, étiologiques, thérapeutiques et évolutifs. Revue Africaine de Médecine Interne, 7, 13-22.
[8]
Masson, é., Ebbo, M., Schleinitz, N. and Bernit, E. (2015) How Do I Explore Haemolytic Anaemia? Therapeutic Medicine, 21, 228-232.
[9]
Loustau, V., Guillaud, C., Garcon, L., Godeau, B. and Michel, M. (2011) Haemolytic Anaemia in Adults: Main Causes and Diagnostic Approach. La Presse Médicale, 40, 470-485. https://doi.org/10.1016/j.lpm.2010.11.013
[10]
Sy, S., Samaké, M., Fofana, A.S., Maïga, D., Coulibaly, M., Sy, D., Kodio, A., Fongoro, S. and Maïga, M.K. (2021) Prévalence de l’Anémie Hémolytique Auto-Immune dans le Service de Néphrologie et d’Hémodialyse du CHU du Point G. Health Sciences and Disease, 22, 100-104.
[11]
Garrigues, P., Celerier, J., Reiss, B., Crochu, G., Cohen, F., Jeannel, J., et al. (2021) Profil des anémies hémolytiques rencontrées dans un service de médecine interne de 2005 et 2021. La revue de Médecine Interne, 42, A369. https://doi.org/10.1016/j.revmed.2021.10.051
[12]
Hachani, A., Mzabi, A., Achour, B., Atig, A., Rezgui, A. and Regaig, H. (2016) Autoimmune Haemolytic Anaemia: Retrospective Study about 90 Cases. La Revue de Médecine Interne, 37, A121-A122. https://doi.org/10.1016/j.revmed.2016.04.073
[13]
Pouchelon, C., Lafont, C., Lafarge, A., Riviere, E., Boutboul, D., Dossier, A., et al. (2021) Caractéristique et évolution des patients adultes atteints d’anémie hémolytique auto-immune sévère admis en reanimation: Résultats d’une étude français observationnelle multicentrique. La Revue de Médecine Interne, 42, A291-A292. https://doi.org/10.1016/j.revmed.2021.10.240
[14]
Zulfiqar, A.A., Mahdi, R., El Adli, A., Martin-Kleisch, P.J.L., Andrès, E., et al. (2016) Autoimmune Haemolytic Anaemia: Experience of Two Internal Medicine Departments and Review of the Literature. Medicine Therapeutics, 22, 8-15.
[15]
Anoun, J., Boudriga, M., Kammoun, F., Hassine, I.B., Karmani, M., Baya, W., et al. (2022) Particularité de l’anémie hémolytique auto-immune chez le sujet agés: étude comparative. La Revue de Médecine Interne, 43, A198-A199. https://doi.org/10.1016/j.revmed.2022.03.131
[16]
Oubelkacem, N., Khammar, Z., Atik, S., Hamri, L., Khoussar, I., Ouazzani, M., et al. (2016) Haemolytic Anaemia during Chronic Lymphocytic Leukemia: A Real Factor of Poor Prognosis. The Journal of Internal Medicine, 37, A30. https://doi.org/10.1016/j.revmed.2016.04.225
[17]
Gourguechon, C., Bertinchamp, R., Oksenhendler, E., Boutboul, D. and Galicier, L. (2016) Autoimmune Haemolytic Anaemia Associated with Multicentric Castlemen’s Disease during HIV Infection: Clinical Features, Management and Evolution of a Series of 21 Cases. La Revue de Médecine Interne, 37, A28. https://doi.org/10.1016/j.revmed.2016.04.222
[18]
Mama, M., Said, F., Khanfir, M. and Houman, M.H. (2018) Profil étiologique des anémies hémolytiques auto-immunes dans un service de médecine interne. La Revue de Médecine Interne, 39, A153. https://doi.org/10.1016/j.revmed.2018.10.103
