International Journal of Research and Reports in Hematology

Silent Multiorgan Injury in Sickle Cell Disease: Redefining Mortality Beyond Pain Crises

2026-06-02T13:13:28+00:00

Sickle cell disease (SCD) has typically been seen through the prism of acute vaso-occlusive crises and other clinically noticeable issues that call for medical attention. The mortality rate among people with sickle cell disease (SCD) is still much higher than that of the general population, despite improvements in survival and a decrease in the frequency of severe acute episodes brought about by advancements in disease-modifying treatments and supportive care. A significant amount of this increased mortality may be caused by silent, progressive multiorgan harm that occurs long before clinical symptoms manifest, according to emerging data. The objective of this review was to evaluate the contribution of silent multiorgan injury to sickle cell disease morbidity and mortality, as well as its underlying pathophysiological mechanisms, patterns of organ-specific damage, diagnostic limitations, and potential for early detection and prevention. A narrative review of the literature was conducted using published studies addressing the mechanisms, manifestations, detection, and management of subclinical organ injury in SCD. The review found that the main causes of silent tissue damage were endothelial dysfunction, oxidative stress, persistent haemolysis, chronic inflammation, hypercoagulability, and repeated microvascular occlusion. The brain, kidneys, liver, spleen, cardiovascular system, and skeletal system are all gradually affected by these processes, frequently years before obvious clinical symptoms show up. Avascular necrosis, higher tricuspid regurgitant velocity, diastolic dysfunction, silent cerebral infarcts, microalbuminuria, and functional asplenia were found to be significant markers of subclinical disease development and unfavourable long-term outcomes. Current therapies have a limited ability to prevent the increasing organ deterioration, and current clinical techniques are still primarily focused on acute problems and often miss early organ damage. The narrative structure of this review and the lack of quantitative synthesis are its main limitations. All things considered, a significant yet underappreciated factor in sickle cell disease morbidity and early death is silent multiorgan damage. To enhance long-term results and address the hidden burden of disease, there must be a greater focus on proactive surveillance, early detection, and organ-protective therapies.

Effect of Some Haematological, Haemostatic and Inflammatory Markers on Parity in Cervical Cancer Patients in Port Harcourt

2026-06-06T12:39:11+00:00

Most cervical cancers are caused by Human Papillomavirus (HPV), the most common sexually transmitted infection that causes warts in various parts of the body. Cervical cancer is the second common female malignant tumor globally that seriously threatens females’ health. This study was aimed at determining the effect of some Haematological, Haemostatic and Inflammatory Markers on Parity in cervical cancer patients in Port Harcourt. This study was a case-control study. A total of 40 participants (20 histologically confirmed cervical cancer positive subjects and 20 histologically confirmed cervical cancer negative subjects) within the age of 18-70 years were recruited for this study. The demographics and informed consent of the study subjects were obtained with the use of a questionnaire. Eight millilitres (8mls) of blood sample were collected using vacutainers from each participant. Weight, height and body mass index (BMI) were recorded. Von Willebrand Factor (vWF), thrombomodulin, FVIII, Tissue plasminogen activator, D-dimer and C-reactive protein were analysed using ELISA technique. Prothrombin time (PT) and activated partial thromboplastin time (APTT) were analysed using manual method; fibrinogen was analysed using the coagulation method, plasma viscosity was analysed using capillary viscometer tube method while erythrocyte sedimentation rate (ESR) was analysed using the Westergren tube method. GraphPad Prism 8.0.2.263 version was used for data analysis. Analysis of variance (ANOVA) was used for different groups. P<0.05 was considered significant. Results were presented as mean ± standard deviation (m±SD) in Tables and Figures. This research work also revealed no statistically significant difference in all haematological parameters of cervical cancer patients vs control subjects based on parity. Therefore, parity plays no role in the alteration of haematological parameters as a result of the disease. The study also revealed a statistically significant linear increase in fibrinogen concentration in cervical cancer subjects based on parity. Subjects who have given birth to more than 4 children recorded a significant increase in their fibrinogen concentration. Other parameters indicated no statistically significant difference. This study revealed that parity does not directly play a significant role in cervical cancer disease.

Broken Trephine Biopsy Needle: A Case Report of a Rare but Not Impossible Complication

2026-05-28T13:53:33+00:00

Background: Bone marrow aspiration and trephine biopsy are essential procedures in haematology for the diagnosis, prognostication, and monitoring of a wide range of haematological disorders. Although generally safe, rare procedural complications may occur, including breakage of the biopsy needle.

Case Presentation: We report the case of a 67-year-old man with recurrent transfusion-dependent anaemia and neutropenia who underwent bone marrow aspiration and trephine biopsy as part of his diagnostic evaluation. During the trephine biopsy procedure, the biopsy needle fractured while being manipulated for core retrieval, leaving an approximately 3 cm fragment lodged within the posterior ilium. Radiographic imaging confirmed the retained fragment. Following multidisciplinary assessment, the patient underwent successful surgical extraction of the needle fragment by orthopaedic surgeons under local anaesthesia with monitored anaesthetic care. The postoperative course was uneventful, and the patient was discharged with appropriate follow-up.

Discussion: Needle fracture during bone marrow biopsy is an exceptionally uncommon complication, with only a limited number of cases reported in the literature. Factors that may contribute to its occurrence include patient movement, inadequate analgesia or sedation, operator-related technical challenges, and compromised needle integrity. Prompt recognition, radiological localisation, and multidisciplinary management are essential to minimise morbidity.

Conclusion: Broken trephine biopsy needles represent a rare but significant complication of bone marrow biopsy procedures. Awareness of this possibility, careful procedural technique, adequate patient comfort measures, and assessment of equipment integrity are important for prevention. Reporting such cases contributes to improved recognition and management of this unusual event.