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.

Prevalence of Rhesus Antibodies (Anti-C, -D, and -E) among Pregnant Women in Ekpoma, Edo State, Nigeria

2026-07-04T07:34:15+00:00

Rhesus alloimmunisation remains a major cause of haemolytic disease of the newborn (HDN), particularly among Rh-negative women exposed to Rh-positive foetal red blood cells. This study investigated the prevalence of Rhesus (Rh) antibodies, specifically anti-C, anti-D and anti-E, among pregnant women in Ekpoma, Edo State, Nigeria. A cross-sectional design was used, involving 101 pregnant women recruited from two antenatal clinics by simple random sampling. Blood samples were tested for Rh antigen status using tile agglutination, and antibody screening was performed using the indirect antiglobulin test. Sociodemographic and obstetric data were collected and analysed using SPSS version 21, with p ≤ 0.05 considered statistically significant. The prevalence of each Rh antibody, anti-C, anti-D and anti-E, was approximately 1%, with all three antibodies detected in a single nulliparous woman aged 18–24 years. No statistically significant associations (p > 0.05) were observed between antibody prevalence and maternal age, gestational age, marital status or parity. These findings suggest a low prevalence of Rh alloimmunisation in the study area, while supporting the continued need for routine antenatal Rh antibody screening and appropriate prophylactic intervention to reduce the risk of HDN. Further studies with larger samples and inclusion of transfusion history are recommended.

Knowledge of Causes and Care of Neonatal Jaundice among Nursing Mothers attending Federal Medical Centre, Umuahia, Abia State, Nigeria

2026-07-06T13:24:54+00:00

Background: Neonatal jaundice is a common neonatal condition that may result in serious complications when recognition and appropriate care are delayed. Maternal knowledge is important for early identification, timely care-seeking and avoidance of unsafe home practices. This study assessed knowledge of the causes and care of neonatal jaundice among nursing mothers attending Federal Medical Centre, Umuahia, Abia State, Nigeria.

Methods: A descriptive cross-sectional survey design was used. A total of 384 nursing mothers attending Federal Medical Centre, Umuahia, participated in the study. Data were collected using a structured questionnaire that assessed socio-demographic characteristics, perception of neonatal jaundice, knowledge of causes, maternal care practices and beliefs, and perceived barriers to orthodox care. Data were analysed using frequencies, percentages and mean scores. A benchmark mean score of 3.5 and above was interpreted as positive.

Results: Most respondents were married, had tertiary education and were aged 30-34 years. Respondents showed good awareness that neonatal jaundice is common in newborns, that infection increases the risk of neonatal jaundice and that severe jaundice may cause neonatal death. However, knowledge gaps were observed regarding breastfeeding-related jaundice, rebound hyperbilirubinaemia and specific treatment principles. Some misconceptions persisted, including beliefs related to sunlight exposure and sugar water. Major perceived barriers to orthodox care included high treatment cost, lack of money for laboratory tests and drugs, long waiting time at the hospital, fear of phototherapy and hospital equipment, cultural beliefs, advice from relatives or elders, and previous hospital experience.

Conclusion: Nursing mothers demonstrated reasonable awareness of neonatal jaundice, but important gaps in knowledge and care practices remain. Strengthened maternal education, clearer counselling during antenatal and postnatal visits, and improved access to affordable neonatal care are needed to promote early recognition and appropriate management.

Phenotype Frequencies of P1 Blood Group Antigen among Residents in Calabar, Nigeria

2026-07-11T10:25:39+00:00

Introduction: The P1 blood group antigen is part of a clinically relevant blood group system that plays an important role in blood transfusion. The prevalence of the P1 blood group antigen among individuals in Calabar, Cross River State, Nigeria, is not yet known.

Aims: This study determined the phenotype frequency of P1 antigen among residents of Calabar metropolis and described its distribution by ABO/Rh blood group, gender and ethnicity.

Materials and Methods: A cross-sectional study design was employed, and a total of 100 individuals who provided informed consent were enrolled. Fifty-nine (59) participants were males and forty-one (41) were females. The P1 blood group was analysed using the standard serological tube technique with Lorne reagent purchased from Lorne Laboratory, Great Britain, United Kingdom.

Results: The frequency of P1 antigen in this study was 71 (71.0%). The distribution of ABO/Rh blood groups among the participants was as follows: O Rh 'D' positive, 77 (77.0%); A Rh 'D' positive, 10 (10.0%); B Rh 'D' positive, 9 (9.0%); AB Rh 'D' positive, 1 (1.0%); A Rh 'D' negative, 1 (1.0%); and O Rh 'D' negative, 2 (2.0%). The most prevalent ethnic group was Efik, 46 (46.0%), followed by Igbo, 18 (18.0%); Ijaw, 10 (10.0%); Ibibio, 10 (10.0%); Anang, 7 (7.0%); Oron, 4 (4.0%); Hausa, 3 (3.0%); and Yoruba, 2 (2.0%).

Conclusion: A prevalence of 71.0% of P1 antigen was recorded among individuals in Calabar metropolis in this study. Although P1 antigen is a lesser-known blood group antigen and its complications are not as widely documented as those of major blood group systems, such as ABO and Rh, it may still influence transfusion reactions, immune responses and disease susceptibility.

Haematological Modulatory Effects of Ethanol Leaf Fractions of Sida acuta and Ficus exasperata, Alone and in Combination, in Alloxan-Induced Diabetic Wistar Rats

2026-07-14T05:47:33+00:00

This study evaluated the haematological modulatory effects of ethanol leaf fractions of Sida acuta and Ficus exasperata, singly and in combination, in alloxan-induced diabetic female Wistar rats. Sixty-three female rats were divided into nine groups (n = 7): A, normal control; B, untreated diabetic control; C, glibenclamide at 0.29 mg/kg; D and E, S. acuta at 200 and 400 mg/kg, respectively; F and G, F. exasperata at 200 and 400 mg/kg, respectively; H, combined 200 mg/kg (100 mg/kg of each fraction); and I, combined 400 mg/kg (200 mg/kg of each fraction). Except for Group A, all groups were diabetic. Diabetes was induced with a single intraperitoneal injection of alloxan monohydrate (150 mg/kg body weight), and treatments lasted for 28 days. Blood was collected into ethylenediaminetetraacetic acid bottles and analysed using an automated haematology analyser. Compared with Group A, Group B showed reduced haemoglobin concentration (Hb), packed cell volume (PCV), red blood cell count and platelet count, with increased total white blood cell count (WBC). Hb and PCV decreased from 12.23 ± 0.78 g/dL and 43.05 ± 2.10% in Group A to 10.65 ± 0.27 g/dL and 37.23 ± 1.20% in Group B. Group I produced Hb and PCV values of 12.23 ± 0.56 g/dL and 44.68 ± 1.43%, respectively, and reduced WBC to 6.44 ± 1.67 × 10⁹/L. Group G had the highest platelet count, at 1061.00 ± 231.83 × 10⁹/L. The fractions produced dose- and treatment-dependent changes in selected haematological indices, with Group I showing the most favourable responses in Hb, PCV and WBC.

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.

Triple-negative Primary Myelofibrosis: A Diagnostic Challenge

2026-06-30T07:06:15+00:00

Primary myelofibrosis (PMF) is a BCR-ABL1-negative myeloproliferative neoplasm that may be diagnostically difficult when canonical driver mutations are absent. We report a male in his 30s with treated hypothyroidism who presented with low-grade intermittent fever and left-sided dragging abdominal pain for one week, with loss of appetite for two months, weight loss for one month and easy fatigability for one month. Examination showed pallor and massive splenomegaly extending beyond the umbilicus into the right iliac fossa. Complete blood count demonstrated pancytopenia, with haemoglobin 5.6 g/dL, total count 1.1 x 10^3/microL and platelet count 55 x 10^3/microL. Peripheral smear showed dimorphic anaemia, nucleated red blood cells, leucopenia, thrombocytopenia and a leucoerythroblastic blood picture, without circulating blasts or dysplastic cells. Imaging confirmed massive splenomegaly without lymphadenopathy. Bone marrow biopsy showed hypercellular marrow with trilineage haematopoiesis, dimorphic erythropoiesis, megakaryocytic atypia with hypolobulated and dwarf forms, and grade 2 marrow fibrosis. BCR-ABL1 fluorescence in situ hybridisation was negative, and JAK2, CALR and MPL testing did not identify clinically significant variants. Positron emission tomography-computed tomography, flow cytometry, autoimmune tests, viral serology and infectious work-up did not support lymphoma or reactive marrow fibrosis. Next-generation sequencing did not detect high-risk or prognostically adverse mutations. On clinicopathological correlation, the diagnosis favoured triple-negative overt fibrotic PMF. The patient was risk stratified as clinically intermediate risk and treated with ruxolitinib and thalidomide, with improvement in cytopenias, constitutional symptoms and spleen size. The case highlights the importance of integrating marrow morphology, exclusion of secondary causes and molecular testing in triple-negative PMF.