Histopathological and Clinical Patterns of Anemia in Older Adults with Chronic Comorbidities in Hyderabad, Sindh

Abstract

Objective: To determine the clinical, haematological, biochemical, and histopathological patterns of anaemia in older adults with chronic comorbidities and assess their association with selected clinical conditions.

Study Design: Cross-sectional descriptive and analytical study.

Place and Duration of Study: Departments of Pathology, Physiology, and Medicine of  Liaquat University of Medical and Health Sciences and affiliated tertiary-care hospitals, and Isra University Hospital, Hyderabad, from September 2024 to March 2025.

Methodology: A total of 424 adults aged ≥60 years with anaemia and at least one chronic comorbidity were enrolled through non-probability consecutive sampling. Clinical assessment, complete blood count, peripheral blood smear, reticulocyte count, iron profile, vitamin B12 and folate levels, renal and liver function tests, inflammatory markers, bone marrow aspiration, and trephine biopsy were performed.

Results: The mean age was 68.4 ± 6.7 years, and 236 (55.7%) participants were males. Hypertension was present in 272 (64.2%), diabetes mellitus in 252 (59.4%), and chronic kidney disease in 163 (38.4%) patients. The mean haemoglobin level was 9.1 ± 1.5 g/dL. Normocytic normochromic anaemia was the most frequent peripheral smear pattern in 193 (45.5%) participants, followed by microcytic hypochromic anaemia in 134 (31.6%). Bone marrow examination showed normoblastic erythroid hyperplasia in 148 (34.9%), megaloblastic changes in 88 (20.8%), and iron-deficient erythropoiesis in 80 (18.9%) patients.

Conclusion: Anaemia in older adults with chronic comorbidities showed diverse and overlapping patterns.