ObjectiveThis study aimed to assess the prevalence of anemia in Hungary between 2019 and 2022 as detailed data in this regard was not available.MethodsThis retrospective, observational, cross-sectional study enrolled 85628 patients with a median age of 63 (44-76 interquartile range) years admitted to the Emergency Department of the University of Pécs, Hungary, between January, 2019, and December, 2022.ResultsThe overall prevalence of anemia was 22.68%. The prevalence of anemia did not change significantly during the study period (2019: 22.30%; 2020: 22.88%; 2021: 22.55%; 2022: 23.00%). However, the prevalence of severe anemia (Hgb<8g/dL) was higher compared to 2019, in each year (2019:2.00%; 2020:2.52%; 2021:2.60%; 2022:2.47%, p<0.001). The increase was observed in each analyzed year among the elderly male patients and in 2021 and 2022 among the elderly female patients. The rising number of patients with COVID-19 diagnosis presenting severe anemia may have contributed to this change. Among all anemic patients, the overall prevalence of microcytic and macrocytic anemia accounted for one-third, while hypochromic and hyperchromic anemia for half of the cases. Hypochromic anemia prevalence decreased and normochromic anemia prevalence increased significantly in each year. The prevalence of microcytic anemia decreased in the year 2020 compared to 2019, the changes being observed among the female patients only.ConclusionsOver the study period, anemia affected approximately one-quarter of the patients each year, while the proportion of severe anemia increased, especially in the elderly.

This case report emphasizes the importance of early detection and prompt treatment of Helicobacter pylori (H. pylori) as a reversible cause of autoimmune gastritis and its associated vitamin B-12 deficiency. Rapid eradication of H. pylori can significantly improve hematologic parameters and prevent the progression of autoimmune gastritis.

Variable resistance to Haemonchus contortus infection and the associated immune mechanisms have been investigated and characterized in different sheep breeds adapted to tropical climates. In a recent study, we compared the local immune responses of the resistant Santa Inês with those of the susceptible White Dorper and Texel sheep breeds under chronic haemonchosis, and evaluated the correlations of immune-related transcripts and different parasitic stages and sexes. The aim of present study was to further elucidate the immune mechanisms among these sheep breeds by comparing local responses, microscopic lesions in the abomasum and hematological parameters in lambs raised under varying levels of parasitic challenge. The naturally resistant Santa Inês breed maintained similar phenotypic characteristics across different levels of parasitic infection loads, whereas White Dorper and Texel breeds exhibited increased susceptibility under moderate to high challenge. Texel lambs showed altered mean corpuscular volume, indicative of macrocytic anemia, and also displayed the lowest resistance under low challenge conditions. Significantly higher levels of eosinophils, lymphocytes and monocytes in peripheral blood, along with increased expression of Galectin-11 gene in the abomasum, were observed in Santa Inês sheep compared to the other breeds. These responses may represent key host mechanisms contributing to improved control of infection. Overall, our findings demonstrate that resistance to H. contortus infection is breed-dependent and modulated by environmental parasite challenge, providing insights that may forward to the targeted strategies for sheep flock management.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzymatic disorder of red blood cells worldwide and typically presents in childhood or early adulthood following exposure to oxidative stressors. Late-life diagnosis is uncommon and may be overlooked in patients without exposure to classic hemolytic triggers. We report the case of a 70-year-old man with intermittent, mild macrocytic anemia who was ultimately diagnosed with G6PD deficiency. This case highlights how G6PD deficiency may remain clinically silent for decades, discusses reasons for delayed diagnosis, and emphasizes the importance of considering inherited hemolytic disorders in older adults with unexplained macrocytic anemia.

This review characterizes VEXAS syndrome (Vacuoles, E1 enzyme, X-linked, Autoinflammatory, Somatic) as a prototype of adult-onset autoinflammation that challenges traditional autoimmune paradigms. Driven by constitutive activation of innate myeloid cells via Ubiquitin-Like Modifier Activating Enzyme 1 (UBA1) mutations, VEXAS affects the nervous system in approximately 6-10% of cases. We identify the peripheral nervous system as the primary target (70%), typically manifesting as refractory axonal polyneuropathy, while central involvement may present as neutrophilic meningoencephalitis. Crucially, we highlight the "hematologic paradox"-hyperinflammation co-occurring with macrocytic anemia rather than thrombocytosis-as the key biomarker distinguishing VEXAS from vasculitic mimics, necessitating early genetic sequencing for targeted clone suppression.

Background/Objectives: VEXAS (Vacuoles, E1-Enzyme, X-linked, Autoinflammatory, and Somatic) syndrome is a recently described adult-onset autoinflammatory disorder. It is characterized by somatic mutations in the UBA1 gene, systemic inflammation, macrocytic anemia, cytopenias, and bone marrow vacuolization and frequently overlaps with Sweet's syndrome, relapsing polychondritis, and myelodysplastic syndrome (MDS). Because treatment options are evolving, we reviewed the current and latest evidence of clinical features and therapeutic methods. Methods: A comprehensive literature review was conducted using PubMed and MEDLINE for studies published between 1 January 2020 and 1 July 2025. Search terms included "VEXAS" and "treatment." Eligible publications comprised clinical trials, multicenter and observational studies, and case reports containing therapeutic data. Findings were analyzed narratively with emphasis on treatment response, steroid-sparing effects, survival outcomes, and molecular responses. Results: Glucocorticoids remain the first-line therapy for acute management; however, this comes with near-universal steroid dependence. DMARDs and TNF-α inhibitors showed limited benefits. IL-6 inhibitors and JAK inhibitors showed improvement in overall response, with JAK inhibitors demonstrating a superior effect. Ruxolitinib showed a higher complete response rate and transfusion independence compared to other JAK inhibitors. Hypomethylating agents, particularly azacitidine, improved hematologic responses in patients with co-existing MDS and reduced UBA1 variant allele burden. Allogeneic hematopoietic stem cell transplantation may be the only current curative method, though with notable transplant-related mortality. Conclusions: JAK inhibitors and hypomethylating agents offer promising disease-modifying potential, while transplant may provide curative intent in selected patients. Ongoing clinical trials are taking place to dictate the treatment direction of VEXAS syndrome.

This study aimed to assess the prevalence and characteristics of previously undiagnosed anemia among children in Taif. The objective was to estimate the prevalence of undiagnosed anemia in a broader pediatric population (aged 2-12 years) across 3 hospitals, and to evaluate severity and morphological patterns. A cross-sectional study was conducted across Taif region's main hospitals serving children; including Taif Children's Hospital, King Faisal Hospital, and Taif Armed Forces Hospitals. A total of 264 children aged 2 to 12 years, presenting to outpatient clinics or emergency departments for acute, non-hematological conditions, were included. Children with previously diagnosed anemia or chronic diseases were excluded. Blood samples were collected to measure hemoglobin (Hb) levels, and anemia was diagnosed based on age-specific Hb thresholds. Descriptive statistics, chi-square tests, and independent t tests were used for data analysis. Out of 264 children, 28 (10.6%) were found to have undiagnosed anemia. The majority (75%) were aged 2 to 5 years, and a higher prevalence was noted among males (67.9%) compared to females (32.1%), though the gender difference was not statistically significant. There was a significant association between younger age and anemia (P < .001). Mean Hb levels were significantly lower in anemic children (10.13 ± 0.90 g/dL) than in non-anemic children (13.11 ± 0.93 g/dL; P < .001). Most cases were mild (71.4%), followed by moderate anemia (28.6%). Normocytic normochromic anemia was the most common type (53.6%), followed by microcytic hypochromic (39.3%) and macrocytic anemia (7.1%). This study highlights a notable prevalence of undiagnosed anemia among children in Taif, particularly in the preschool age group. The findings underscore the need for routine screening in pediatric outpatient and emergency settings, even in the absence of overt symptoms. Early detection and intervention are essential to prevent long-term developmental complications. Public health efforts should focus on nutritional education, iron supplementation, and comprehensive diagnostic evaluations to address this hidden burden.

We describe major changes in the nitrous oxide market fueling recreational use with a focus on prevalence, desired effects, adverse events, treatments, and public health interventions. Nitrous oxide is currently sold with easy and discreet access for children and young adults in formulations that attract them. Over 13 million people in the United States have ever used nitrous oxide recreationally and inhalants are mostly used by pre-teen to early 20-year-olds. Poison control center calls have increased 1,300% from 2003 to 2024 and deaths have risen 6-fold from 2010 to 2023. There are many acute adverse events ranging from frostbite to asphyxia. Adverse effects from chronic use are related to cobalt oxidation which impairs vitamin B12 functioning. The resulting dysfunction of methionine synthase induces methionine deficiency frequently causing paresthesia, ataxia, unsteady gait, and cognitive issues. Less commonly, paralysis, bladder and erectile dysfunction, macrocytic anemia and thromboembolism can occur. The European Federation of Clinical Chemistry and Laboratory Medicine guidance specifies diagnostic parameters, supportive care, and replenishment of vitamin B12 levels with intramuscular cyanocobalamin.