Hematological Parameters in Native Highlanders of Ladakh Aged 4-19 Years

Summary and Review of the Abstracts on Hemostasis/Thrombosis Presented at Haematocon 2018, Kochi

The hemostatic pathways involve a complex interplay of a vast array of inherited and acquired factors. Derangements of these pathways lead to several disorders that are complex and challenging not just for laboratory and clinical hematologists but also of concern to public health officials and policy makers. The past decade has seen an increased focus on research in this area with several recent meetings focusing on the diagnosis and management of persons afflicted with these disorders. Haematocon 2018 is the national conference of the Indian Society of Haematology and Blood Transfusion, and papers presented at this year's event offered a glimpse of the contemporary research efforts in India. This mini-review summarizes and places in perspective, salient results from this meeting. The papers are divided into broad subsections of hemophilia, rare clotting factor deficiencies, platelet function defects, macrothrombocytopenia syndromes, thromboelastography, inherited and acquired prothrombotic states, and finally a miscellaneous section. Relevant recent Indian publications on the theme are also discussed.

Erythropoietin and ferritin response in native highlanders aged 4-19 years from the Leh-Ladakh region of India

The pivotal role of erythropoietin (EPO) in hypoxic adaptation has led to various studies assessing the EPO and ferritin response in native highlanders from Andes and Tibet. We assessed the relationship between EPO, haemoglobin and ferritin in 335 native highlanders (172 boys and 163 girls, aged 4 to 19 years) from Leh-Ladakh, India, who had no history of travel to lowland areas. Complete blood counts, serum EPO and ferritin levels were measured. We stratified study subjects based on age, gender, pubertal status and analysed the EPO and ferritin levels between the stratified groups respectively. The mean EPO level in boys was lower than girls. The mean ferritin level in boys was significantly higher (P = 0·013) than in girls. There was no significant variation in the EPO and ferritin levels amongst the various age groups in our study. Near normal EPO levels since childhood with a negative correlation with haemoglobin is suggestive of a robust adaptive mechanism to high altitude from the early years of life. Low ferritin levels are indicative of decreased iron stores in these native highlanders.