{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T07:41:32Z","timestamp":1775634092833,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,6,2]],"date-time":"2017-06-02T00:00:00Z","timestamp":1496361600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Clinical Apheresis"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Daily laboratory testing (DLT) is an important cause of iatrogenic anemia. Therapeutic plasma exchanges (TPE) represent another source of blood loss. This study investigated the contributions of DLT and TPE to changes in hemoglobin of inpatients with myasthenia gravis (MG) exacerbation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study design and methods<\/jats:title><jats:p>All admissions for MG that included TPE between 2008 and 2012 were identified. The DLT\u2010 and TPE\u2010related blood losses per patient were estimated based on the number of laboratory tests and TPE procedures. The primary endpoint was the difference between the discharge hemoglobin (Hgb) and the admission Hgb (\u0394Hgb). Univariate and multivariable analyses were used to identify clinical predictors of \u0394Hgb.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 46 patients (52% male, average age of 58 years) had 90 hospitalizations and underwent 424 TPEs during the study\u2010period. Their average length of stay (LOS) was 10.4 days, and total DLT and TPE\u2010related blood losses were 107 and 94 mL, respectively. While 41% of patients were anemic on admission, 90% were anemic at discharge. The average \u0394Hgb was \u22122.2 g\/dL. The patient's blood volume, renal function, admission number, LOS, and combined blood losses correlated with \u0394Hgb by linear regression, but only DLT was an independent predictor of \u0394Hgb in the multivariable analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Approximately 50% of MG patients admitted for TPE developed hospital\u2010acquired anemia, which was directly correlated with the volume of blood collected for laboratory tests. A variety of strategies to reduce DLT could circumvent this iatrogenic complication.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jca.21554","type":"journal-article","created":{"date-parts":[[2017,6,2]],"date-time":"2017-06-02T08:56:41Z","timestamp":1496393801000},"page":"14-20","source":"Crossref","is-referenced-by-count":10,"title":["Hospital\u2010acquired anemia due to diagnostic and therapy\u2010related blood loss in inpatients with myasthenia gravis receiving therapeutic plasma exchange"],"prefix":"10.1002","volume":"33","author":[{"given":"Steven A.","family":"Mann","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Indiana University School of Medicine Indianapolis Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"III","given":"Lance A.","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Pathology Division of Laboratory Medicine, University of Alabama at Birmingham Birmingham Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marisa B.","family":"Marques","sequence":"additional","affiliation":[{"name":"Department of Pathology Division of Laboratory Medicine, University of Alabama at Birmingham Birmingham Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4168-3859","authenticated-orcid":false,"given":"Huy P.","family":"Pham","sequence":"additional","affiliation":[{"name":"Department of Pathology Division of Laboratory Medicine, University of Alabama at Birmingham Birmingham Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,6,2]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhm.2061"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ehmc.2013.10.002"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.12886"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(71)92483-4"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.12642"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1036-7314(00)70615-1"},{"key":"e_1_2_6_8_1","first-page":"28","article-title":"Complications of critical care: lab testing and iatrogenic anemia","volume":"33","author":"Woodhouse S.","year":"2001","journal-title":"MLO Med Lab Obs."},{"key":"e_1_2_6_9_1","first-page":"84","article-title":"Anemia in critical illness","volume":"113","author":"Eckardt KU.","year":"2001","journal-title":"Wien Klin Wochenschr."},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1497.2005.0094.x"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc5054"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3148.2009.00960.x"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2011.361"},{"issue":"7","key":"e_1_2_6_14_1","first-page":"S271","article-title":"Approximate iatrogenic blood loss in medical intensive care patients and the causes of anemia","volume":"93","author":"Tosiri P","year":"2010","journal-title":"J Med Assoc Thai."},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2010.12.003"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.compbiomed.2012.11.008"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.12831"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.12833"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccc.2007.07.005"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPOWHOIZBZ3FRW"},{"key":"e_1_2_6_21_1","first-page":"318","article-title":"Managing utilization of new diagnostic tests","volume":"17","author":"Lewandrowski K.","year":"2003","journal-title":"Clin Leadersh Manag Rev."},{"key":"e_1_2_6_22_1","unstructured":"ABIM Foundation.Choosing Wisely Initiative.2016.http:\/\/www.choosingwisely.org\/about-us. 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