Leukemia mimicking juvenile rheumatoid arthritis

Leukemia is the most common childhood cancer and acute lymphoblastic leukemia [ALL] represent about 75% of all cases. All patients who present with arthritis should have thorough investigations otherwise early diagnosis may be missed. This study describes four patients which presented with arthritis but later on they were diagnosed to be suffering from leukemia

Iodine supplementation in iodine-deficient hypothyroidism and sub-clinical hypothyroidism

To see the effect of iodine supplementation in iodine-deficient hypothyroidism and sub-clinical hypothyroidism. This is a cross sectional prospective study. Thyroid Clinic of Centre for Nuclear Medicine and Ultrasound, Khulna [CNMU, Khulna] run jointly by CNMU, Khulna and Medicine department of Khulna Medical College, Khulna for a period of 3 years from January 2001 to December 2003. Patients were selected from the Thyroid Clinic. Inclusion criteria were [1] presence of goitre, [2] normal or low T4 and high TSH level and [3] high two hours and 24 hours radioactive iodine uptake. Percentage of euthyroidism with iodine supplementation in iodine-deficient hypothyroidism and sub-clinical hypothyroidism. Changes in goitre grade, thyroid volume, serum T4 and TSH. Out of fifty-seven patients, 42 [73.7%] resumed euthyroidism with iodine supplementation alone and 15 [26.3%] needed thyroid replacement along with iodine supplementation. Regarding the goitre grade and thyroid volume, out of 6 goitre grade 1B, two [33.3%] remained goitre 1B, three [50%] had grade 1A and one [16.7%] had goitre grade 0 respectively and out of 51 goitre grade2, six [11.8%] remained grade 2, 32 [62.7%] had grade 1B and 13 [25.5%] had grade 1A goitre respectively with overall reduction of thyroid volume from 24.60 +/- 6.07 ml to 16.86 +/- 3.23 ml i.e., reduced by 31.5%. Regarding the biochemical status, mean T4 increased from 65.65 +/- 27.32 to 89.59 +/- 21.69 nmol/L and mean TSH decreased from 24.28 +/- 15.90 mIU/L to 3.59 +/- 1.24 mIU/L. Iodine supplementation in iodine-deficient hypothyroidism and sub-clinical hypothyroidism reverses abnormal thyroid function as well as reduces the goitre size