Essential thrombocythemia in a two-year-old child, responsive to hydroxyurea but not aspirin

Essential thrombocythemia [ET] is a myeloproliferative neoplasm that occurs mostly in patients above the age of 50 years. Its incidence in children is very rare, with around 100 cases reported in the literature. High-risk patients are defined by previous life threatening major thrombotic or severe hemorrhagic complication or age > 60. Those patients probably benefit from cytoreductive therapy. On the other hand, antiplatelet drugs are recommended for patients with low risk group. Although rare, ET should be considered in the differential diagnosis of persistent thrombocytosis in children, even at a very young age. A constellation of clinical, pathologic, and molecular testing are essential for diagnosis. Given the rarity of these cases, there is currently no consensus for treatment guidelines in children, especially in asymptomatic patients. We describe a case of a two year old girl who presented with unexplained, isolated thrombocytosis which persisted for eight years. Bone marrow biopsy demonstrated typical features of ET. Over the course of the disease, hydroxyurea, but not aspirin, showed better control of symptoms and lowered the platelets level

Patterns of cigarette smoking in Jordan: a study of greater Amman area

The patterns of smoking in Jordan were determined in a sample of 3489 subjects representing various strata of society. The sample included 2103 students and 1386 nonstudents. In the nonstudent population, 58.5% of the male and 27.4% of the female subjects were smokers; overall, 96% smoked manufactured cigarettes. Males smoked an average of 25 cigarettes per day, and females an average of 16 cigarettes per day. Males had smoked for an average of 16 years and females an average of 13.4 years. Smoking was highest among skilled and non-skilled workers and illiterate persons. Among students, smoking was higher in males at the university [52.9%] and college [54.3%] level; 16.7% of high school males smoked. In female students at the university or college level, 20.3% and 9.1% smoked, respectively, and 5.4% of high school females smoked. Manufactured cigarettes were used by 99.3% of the students. Male students smoked a mean of 18.5 cigarettes per day for an average of 6.4 years. Female students smoked a mean of 9.6 cigarettes per day for an average of 6.2 years. Based on our findings, it is apparent that a rigorous antismoking campaign is needed

Hemophilia in Jordan: a four-year prospective study

A four-year prospective study of inherited hemorrhagic syndromes in Jordan was done. A total of 100 patients from 41 families were found to have hemophilia A [67 patients], Christmas disease [32 patients] and factor XI deficiency [2 patients]. There were 10 deaths "14. 9%" related to hemophilia A, and four to Christmas disease [12. 9%]. Arthropathy was found in 38. 6% of patients with hemophilia A and 29. 6% of patients with Christmas disease. Of the hemophilia A, 34 patients [50.7%] were severe. Nineteen [28.4%] were moderate and 14 [20.9%] were mild. Of the Christmas disease 13 patients [41.9%] were severe, 16 patients [51.6%] were moderate and two patients [6.4%] were mild. The two patients with factor XI deficiency were mild. Family history was negative in 23% of patients with hemophilia A and in 16% of patients with Christmas disease. No factor inhibitors were detected in any patient. It is concluded that hemophilia A is most frequent type of hemophilia seen in Jordan. High proportion of hemophiliacs were severe and a significant number of them had fatal hemorrhage. Hemophilic arthropathy was common. No family history of bleeding was found in a significant number of patients