[Effect of hepatitis C and B infections on anemia in hemodialysis patients]

Hepatitis C [HCV] and B [HBV] infections are commonly seen in dialysis patients, but them long-term deleterious effects in these patients are unknown. We evaluated the effect of HCV and HBV infections on anemia in our hemodialysis population. A total of 90 chronic hemodialysis patients with anemia at kamkar and Hazrat Valiasr hemodialysis centers were included for the period 3 months, in 2008. Data classified according to the hepatitis-free, chronic hepatitis B and C groups. Nineteen HCV- positive and eleven HBV-positive patients were included for comparison analysis with 60 control patients. Erythropoietin was administered for 3 month. They were followed for 3 months and their hemoglobin and hematocrit were measured before administration of erythropoietin and the end of third month. For statistical analysis, T-test was employed. The mean rise of hemoglobin and hematocrit in hepatitis-free, HCV and HBV groups were 1.50 +/- 1.45 g/dL and 3.88% +/- 5.01%, 2.56 +/- 1.40 g/dL and 7.56% +/- 3.75%, 1.86 +/- 1.17 g/dL and 5.73% +/- 4.11%, respectively. The mean rise of hemoglobin and hematocrit in HCV group was significantly higher than hepatitis-free group and t test showed a significant statistical correlation. However the mean rise of hemoglobin and hematocrit in HBV group was higher than hepatitis-free group but t test didn't show a significant statistical correlation. We found that hepatitis C virus infection was associated with significant elevation in mean of hemoglobin and hematocrit than hepatitis-free group

[Case report: ampullary adenocarcinoma primary presentation by fever, chills and anemia]

Ampullary tumor is a rare cancer. These patients most commonly present with obstructive jaundice but sometimes disease appear with uncommon signs. This report is an example of such cases. Our case is a 53 year old man who presented with recurrent fever and chills and iron deficiency anemia and has been misdiagnosed for two years. The proper diagnosis occurred when the patient showed abnormal liver function tests and more evaluation with endoscopic ultrasonography detected a mass in distal part of common bile duct then pathology confirmed our diagnosis. Despites that jaundice is most prevalent symptom in patients with an ampullary tumor but sometimes disease appear with rare signs such as iron deficiency anemia