Acute liver failure secondary to chronic lymphocytic leukemia

Chronic lymphocytic leukemia is an indolent malignancy of lymphocytes commonly seen in elderly. Dissemination of malignancy is a rare cause of acute liver failure and has rarely been reported. Here we describe the case of a sixty five year old male presenting with acute liver failure. He is a diabetic with no known history of seropositive hepatitis, drug intake or any addictions. Bone marrow and liver biopsy suggestive of chronic lymphocytic leukemia. He eventually succumbed to his illness.

Brucellosis - A Major Differential For Juvenile Idiopathic Arthritis

Brucellosis is a Gram-negative, aerobic zoonotic infection acquired by Brucella species and transmitted from animals to humans through the ingestion of infected food products, direct contact with an infected animal, or inhalation of aerosols. Usually, the disease remains undiagnosed due to lack of awareness and inadequate reporting and is a challenging health problem in tropical countries. We report a case of 16-year-old male presenting to us with chronic inflammatory symmetric polyarthritis misdiagnosed as juvenile idiopathic arthritis but later found to be suffering from brucellosis on reevaluation. Through this case report, we would like to highlight the possibility and advantage of the high degree of suspicion for an infectious etiology responsible for arthritis in the background of autoimmunity and would also like to emphasize on the possibility of Brucella inducing a false-positive response for young patients presenting with arthritis.

Study of impact of subclinical hypothyroidism on iron status and hematological profile

Background: Thyroid hormones play an important physiological role to maintain balance of metabolism of entire human body. Erythrocyte abnormalities are frequently associated with thyroid disorder. Subclinical hypothyroidism, often a hidden entity, is associated with iron-deficiency anemia along with other hematological disorders. Thyroid hormones have a crucial role in metabolism and proliferation of blood cells. Thyroid dysfunction has profound effects on blood cells such as anemia, alters RBC indices including MCV, MCHC as well as iron stores. Present study was carried out to investigate and explore subclinical hypothyroid patients, to know the effect of subclinical hypothyroidism on hematological parameters and body iron store.Methods: This retrospective study included 200 newly diagnosed, untreated subclinical hypothyroid, and 200 healthy euthyroid individuals. The hematological parameters and thyroid profile of the subjects were assessed by the mean, standard deviation (SD). Student抯 t-test was used to report our results, with p-value <0.05 considered as statistically significant.Results: In this study we have compared hemoglobin level, red cell indices, serum Ferritin among study group and euthyroid healthy group and found that mean hemoglobin, serum ferritin and RBC indices were significantly depleted in subclinical hypothyroid patient in comparison to euthyroid group. 37 of total 200 [18.22%] newly diagnosed subclinical hypothyroid patients was suffering from Iron deficiency anemia with significant number of patients having hemoglobin level less than 10 gm%.Conclusions: Iron deficiency anemia is quite common in Subclinical hypothyroidism and is often associated with depleted body iron store and complication of getting converted into primary hypothyroidism. As there is no significant clinical manifestation of SCH at earlier stages with anemia it is advisable to routinely investigate it for early detection allowing its early management.