Correlation between serum ferritin level and histopathological disease severity in non-alcoholic fatty liver disease

Background: Non-alcoholic fatty liver disease [NAFLD] is one of the most common causes of chronic liver disease worldwide. Recently several parameters, such as serum ferritin, have emerged as possible predictors for the severity of NAFLD and insulin sensitivity. We aimed to investigate the value of serum ferritin level as a useful biomarker for the prediction of histopathological disease severity in non-alcoholic steatohepatitis [NASH], the necro-inflammatory form of NAFLD

Methods: This was a prospective cross sectional study in which demographic, clinical, histological, laboratory, and anthropometric data of 30 adult patients with biopsy-proven NAFLD/NASH were analyzed

Results: In our patients population with mean age of 37.9 years and mean BMI of 26.5, statistical analysis did not show a significant difference between the three grades of steatosis in the mean ferritin levels [p=0.559]. It was also observed that ferritin level did not have a significant correlation with the stage of fibrosis [p =0.228]. The mean transferrin saturation did not show significant difference in different stages and grades of NASH [p =0.260 and 0.944, respectively], either

Conclusion: Serum ferritin level may not be useful as a single marker for the prediction of histopathological severity of disease in young patients with NASH who are not morbidly obese

PAX-5 positive anaplastic large cell lymphoma presenting by dysphagia; a case report

Anaplastic large cell lymphoma [ALCL] is a distinct pathologic entity with characteristic morphologic, im-munophenotypic and cytogenetic features. Obstructive symptoms are rare presentation of ALCL. We report a 16-year-old boy who initially presented with dysphagia. Upper gastrointestinal endoscopy revealed severe stenosis with an infiltrative process starting from 24 cm of incisors in lower esophagus Esophageal mucosal biopsy demonstrated lymphomatous involvement that ancillary tests confirmed the diagnosis of ALCL, ALK [kinase-positive], and PAX5 positive. The patient responded to CHOP-based chemotherapy. This case illustrated an unusual presentation of primary Non Hodgkin lymphoma of esophagus

Common polymorphisms of ATP7B gene as a good marker in linkage analysis in Wilson disease patients from Southern Iran

Background: Wilson disease [WD] is caused by numerous pathogenic mutations of the ATP7B gene. There are several mutation screening methods that can be used for the diagnosis and carrier detection of WD, however such methods are costly and time-consuming. Therefore, other diagnostic methods should be used for urgent situations such as prenatal diagnosis

Objective: To report common polymorphisms of ATP7B gene in WD patients from southern Iran to be use in linkage analysis in the WD affected families

Material and methods: Genomic DNA was extracted from 30 patients and PCR was carried out for ATP7B gene. DHPLC was then performed and PCR products with abnormal peak profiles were subjected to direct DNA sequencing

Result: Several patients showed abnormal peak profiles in DHPLC analysis and subsequent sequencing results demonstrated that some polymorphisms were more common in southern Iran. Those were c.1216T>G [exon 2], c.1366C>G [exon 3], c.3419 T>C [exon 16], c.3903 + 6C>T [intron 18] and c.4021+50G>C [intron 19]

Conclusion: These common polymorphisms can be used by linkage analysis for the prenatal diagnosis and carrier detection in affected families with Wilson disease

Hidden Source for Upper Gastrointestinal Bleeding

A 50-year-old lady presented with bloody vomiting and melena since four days prior to admission. Her medical history was significant only for hypertension which was controlled by a 5 mg daily dose of amlodipine. She occasionally took NSAIDs. On admission, the physical exam revealed only mild tachycardia and pallor. Hemoglobin was 9.7 g/dl, which subsequently declined to 7.9 g/dl. The first upper gastrointestinal [GI] endoscopy was remarkable for a paraesophageal hiatal hernia, with no site of bleeding detected. The second upper GI endoscopy did not find any source for bleeding. A third endoscopic examination revealed a new finding [Figures A and B]

Establishment of a population-based registry of inflammatory bowel diseases in Fars province, Iran

Inflammatory bowel diseases [IBD] are debilitating diseases that lead to a variety of problems in a patient's daily life and are a huge burden for the health care system. Since this group of diseases are multifactorial and complex, long-term longitudinal studies are clearly needed to understand them better. A population- based registry [IBD-FaR] has been established in Fars, a southern Iranian province, with the intent to create a reliable data source. This registry will be of considerable help in future planning of health care resources necessary to deal with IBD and to enable investigators to test their theories on the origin and/or treatment of IBD. This registry is managed by both the Gastroenterohepatology Research Center and Health Policy Research Center at Shiraz University of Medical Sciences. A governing committee is responsible for decisions regarding budget allocations and use of data. The designed questionnaire includes a consent form, basic history data, risk factors, related procedures, medical therapy, and follow-up data. The establishment process has two parallel phases: in the first phase, data is collected from numerous sources, including annual hospital discharge data, referral from university affiliated physicians and private practices, pathologic reports, death certificates, self-referral, and insurance system data. In the interview, the questionnaire is completed and blood samples are taken. The gathered data are entered in a custom-designed, computerized data base. In the second phase, annual follow up interviews will be conducted. New IBD patients are also being registered. This phase will continue indefinitely, in order to include new incident cases. Briefly, from May 2011 until December 2011, there were 188 patients [94 [50%] females and 94 [50%] males] diagnosed with IBD who were registered in IBD-FaR. Patients' age range was between 15 and 80 years. A total of 164 [87.2%] patients out of 188 were registered as diagnosed with ulcerative colitis [UC] and 23 [12.2%] were registered as having Crohn's disease [CD]. Most patients 164 [87.2%] had negative family histories of IBD. By retrospective and prospective data collection methods, this central database of IBD cases can determine the incidence, prevalence, and demographic characters of IBD in a defined population. It can facilitate future research to identify etiology, disease process, new treatment options, factors affecting prognosis, recurrences, optimal health care, morbidity and mortality of IBD, and at last but not least, provide educational and social support for patients by educational materials and organizing nongovermental organizations [NGOs]