Initial presentation of acute lymphoblastic leukemia with osteoporosis and multiple spontaneous bone fractures

Acute lymphoblastic leukemia [ALL] is the most common childhood malignancy. Skeletal abnormalities have been described in association with ALL including osteoprosis and bone fractures. Different factors including the disease itself or soluble products of malignant cells and treatment agents like cytotoxic drugs, methotroxate, corticosteroids and radiotherapy may be responsible for defective bone homeostasis in these patients. Orthopedic conditions and pain may be the first manifestation of acute leukemia and it is important for physicians to recognize the skeletal manifestation of acute childhood leukemia because of a delay in diagnosis has adverse effect on survival. We present a child with ALL that refer with multi bone fractures as a first manifestation of the disease

Anemia and iron deficiency in adolescent school girls in Kavar urban area, southern Iran

Anemia is one of the most common public health problems especially in developing countries. We investigated the prevalence of anemia, iron deficiency anemia and related risk factors in adolescent school girls in Kavar urban area in southern Iran. A total of 363 adolescent school girls were evaluated by a cross sectional study. Socioeconomic demographic and related risk factors were obtained by a questionnaire. Hematological parameters and serum iron indices were measured. There were 21 cases of anemia [5.8%], 31 [8.5%] iron deficiency and 6 [1.7%] iron deficiency anemia. Most of anemic girls [85.7%] had mild anemia. MCV, TIBC, age, and BMI had statistically significant relationship with hemoglobin. Only parasites infestation in the last three months had a 6.83 times more risk of anemia than those without this history [95% CI, 1.66-28.11]. The prevalence of anemia and iron deficiency anemia in this study were substantially less than what reported in many other regions of Iran as well as other developing countries. It seems that related implemented strategies in the recent years have been successful. More especial attention to prevention of parasite infestation should be considered in this area

prevalence and clinical significance of anticardiolipin antibody in acute myeloblastic leukemia

Antiphospholipid antibodies, including lupus anticoagulants and anticardiolipin [aCL] antibodies are associated with a wide variety of disorders including malignancies. The aim of this study was to investigate the prevalence and prognostic significance of aCL antibodies in Iranian patients with acute myeloblastic leukemia [AML]. Forty-one patients with AML [27 men and 14 women, mean age 34.9 +/- 16.7 years] were included in this study. aCL IgG and aCL IgM antibodies were evaluated in patients before induction chemotherapy. All patients were followed up for chemotherapy response. Antibodies [IgG, IgM or both] were found in 26 of 41 patients [63.4%], of whom 19 [46.3%] had a low titer, 6 [14.6%] a moderate titer and 1 [2.4%] a high antibody titer. No correlation was found between complete remission or relapse and aCL antibodies positivity. aCL antibody titers are slightly to moderately elevated in patients with hematologic malignancies, and these antibodies do not correlate with disease prognosis

[Evaluation of discrimination indices validity for screening of betas-thalassemia trait]

Beta-thalassemia trait [beta-TT] and iron deficiency anemia [IDA] are the most common forms of microcytic anemia. Screening of beta-thalassemia trait is important for medical counseling before marriage and preventing beta-thalassemia major birth results. The most common problem in screening beta-TT is differentiating it from IDA. The aim of this study was to define the sensitivity, specificity, and predictive values of some discrimination indices for screening of beta-TT in a sample of such patients. A total of 82 patients with microcytic anemia [MCV< 80 fl] were selected from Namazi Hospital, Shiraz, Iran, and 9 discrimination indices were calculated for them. The patients were divided intotwo groups: 42 patients with beta-TT and 40 patients with IDA. The sensitivity, specificity, positive and negative predictive values and Youden,s index of each discrimination index were calculated for screening beta-TT. None of the discrimination indices showed 100% of sensitivity and specificity. But the Shin and Lal index, RDW index and RBC count showed the highest and valuable value for screening beta-TT. Some discrimination indices like Shin and Lal index, RDW index and RBC index are valuable indices in screening beta-TT