Effect of microcytic hypochromic anemia and parasitic infestations on stature in adolescents

Microcytic hypochromic anemia is the commonest form of iron deficiency anemia in adolescents. The occurrence of this type of anemia among adolescents is around 27% in developing countries. Clinical management should be based on a full knowledge of the prevalence of this disease in the age group mentioned. The present study reported the distribution of this type of anemia across age, anthropometric guides, and parasitic infestations in a sample of 300 adolescents attending various schools in Giza region, Egypt. Red blood cell size and iron concentration were assessed by mean corpuscular volume, hemoglobin levels, serum ferritin and total iron binding capacity from a venous blood sample. The adolescent was considered to have the microcytic form of anemia when their mean corpuscular volume was below 80 femtoliters [fL]. An adolescent with hypochromic anemia was defined as any subject with hemoglobin [Hb] below the WHO cutoff for age and sex: 12.0 g/dl for girls and for boys aged 12.5-14.99 years and 13.0 g/dl for boys aged > 15 years. Also, hypochromic anemia included every subject having either serum iron < 50 microg/dL, or a serum total iron binding capacity [TIBC]> 400 microg/dL. The incidence of microcytic hypochromic anemia in this study was 53%. There were highly statistically significant differences between anemic and non-anemic groups as regards age and height [P 0.05]. Anemic adolescents also had significantly lower values for weight [P < 0.01], BMI [P < 0.01] and hemoglobin concentration [P<0.01] compared to non-anemic adolescents. Also, microcytic hypochromic anemia was more common in adolescents who did not have lunch regularly. Adolescents with current parasitic infestations showed a higher frequency of anemia compared to those who did not. There were no statistically significant differences between adolescents with parasitic infestation and adolescents without parasitic infestation as regards age, weight, height and BMI [P >0.05]. Signs of pallor were more common in adolescents suffering from microcytic hypochromic anemia. Subjects with a history of chronic conditions such as cardiac diseases, renal failure or cancer had a significantly higher incidence of anemia than adolescents who did not. It was concluded that the anemic group of adolescents enrolled in the study were susceptible to growth retardation. This type of anemia is more common in adolescents who do not have lunch, have a chronic disease or a parasitic infestation

Some bone markers in children with type I diabetes mellitus

Diabetes mellitus and osteoporosis are chronic disease with great socioeconomic consequences, mainly due to the late complications and consequences disabilities. Type I diabetes mellitus [DM 1] has been related to a reduced bone mineral density [BMD] in childhood. In order to evaluate alternation in the one metabolism in type I diabetes we measured a urine osteocalsic marker for bone resorption; deoxypyridinoline [DPD] as well as, the circulating osteoblastic markers; serum osteocalcin and osteoprotegerin [OPG]. Further more, we evaluated their relation to the disease duration and severity. The influenced of sex and age on bone health were also assessed. Cross-sectional case-control study was conducted on forty children with DMI and twenty control subjects matched for age and sex with similar socioeconomic and cultural status. Serum levels of osteocalcin and osteoprotegerin were measured, also urinary levels of deoxypyridinoline [DPD] was measured. Children with DMI showed lower serum levels of osteoclacin and OPG and a rise in urinary level of [DPD] in comparison with control subjects. The osteoblast function significantly decreased in diabetic patients, which one best is characterized as a maturation defect. Altered bone mineral acquisition in children with DMI may limit peak bone mass acquisition and increase the risk of osteoporosis in later life. So the clinical management of diabetic osteopenia would become important for the reservation of quality of life in diabetic patients

Assessment of anti-neutrophil cytoplasmic antibodies and selected serum pro-inflammatory cytokines in systemic lupus erythematosus: prevalence and clinical significance

This study was designed to elucidate the prevalence and clinical implications of various cytokines such as TNF-alpha, IL-6 and IL-2 in presence or absence of anti-neutrophil cytoplasmic auto- antibodies [ANCAs] in children with SLE. The present study was conducted on 29 children with SLE and 20 healthy children of matched age and sex as controls. Patients were selected from the Rheumatology Clinic, Cairo University Pediatric Hospital. Serum levels of ANCAs, ANA, anti-ds-DNA were assayed by an indirect immuno-fluorescence technique [IIP]. Serum levels of cytokines [TNF-alpha, IL-6 and IL-2] were assayed by ELISA technique. The anti-neutrophil cytoplasmic auto- antibodies were present in 55% of children with SLE. Furthermore, serum levels of TNF-alpha, IL-6 were increased and IL-2 level was decreased in SLE children positive for ANCAs. In addition, SLE complications were increased in those children. These results demonstrate that ANCAs may be detectable in SLE sera and their presence could be associated with particular clinical manifestations