Hepatitis C; frequency of thrombocytopenia patients treated with interferon

To determine the frequency of thrombocytopenia and its manifestations in patients with Chronic Hepatitis C Virus infection treated with interferon and ribavirin. In door and out door patients. Case series. Department of Medicine PNS Shifa Hospital Karachi, from 1[st] August 2006 to 1[st] July 2007. A Proforma was designed to enter the data of 100 patients fulfilling the inclusion criteria included in the study. Adult patients between the ages of 18 and 50 years of both gender were selected. Presence of anti HCV antibodies, elevated serum alanine transaminase, a positive polymerase chain reaction for hepatitis C ribonucleic acid and compensated liver disease were prerequisites. All patients were treated with combination of interferon and ribavirin. Blood counts, alanine transaminase and prothrombin time were done at baseline and at 2, 4 and 8 weeks intervals after starting interferon. A drop in platelets count below 100,000/cmm was taken as interferon induced thrombocytopenia. In our study thrombocytopenia occurred in 1 1% patients. Grade 3 thrombocytopenia [platelet counts < 50,000] occurred in 01 patient out of hundred in which there was severe gum bleeding and purpura so antiviral treatment was discontinued. Grade 2 thrombocytopenia [platelet counts between 50,000-75,000] was observed in 03% patients but there were no bleeding episodes, 50% reduction dose was done in these patients. Grade 1 thrombocytopenia [platelet counts between 75,000- 100,000] was noticed in 07% patients but there were no bleeding manifestations and dose reduction was not done. Combination therapy is well tolerated, however, it can cause life threatening complications like bleeding episodes in a few patients. Bleeding complications and manifestations as a result of thrombocytopenia are uncommon

Effect of hydroxyurea in children with sickle cell disease in Saudi Arabia

The objective of this study is to demonstrate the effects of hydroxyurea in children with sickle cell disease at Madina Maternity and Children's Hospital and to evaluate its short term safety. This was a retrospective review over two years period from 2004 - 2006. The inclusion criteria were: Children with sickle cell disease who had three or more attacks of painful crisis per year Children with sickle cell disease who had two or more episodes of acute chest syndrome per year. The dose range of Hydroxyurea was 15 - 30 mg/kg/day. The clinical episodes and the laboratory investigations were monitored monthly. The total patients included initially were 14; 4 patients were excluded because of poor compliance to treatment. 10 patients were eligible for the study. 6 were male and 4 were female. 8 patients were Saudi and 2 patients were non Saudis. The age range was 5 - 15 years. The attacks of painful crisis and acute chest syndrome were significantly reduced after Hydroxyurea treatment, also laboratory investigation showed significant increase in MCV and Hemoglobin F values after Hydroxyurea. We conclude that Hydroxyurea is effective in children with sickle cell disease and had no major short term adverse effect. However long terms follow up is required to evaluate long term adverse effect