Immunophenotypic diagnosis of acute lymphoblastic leukemia using flow cytometry; experience at King Hussein Medical Center

To identify the importance of flow cytometry [FCM] in diagnosis and subclassifying acute lymphoblastic leukemia, and to highlight its capability to detect antigen aberration. The Results of flow cytometry for 165 patients, between January 2006 and December 2011 who were diagnosed with acute lymphoblastic leukemia [ALL] were retrospectively reviewed with respect to age and gender distribution and immunophenotypic findings. 63% of patients were children [104 out of 165 patients] with age less than fourteen years old. 114 patients were male while 51 patients were female with male to female ratio 2.2: 1. Precursor-B- acute lymphoblastic leukemia represents eighty percent [132 patients] of cases, of 106 patients [87.6%] were [CD10/CD19] positive, 125 patients [94.7%] were positive for cytoplasmic CD79a, 126/129 [97.6%] were positive for HLA-DR, and 15 patients [11.36%] were CD10 negative. Aberrant myeloid antigen expression was noted; CD33 and CD13 were positive in 15/113 [13.3%] and 2/108 [1.85%] respectively. On the other hand precursor-T- acute lymphoblastic leukemias were found in thirty three patients, 84.4% of them were Anti-TdT positive, and all were negative for B-cell markers. Myeloid antigen expression results were as follows; 1/29 [3.4%] and 2/29 [6.9%] positive for CD33 and CD 13 respectively. Flow cytometry is a golden tool in diagnosis and identifying ALL subtypes. Precursor-B- acute lymphoblastic leukemia represents most of ALL cases with minority of cases are CDlOnegative. Aberrant myeloid antigen expression would not change the diagnosis of ALL in either B- or T- subtypes. Further clinical correlation is needed to figure out aberrant markers prognostic implications

Hemoptysis in children: single center experience

To review the causes of hemoptysis in children presenting to the respiratory department at King Hussein Medical Center. A retrospective chart review of all children who presented with hemoptysis was conducted from 1[st] April 2002 to 1[st] April 2012. Diagnosis of pulmonary hemorrhage was based on radiological and bronchoscopic findings. Demographic data, age at presentation, number of attacks, and presence of another diagnosis were recorded. Radiological and laboratory data were included as well. A total of 60 children with 68 episodes of hemoptysis were reviewed. Diffuse pulmonary hemorrhage was seen in five patients, three of them had idiopathic pulmonary hemorrhage, one had celiac disease and another had Wagener disease. Of the 55 patients with localized pulmonary hemorrhage the most common cause was cystic fibrosis [30%] and congenital heart disease [27%], followed by pulmonary arteriovenous malformation [8%], ruptured hydatid cysts [7.3%] and retained foreign body [5.4%]. Fifty one out of the 55 [92.7%] with localized hemorrhage had localized patch on the chest x-ray; 40% had previous x-ray within the previous two years showing the same radiological patch at the time of hemoptysis episodes. Massive hemoptysis was found in three patients. Diagnostic flexible bronchoscopy was done in all patients within one week of the episode of hemoptysis. High resolution chest CT-scan was done for all patients with the diffuse type. Dynamic chest CT-scan was done in 50% of patients with localized hemorrhage. Embolization was done in five patients with AV malformation and two patients with cystic fibrosis. Surgical lobectomy was done in those with sequestration, hydatic cyst and one patient with foreign body and another one with localised bronchiectasis. Hemoptysis is not uncommon in children. As an entity it should always be thoroughly investigated. Etiology differs according to age. Idiopathic pulmonary hemorrhage still constitutes a major group

Spectrum of pediatric systemic lupus erythematosus at Queen Rania Al-Abdullah hospital for children

The aim of this study is to describe clinical signs, symptoms, laboratory characteristics, and medication used in pediatric Systemic lupus Erythematosus, both at presentation and during the course of the disease in Jordanian children at Queen Rania Al-Abdulla Hospital for children. This is a retrospective descriptive study that included patients managed over a period of 11 years, from January 2000 to December 2010. The charts of 25 patients from the pediatric Rheumatology unit at Queen Rania Al-Abdulla Hospital for children, who met four or more of the revised American College of Rheumatology classification criteria for Systemic lupus Erythematosus were reviewed. There were 22 females and three males with F: M ratio of 7.3:1. The mean age at diagnosis was 10.9 years [range 7-14 years] with only five patients [20%] below the age of 10 years. The mean time from the start of illness to diagnosis was 8.6 month [range 1-36 months]. At presentation cutaneous manifestations were found in 17 [68%] patients, 60% of patients had arthritis. Serositis and neurological manifestations were seen in 24% of cases. Hematological dysfunctions were present in 48%. Renal involvement was found in 40% of cases. Kidney biopsy was done for seven patients with renal manifestations. Three had class IV, two class III and two class I World Health Organization nephritis stage classification. No organ damage was found in 18 patients with Systemic lupus Erythematosus, while three patients developed end stage renal disease, two had neuropsychiatric disease [one cerebrovascular accident and one with chorea], one had cataract and one had peripheral vascular thrombosis, and gangrene of the hands and feet. Antinuclear Antibodies was positive in all patients. To the best of our knowledge this is the first review of Systemic lupus Erythematosus in pediatric population in Jordan. Comparison of our cohort with other reports from our region and other parts of the world confirmed that more or less the pediatric Systemic lupus Erythematosus behavior in presentation and laboratory findings is comparable

Lead poisoning due to herbal remedy in an infant: a case report

Home remedies and medicines can help sick people. However, some of these home remedies contain lead and have adverse effects. Infants and children aged nine months through five years are at greatest risk from lead poisoning. This is a case report of lead toxicity due to the use of Jordanian traditional herbal medicine in ten months old male infant who had laryngiotrachiomalacia