Serial tumour markers serum carcinoembryonic antigen and cancer antigen 15-3 assays in detecting symptomatic metastasis in breast cancer patients

The value of serum tumour markers in the prognosis of patients with breast cancer is controversial. This prospective study in Yazd, Islamic Republic of Iran, assessed the value of the tumour markers carcinoembryonic antigen [CEA] and cancer antigen [CA] 15-3 in 159 patients with primary breast cancer. CEA and CA15-3 assays [mean 14 per patient] were performed at diagnosis, end of surgery and chemotherapy and every 3 months in the first 2 years and every 6 months in second 2 years of the follow-up period. During follow-up, 33 patients [20.8%] presented symptomatic metastasis. A significant relationship was seen between metastasis status and positive CEA and CA15-3 levels. The sensitivity and specificity were 66.7% and 98.4% for CEA respectively and 84.8% and 91.3% for CA15-3 respectively. Optimum cut-offs were 4.95 ng/mL and 30.5 U/mL for CEA and CA15-3 respectively

Antiphospholipid antibodies in neoplastic patients

Anti-phospholipid syndrome [APS] is an autoimmune systemic disease characterized by the persistent presence of anti-phospholipid antibodies [APA] and the occurrence of thrombotic events. Nowadays, the association between specific antibodies for anionic phospholipids with thrombotic events and other main clinical manifestations is well-recognized as "antiphospholipid syndrome". The present study was done to evaluate the frequency of antiphospholipid antibodies in neoplastic patients. One hundred and eighty patients were included in this cross sectional study. Their suspected neoplasm disorders were confirmed by pathology or flowcytometry. History taking and clinical examination were done for patients to detect all symptomatic clinical thrombotic events. Antiphospholipid antibodies were tested for all patients. The study was concluded with 156 study samples. Thirty three patients [21.2%] had antiphospholipid antibodies. There was no significant difference on antiphospholipid antibodies frequency between two genders. APA frequency showed no significant difference between solid or non-solid tumors. The rate of thrombosis was significantly higher in neoplastic patients with antiphospholipid antibodies. Frequency of antiphospholipid antibodies was significantly higher in neoplastic patients. Antiphospholipid antibodies were one of the multifactorial accelerating factors for thrombotic events in neoplastic patients

[ case of resistant megaloblastic anemia responding to thiamine]

Thiamine responsive megaloblastic anemia [TRMA], also known as Roger syndrome is an autosomal recessive disorder resulting from the deficiency of thiamine [Vitamin B1] transporter protein. This is the report of a 3-year follow up of a female child who presented in 2000 at the age of 11 with severe anemia, congenital deafness and diabetes mellitus. In our follow-up period we prescribed 100-mg thiamine tablet daily and after that there was a rise in her hemoglobin level to normal. Her hyperglycemia was controlled during the early phase of treatment. It recurred several months after start of treatment, but needed lower doses of insulin for control. Hearing loss did not respond to thiamine. Presently, the patient is apparently in good condition with normal hemoglobin level

[ case report of inflammatory myopathy and sideroblastic anemia]

Mitochondrial myopathy, lactic acidosis, and siderobastic anemia [MLA SA] syndrome is one of the newly reported mitochondrial diseases, seven cases of which have been reported. We report a child with inflammatory myopathy, sideroblastic anemia and lactic acidosis .The patient is a 8.5 year old boy with normal cognitive function suffering from chronic progressive weakness in lower extremities, inability to walk since four months and pallor. In paraclinical evaluation, sideroblastic anemia, mild lactic acidosis and elevated muscle enzymes were seen. Inflammatory myopathy [myositis] in muscle biopsy was detected as well .The patient was administered oral prednisolone, folic acid, B[6] and underwent regular physiotherapy. He ambulated after four months and resumed education and schooling