Letrozole Effect on Final Height of Patients with Constitutional Delay of Growth and Puberty.

INTRODUCTION: The inhibitory effect of aromatase on predicted adult height and near final height has been studied in patients with constitutional delay of growth and puberty (CDGP). AIM: This is the first study aimed at verifying the letrozole (Lz) effect on final height of patients with CDGP. MATERIAL AND METHODS: In this study 8 patients with CDGP underwent treatment with Lz (2.5 mg/day) for a year, and 8 patients with CDGP, who did not receive Lz were followed -up to reaching final height. Height discrepancy was calculated by subtracting PAH from final height measurement. RESULTS: the final height for Lz and Control Groups were 171± 4.5 cm and 168.8±4.1Cm respectively. The final heights for Lz group were significantly (p=0.04) higher than the control group. Final height in comparison with PAH at the beginning of the study showed significant difference (p=0.022) in Lz group whereas the difference was not significant (p=0.8) in control group. For height discrepancy the measurements were +1.9 cm and +0.1 cm for Lz and control group respectively with significant difference (p=0.04). CONCLUSION: Our study, which is the first one in evaluating the impact of Lz on FH, illustrated that Lz treatment will ultimately lead to augmentation of FH in boys with CDGP.

Thyroid function test in diabetic ketoacidosis.

BACKGROUND: Metabolism of thyroid hormones is influenced by acute systemic illnesses including diabetic ketoacidosis. In these cases T3 level is usually decreased and this condition is called "low T3 syndrome" which is usually reversed by treating the under lying Disease. OBJECTIVES: thyroid function test analysis before and after diabetic ketoacidosis treatment. METHOD: In this cross sectional study thyroid function tests were analyzed in 16 diabetic ketoacidosis patients according to American diabetic association before and after insulin therapy. RESULT: mean triiodothyronine (T3) level before and after ketoacidosis treatment were 63.2±28.2ng/dl/and 78.5±26.2ng/dl (P. value 0.00) respectively and the mean thyroxin level (T4) before and after ketoacidosis were 3.18±1.4ng/dl and 5.17±2.4ng/dl (P. value=0.00) .Mean thyrotropin (TSH) level and triiodothyronine uptake (T3RU) before and after treatment showed no significant difference. CONCLUSION: Diabetic ketoacidosis is a sever systemic disease which along with reduction in T3 level, T4 level is also decreased and TSH level is normal. The changes in Thyroid hormones are reversed to normal after treatment of ketoacidosis so it is recommended in interpreting results of TFT in these patients we should consider these facts and thyroid function test should be repeated after treatment.

Effect of hepatic iron concentration and viral factors in chronic hepatitis C-infected patients with thalassemia major, treated with interferon and ribavirin.

BACKGROUND: Beta thalassemia major patients are vulnerable to transfusion-transmitted infection, especially hepatitis C virus (HCV), and iron overload. These comorbidities lead to cirrhosis and hepatocellular carcinoma in these patients. In order to prevent these complications, treatment of HCV infection and regular iron chelating seems to be necessary. The aim of this study was to evaluate the effect of hepatic iron concentration (HIC) and viral factors on the sustained virological response (SVR) in chronic HCV-infected patients, with beta thalassemia major being treated with interferon and ribavirin. MATERIALS AND METHODS: We enrolled 30 patients with thalassemia major and chronic HCV who were referred to the Hematology Clinic of Guilan University of Medical Sciences, between December 2002 and April 2006. HIC was measured by atomic absorption spectroscopy before treatment. The viral factors (viral load, genotype) and HIC were compared between those who achieved a SVR and nonresponders. RESULTS: Mean age of the 30 thalassemic patients, was 22.56 ± 4.28 years (14-30 years). Most patients were male (56.7%). Genotype 1a was seen in 24 (80%) cases. SVR was achieved in 15 patients (50%). There were no significant correlations between HIC (P = 1.00), viral load (P = 0.414), HCV genotype (P = 0.068), and SVR. No difference was observed in viral load (P = 0.669) and HIC (P = 0.654) between responders and nonresponders. CONCLUSION: HIC, HCV viral load, and HCV genotype were not correlated with virological response, and it seems that there is no need to postpone antiviral treatment for more vigorous iron chelating therapy.