Iron overload

The normal iron content of the body is 3---4 g. It exists in hemoglobin, in iron-containing proteins different to hemoglobin, in iron bound to transferrin in plasma, and in the form of ferritin and hemosiderin. There is approximately 1 g of storage iron, mostly in liver, spleen, and bone marrow. Iron is lost in sweat, shed skin cells, and gastrointestinal loss at a rate of approximately 1 mg/day. Menstruating women lose an additional 0.5 mg/day to 1.0 mg/day of iron. Iron overload occurs when there is increased absorption of iron from a normal diet, or when the subject has received large doses of parenteral iron from multiple red cell transfusions or multiple infusions of intravenous iron

Deficiencia del factor XIII: reporte de un caso

La deficiencia del factor XIII de la cuagulación se describió por primera vez en 1960 y han sido publicados alrededor de 200 casos. Se caracteriza por la aparición de sangrados tardíos después de un traumatismo, se confirma con la cuantifi cación del factor XIII. Se informa de un paciente de 2 años de edad con deficiencia del factor XIII. Primer caso en nuestro hospital. Abstract: Congenital Factor XIII defi ciency was fi rst described in 1960 and about 200 cases have been published about it. It is characterized by the appearance of delayed bleeding after suffering a trauma. It is diagnosed by demonstrating an increase in the solubility of a clot in urea and is confi rmed by quantifi cation of factor XIII. We report a 2-year-old patient with factor XIII defi ciency. This is the fi rst case seen in our hospita

Use of complementary and alternative medicine by patients with hematological diseases: experience at a university hospital in northeast Mexico

Background: Complementary and alternative medicine includes a diverse group of medical and healthcare systems, practices and products not considered part of conventional medicine. Although there is information on unconventional practices in oncological diseases, specific data regarding the use of complementary and alternative medicine by hematology patients is scarce. Objective: The aim of this study is to document the prevalence of this modality of unconventional therapy in patients with malignant and benign hematological diseases, particularly children with acute lymphoblastic leukemia. Methods: An observational study of adult patients and guardians of children with malignant or benign hematological diseases was carried out by applying a structured questionnaire detailing the use and results of the most prevalent complementary and alternative medicine practices. Results: One hundred and twenty patients were included; 104 had malignant and 16 had benign hematological diseases. The use of complementary and alternative medicine was greater in benign diseases but the difference was not statistically significant (64.7% versus 41.7%; p-value = 0.08). Patients and guardians with high school or college educations used these alternative practices more than patients with less schooling (60.7% versus 54.7%; p-value = 0.032). The use of folk remedies was most prevalent followed by herbal preparations and spiritual healing. Sixty-four percent of patients that used these unconventional practices reported improvement in their symptoms and increased capacity to perform daily activities. Conclusion: No significant difference was documented between patients with malignant or benign hematological diseases using these alternative practices. The majority of complementary and alternative medicine users reported improvement of the disease or chemotherapy-related symptoms

Revisiting the complete blood count and clinical findings at diagnosis of childhood acute lymphoblastic leukemia: 10-year experience at a single center

Background: Heterogeneity regarding clinical and laboratory findings at diagnosis of acute lymphoblastic leukemia exists. The frequency of complete blood count abnormalities and its combinations, symptoms and physical findings were investigated in Hispanic children from an open population at the diagnosis of acute lymphoblastic leukemia. Methods: The patient charts and electronic records of under 16-year-old children diagnosed with acute lymphoblastic leukemia over 10 years at a regional hematology center of a university hospital were analyzed to retrieve data concerning the complete blood count at first evaluation. Type and distribution of abnormal data, frequency of symptoms and physical findings at presentation were documented. Results: The records of 203 children aged 0–15 years diagnosed with acute lymphoblastic leukemia from 2006 to 2016 were revisited. The results of the blood workup showed a median white blood cell count of 7120 × 109/L (range: 450–600,000 × 109/L), and a median hemoglobin concentration of 7.5 g/dL (range: 2.4–15.3 g/dL), whereas the median platelet count was 47,400 × 109/L (range: 4000–544,000 × 109/L). Leukocytosis and leukopenia were present in 36.6% and 36.1% of cases, respectively; anemia was diagnosed in 82.9% children. The order of frequency for major clinical symptoms was fatigue 62%, fever 60%, bone and joint pain 39%, hyporexia 33% and weight loss 21%, while main physical findings were hepatomegaly 78%, splenomegaly 63%, lymphadenopathy 57%, pallor 48%, and purpura 30%. Conclusion: Data differing from those classically expected at diagnosis of acute lymphoblastic leukemia in children were documented in a cohort of Hispanic children over one decade with a wide spectrum of complete blood count abnormalities, forms of presentation and frequency of physical findings. Keywords: Acute lymphoblastic leukemia, Complete blood count, Leukocytosis, Hepatomegaly, Splenomegal