Vol 11, No 2 (2017)

Case Report(s)

  • XML | PDF | downloads: 200 | views: 298 | pages: 89-91

    Hepatitis A is common in children and usually is a self-limiting disease.  Although extrahepatic and hematological immune manifestations following acute hepatitis A virus (HAV) infection have rarely been reported, they are frequently observed in other viral hepatitis. In this paper, we report the case of a 3-year-old girl who developed immune thrombocytopenic purpura (ITP) and hemolytic anemia after HAV infection. She was presented with malaise, pallor, ecchymosis, petechiae and purpura on the trunk and extremities.


  • XML | PDF | downloads: 207 | views: 563 | pages: 92-95

    Introduction: Hepatitis A virus is the most prevalent viral hepatitis. It is globally a major public health problem with different clinical symptoms. This study aimed at investigating the clinical findings and prevalence of glucose 6-phosphate dehydrogenase (G6PD) deficiency in children with hepatitis A.
    Materials and Methods: In this prospective study, demographical information, clinical findings, and G6PD level of hepatitis A patients, who were visited at Pediatric Hematology clinic, were entered into the database. The diagnosis of hepatitis A infection was based on the presence of anti-HAV IgM antibody. The activity of G6PD enzyme was measured with florescent spot test.
    Results: Of the 117 children with hepatitis A, 52 (44.4%) were male and 65 (55.6%) were female. The mean age of these patients was 2.79±5.39 years. The most prevalent clinical manifestations were dark yellow urine and anorexia. G6PD deficiency was observed in 26 (26.3%) out of 99 patients whose G6PD levels were measured.
    Conclusion: Given the high prevalence of G6PD deficiency in this study, the measurement of G6PD level along with other liver and biochemical markers in areas with endemic hepatitis A is recommended. In addition, it is recommended that patients undertake precise monitoring for hemolysis and renal function.


  • XML | PDF | downloads: 183 | views: 416 | pages: 96-101

    Background: Angiogenesis, the formation of new blood vessels from preexisting ones, is among the most important physiological and pathological processes that occur in the body. Under pathological conditions such as tumor growth, psoriasis, corneal neovascularization and rheumatoid arthritis, angiogenesis is substantial for the development of the disease. Zataria multiflora is a member of the Labiatae family with a vast range of traditional uses which has been long known and applied in Iran old medicine. The aim of this study was the evaluation of anti-angiogenic potential of Zataria multiflora.
    Materials and Methods: In this study, human umbilical vein endothelial cells (HUVECs) were isolated from newborn umbilical veins and then cultured for cytotoxicity (LDH test) assay. Regarding LDH results, following tests such as angiogenesis (cytodex-3 micro carrier) and migration (wound healing) tests were designed.
    Results: The cytotoxicity assays showed no toxicity of Z.multiflora toward HUVECs in the range of 10-450µg/mL of the extract. This extract was also able to inhibit angiogenesis and migration at 200µg/mL.
    Conclusions: Our data clearly demonstrated an inhibitory effect of Z.multiflora on angiogenesis and migration of HUVECs. Z.multiflora could be introduced as a significant angiogenesis inhibitor for angiogenesis-dependent diseases in further complementary studies.



  • XML | PDF | downloads: 264 | views: 531 | pages: 102-107

    Background: Disulfiram is oral aldehyde dehydrogenase (ALDH) inhibitor that has been used in the treatment of alcoholism. Recent studies show that this drug has anticancer properties; however, its rapid degradation has limited its clinical application. Encapsulation of disulfiram polymeric nanoparticles (NPs) may improve its anticancer activities and protect rapid degradation of the drug.
    Materials and Methods: A poly (lactide-co-Glycolide) (PLGA) was developed for encapsulation of disulfiram and its delivery into breast cancer cells. Disulfiram encapsulated PLGA NPs were prepared by nanoprecipitation method and were characterized by Scanning Electron Microscopy (SEM). The loading and encapsulation efficiency of NPs were determined using UV-Visible spectroscopy. Cell cytotoxicity of free and encapsulated form of disulfiram is also determined using MTT assay.
    Results: Disulfiram encapsulated PLGA NPs had uniform size with 165 nm. Drug loading and entrapment efficiency were 5.35 ±0.03% and 58.85±1.01%. The results of MTT assay showed that disulfiram encapsulated PLGA NPs were more potent in induction of apoptosis compare to free disulfiram.
    Conclusion:Based on the results obtained in the present study it can be concluded that encapsulation of disulfiram with PLGA can protect its degradation in improve its cytotoxicity on breast cancer cells.

  • XML | PDF | downloads: 207 | views: 402 | pages: 108-113

    Background: It has been suggested that inflammatory state due to obesity can lead to alteration in iron metabolism. Women in reproductive age are at higher risk of iron deficiency. In this study, we aimed to evaluate inflammatory status and iron markers in young overweight and obese women.
    Subjects and Methods: In this study, 120 young and healthy women with a BMI ≥ 25 kg/m2 were enrolled. Biochemical data including iron profile and inflammatory markers were analyzed using mean ± standard deviation or median (interquartile range) and multivariate multiple regression model via MANOVA.
    Results: Iron deficiency anemia (hemoglobin < 120 g/l) and iron deficiency without anemia (serum ferritin<30.0 mg/l) were detected in 21.67% and 33.33% of participants, respectively. Multivariate modeling showed that BMI was a significant predictor of transferrin saturation (p = 0.037), CRP (p = 0.013), soluble transferrin receptor (p=0.045), and soluble transferrin receptor/ ferritin ratio (0.015).
    Conclusion: The results of this study supported the positive association between obesity and inflammation and mild changes in iron markers.


  • XML | PDF | downloads: 177 | views: 909 | pages: 114-120

    Background: Myelodysplastic syndromes (MDSs) include a diverse group of clonal bone marrow disorders characterized by ineffective hematopoiesis and pancytopenia.It was found that down regulation of APAF1, a putative tumor suppressor gene (TSG),leads to resistance to chemotherapy and disease development in some cancers. In this study, we investigated the relation of APAF1 methylation status with its expression and clinicopathological factors in myelodysplastic syndrome (MDS) patients.
    Materials and Methods: Methylation Sensitive-High Resolution Melting Curve Analysis (MS-HRM) was employed in studying the methylation of CpG islands in the APAF1promoter region in MDS. Gene expression was analyzed by using real time RT-PCR.
    Results: 42.6% of patient samples were methylated in promoter region of APAF1 analyzed, while methylation of the genewas not seen in controls (P<0.05). Methylation of APAF1 was significantly associated with the suppression of its mRNA expression (P=0.00). The methylation status of APAF1in advanced-stage MDS patients (80%) was significantly higher than that of the early-stage MDS patients (28.2%) (P=0.001). The difference in frequency of hypermethylated APAF1 gene was significant between good (37.5%) and poor (85.71%) cytogenetic risk groups (P=0.043). In addition, a higher frequency of APAF1 hypermethylation was observed in higher-risk MDS group (69.2%) compared to lower-risk MDS group (34.14%) (P=0.026).
    Conclusion: Our study indicated that APAF1hypermethylation in MDS was associated to high-risk disease classified according to the IPSS, WHO and cytogenetic risk.

  • XML | PDF | downloads: 191 | views: 411 | pages: 121-132

    Background: In the field of cellular therapy, the impact of confluence degree on harvesting or differentiation of BMMSCs and the effect of cell-to-cell contact remain controversial. Therefore, the effect of confluence on properties of BMMSCs was studied and efficiency of confluence-associated osteogenic differentiation was identified.
    Materials and Methods: The impact of 20, 50, 70, 80 and 100% confluences on proliferation properties of BMMSCs, expression of ERK and p-ERK proteins and glucose consumption rate was studied. Efficiency of confluence-associated osteogenic differentiation was identified by determining calcium deposition, Alizarin Red staining, ALP activity and expression of osteopontin and osteocalcin genes.
    Results: There was a correlation between confluence % and BMMSCs density. Viability was declined at the lower and higher confluences. The highest CFU-F, Brd-U uptake and population doubling were obtained at 80% confluence. ERK band intensity in 100% confluent BMMSCs was lower compared to other confluences. Bands of p-ERK were highly detectable in 70% and 80% confluences. Glucose consumption rate of 70% and 80% confluences in the last days were higher than 20% and 100% confluences. Although higher osteogenic differentiation was estimated at 80% confluence using calcium deposition, Alizarin Red staining and ALP activity, it was also extended at 100% confluence Osteopontin gene was expressed among all confluences including 100% confluence, while osteocalcin gene was expressed highly in 70% confluent cells.
    Conclusion: We concluded that the optimum seeding density for maximal expansion and harvesting purposes is 80% confluence and for osteogenic differentiation up to 100% confluence is also acceptable.

  • XML | PDF | downloads: 229 | views: 442 | pages: 133-138

    Background:In recent years, the success in management of thalassemic patients, has allowed for some previously unrecognized complications including renal abnormalities to emerge. This prospective study aimed to investigate kidney iron overload by means of MRI T2* and also renal function based on laboratory tests for early markers of glomerular and tubular dysfunction among adult Iranian transfusion-dependent thalassemia major patients. 
    Subjects and Methods: Two-hundred and two patients with transfusion-dependent β-thalassemia major were included in this study in Zafar Adult Thalassemia Center, Tehran, Iran. For all patients, kidney MRI T2* as well as evaluation of BUN, creatinine, uric acid, calcium, phosphorus, sodium (Na), potassium (K), total protein, albumin, cystatin C, serum ferritin  β2-microglobulin, NAG (N-acetyl-beta-D-Glucosaminidase), and urine protein were performed.
    Results: One-hundred and fourteen female and 88 male transfusion-dependent β-thalassemia major patients with mean age of 30.1 ± 9.4 participated in the present study. We found that 77.7% of our patients had kidney hemosiderosis based on MRI T2*. Also, 67 patients (33.2%) had elevation of serum cystatin C, and 104 patients (51.5%) had reduced estimated glomerular filtration rate (e-GFR). Increased urinary excretion of NAG and hypercalciuria were found in 50% and 79.2% of participants, respectively.
    Conclusion: Renal hemosiderosis and asymptomatic renal dysfunction are prevalent among transfusion- dependent β-thalassemia major patients which necessitate regular screening with early markers of glomerular and tubular dysfunction. Further studies in order to investigate the correlation between renal hemosiderosis and early markers of kidney dysfunction among these patients are recommended.

  • XML | PDF | downloads: 199 | views: 580 | pages: 139-147

    Introduction:The increased risk of hemolytic reactions and erythrocyte recovery delay in ABO incompatible hematopoietic stem cell transplantation (HSCT) are well established. Effects of ABO incompatibility on other transplantation outcomes are evaluated in this study.
    Subjects and Methods: We prospectively followed 501 patients undergoing allogeneic stem cell transplantation regarding their ABO compatibility groups for a median time of 34.7 months. Patients were studied in minor, major and bidirectional mismatched and matched groups.
    Result: Mean survival time (OS) was lower in minor mismatched group (p-value= 0.017). Minor and bidirectional mismatched groups received significantly more packed cell units than matched group (p-value < 0.0001 and p-value =0.002, respectively).Mean number of platelet unit infusion was significantly more in major mismatched recipients than matched group (p- value=0.031). Death rate was much more than expected in minor mismatched group. Two cases of PRCA (pure red cell aplasia) were found in major mismatched group. No statistically significant difference was found in the incidence of acute GVHD, chronic GVHD, time to neutrophil recovery, relapse- free survival, non-relapse mortality and relapse rate among groups.
    Conclusion:In order to prevent complications of ABO-incompatible SCT such as decrease in OS and the need for more transfusions, choosing ABO-compatible donors would improve transplantation outcomes.

  • XML | PDF | downloads: 242 | views: 424 | pages: 148-157

    Background: The conventional chemotherapeutic regimens which applied for treatment of acute myeloid leukemia (AML) mostly target tumor bulk but not leukemic stem cells (LSCs). Aberrant expression or activation of mediators such as osteopontin (OPN) or PI3K/PTEN/Akt/mTOR pathway plays a key role in making prone to develop leukemia. Preventing or treating cancer by curcumin (CUR) has been suggested recently. CUR induces apoptosis and growth inhibition through various mechanisms in leukemic cells. In present study, we tried to measure the toxic response in vitro to CUR for evaluation of changes in cell viability, survival and molecular-mediated resistance in primary AML cells.
    Materials and Methods: Isolated primary CD34+/CD38− bone marrow derived AML cells were treated with CUR, Daunorubicin (DNR) and/or their combination by MTT assay, Annexin V/PI staining, and colony-formation. The mRNA expression of OPN/AKT/mTOR/PTEN/β-catenin genes was measured by Real-Time PCR. The siRNA against OPN was applied for CUR- treated cells.
    Results: Growth inhibition effect of DNR increased in combination with CUR on primary CD34+/CD38- AML cells. Suppression of OPN with siRNA increased the cytotoxic effects of CUR. Likewise, OPN gene expression increased in response to CUR treatment in AML cells. AKT, mTOR, β-catenin or PTEN gene expression increased by CUR, but OPN siRNA decreased the level of mRNA expression of mentioned molecular pathway.
    Conclusion: The chemo-resistance of AML cells against therapy might be relevant to increasing of OPN mRNA expression and activity of other mediators including AKT, mTOR, PTEN, and β-catenin. In this context, targeting of OPN might be more impact on CD34+ AML cells.

  • XML | PDF | downloads: 252 | views: 604 | pages: 158-163

    Background: Gastric cancer is one of the most common cancers in the world. There are many genomic and molecular factors that cause gastric cancer to occur. Also, many markers that associate with tumor invasiveness have been known. 
    E-Cadherin is a calcium- mediated cell adhesion molecule. In some studies, abnormal expression of E-Cadherin has been seen in gastric carcinoma. However, in the studies done there has been some conflicting information about abnormal expression of this marker in a variety of gastric carcinoma and also about the expression of this marker and its correlation with various clinicopathologic factors of tumor.
    Subjects and Methods: A case control study was performed on total or partial gastrectomy tissue samples obtained from 70 patients with gastric cancer and adjacent non-neoplastic tissues. The immunohistochemistry was used to assess E-Cadherin expression. The correlation between abnormal E-Cadherin expression and tumor histopathology was evaluated in all patients.
    Results: Among 70 patients who were analyzed, 48.6% showed abnormal E-Cadherin expression. A significant correlation was seen between abnormal E-Cadherin expression and tumor stage, grade, lymph node metastasis, tumor phenotype, tumor type, depth of invasion and age.
    Conclusion: Abnormal E-Cadherin expression is a common phenomenon in gastric cancer. Because there was a strong correlation between abnormal E-Cadherin expression and tumor stage, tumor grade, depth of invasion and regional lymph node involvement, this marker may be used as a predictive factor for tumor invasiveness in gastric cancer.

  • XML | PDF | downloads: 287 | views: 445 | pages: 164-171

    Background: Xmn-1 polymorphism of