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Objective. The aim of our study was to evaluate the prognostic value of reticulocyte hemoglobin content for diagnosis of iron deficiency in 6-24-month-old children.Material and methods. Children aged 6 to 24 months were consulted for suspected iron deficiency in the outpatient department in 2006-2007. Criteria for inclusion into the study were normal birth time and weight, no infection during the last two weeks before blood sampling (Creactive protein <5 mg/L), no iron supplements 1 month before the study. Red blood cell, reticulocyte indices and biochemical tests were analyzed. A total of 180 children were enrolled in our study. Iron deficiency was diagnosed when at least two of four parameters (ferritin, transferrin, transferrin saturation, and soluble transferrin receptors) reflected iron deficiency.Results. According to our criteria of iron deficiency, patients were divided into two groups: 116 had iron deficiency and 64 had normal iron stores. The iron deficiency group had significantly lower hemoglobin, mean corpuscular hemoglobin, mean corpuscular volume, reticulocyte hemoglobin content, ferritin, soluble transferrin receptors, iron and higher red cell distribution width, transferrin, and transferrin saturation (P<0.05) compared with the normal iron store group. Reticulocyte hemoglobin content, ferritin, and transferrin saturation had the highest sensitivity and specificity (76.6% and 78.4%, 81.3% and 81.9%, 85.9% and 87.9%, respectively).Conclusion. Reticulocyte hemoglobin content is comparable test with ferritin and transferrin saturation and can be used to detect iron deficiency in 6-24-month-old children.

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Background: Thyroid cancer (TC) is a rare condition in children. It may be associated with radiation, iodine deficiency or familial inheritance. Aims: The objectives of this study were to analyse the prevalence and incidence trends over 3 decades and clinical features of TC in the paediatric population in Lithuania. Methods: We reviewed all TC cases diagnosed in children aged less than 18 years during the period 1980-2014 using medical records from 3 main hospitals in Lithuania where such TC cases are managed. Results: During the 35-year period (1980-2014) there were 57 cases (45 females) of TC in children in Lithuania. The mean age at the time of diagnosis was 14.51 ± 0.52 years. The crude incidence rate of TC ranged from 0 to 0.93 cases per 100,000 children per year and the mean annual increase was 5.26% (p < 0.001). Papillary carcinoma was the most common histological type (73.7%). No association was found between the incidence of TC and the reported areas of radioactive contamination after the Chernobyl accident. In total, 8.8% of patients had secondary TC after initial radiotherapy of a primary oncologic disease. Conclusion: The incidence of TC in the Lithuanian paediatric population between 1980 and 2014 ranged from 0 to 0.93 cases per 100,000 children per year and there was a 5.26% annual increase (p < 0.001), most probably related to the increased use of ultrasound testing.

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Radiation-induced sarcoma (RIS) has been reported as a late secondary malignancy following radiotherapy for various types of cancer with a median latency of 10 years. We describe an early RIS that developed in an adolescent within three years of treatment (including PD-L1 check-point inhibitor Nivolumab) of a relapsed classic Hodgkin lymphoma (HL) and was diagnosed post-mortem. The patient died of the progressive RIS that was misleadingly assumed to be a resistant HL based on the positive PET/CT scan. Repetitive tumor biopsies are warranted in cases of aggressive and multi-drug resistant HL to validate imaging findings, ensure correct diagnosis and avoid overtreatment.

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