Repeated bone marrow examination was found to be of value in assessing response to treatment in megaloblastic anemia. The objective of this study was monitoring the response of megaloblastics to treatment, concerning the location of neutrophilic myeloperoxidase and myeloperoxidase index (MPXI) and their variation in megalo blastic erythroid progeny. It is possible to follow up megaloblastic cases using a Technicon H1 (Bayer) automated cell counter. Complete blood counts (CBC) of 50 patients whose bone marrow aspirations revealed megaloblastic state and subsequently responded to treatment with B12 and folate were studied through pre- and post-treatment measurements. MPXI level in 41 patients was above normal range (normal:-10 to +10). Nine patients had normal MPXI, though mean cell volume (MCV) was higher than 100fL. The highest value of MPXI was 41.5.Themean values of MPXI were 18.3 and 2.05 in pre- and post-treatment measurements respectively. MPXIs were decreased after treatment in92% of patients (p= 0.008). According to this investigation, the MPXI measurement is a suitable test in monitoring the response for treatment.

The charts of 27 patients with Kawasaki disease (KD) admitted to Nemazee Hospital in Shiraz from January 1991 to October 1998 were reviewed to identify the results of mean peroxides index (MPXI) values, a measure of neutrophil staining intensity, obtained by the Technicon H1 analyzer (Technicon Instruments Corp., Tarrytown, NY) within the first 10 days of the illness; 2 separate groups of patients were assessed as control subjects: 27 disease control (DC) children with fever plus one other KD criterion; and 27 laboratory control (Le) subjects with nonfebrile disorders interpreting also as a normal reference population. Compared with control groups, patients with KD had lower quantities of MPXI [(Meani±SD, -11.71±5.87 in KD group) vs. (1.53±4.30; p<0.001 in DC group, and 1.74±6.52, p<0.001 in LC group)]. Depending on the location of the cut-off point expressed on an interval scale, this test had the ability to be 100% specific (if MPXI<-6.0) and 100% sensitive (if MPXI>0).Considering the low prevalence of hereditary myeloperoxidase (MPO) deficiency (1 in 2000), measurement of MPXI, when performed as part of a complete count on an automated hematology instrument, could be counted as an important adjunct to clinical evaluation and also according to the low values of MPXI inpatients with KD, it can be included among the acquired causes of MPO deficiency.

A growing body of evidence suggests that inflammation may play a role in unstable angina and acute myocardial infarction. Neutrophil activation has been demonstrated in unstable angina and acute myocardial infarction. Myeloperoxidase is the major constituent of primary azurophil granules is neutrophil and discharged after activation. The chart of thirty-two patients (female 19 male 13) who were admitted in coronary care unit because of myocardial infarction and unstable angina pectoris were selected. Myeloperoxidase content (MPXI) had been determined using H1 hematology analyzer. In normal subjects this index is about 0 and negative values appear when the neutrophil are depleted of myeloperoxidase, which typically happens after neutrophil activation. Risk factors such as current smoking, hypertension, diabetes mellitus and high cholesterol level were recorded. The mean age of patients was 65 years old (female 66 male 64) with a range of 29 to 91. Leukocytosis and neutrophilia were present in 13 (40%) and 16 (50%) respectively. The range of ESR was between 1 to 28 (millimeter/hours) with mean = 10.4. The mean of MPXI was -3.04 (female -4.5 male -1.3, P=0.27). MPXI in patients who had positive and negative history of chronic stable angina was -5.14 and -2.3 (P=0.64) respectively. Because most of the patients had two or more risk factors, the relation between risk factors and MPXI, independently, was not possible to evaluate. There was no correlation between amount of creatin phosphokinase rising and age with MPXI values. During myocardial ischemia, neutrophil activity is increased. Further study is needed for determination whether neutrophil activation is caused by myocardial event or whether it is an independent, primary event.

A Six-year-old boy was admitted to the infectious ward (Emam Reza Hospital) because of sever gingivostomatitis, headache and fever.The patient had episodes of infection in lungs (pneumonia) last year and knee joint infection (Septic Arthritis) two years ago. And several infectious complications began in infancy and recur throughout his childhood. All these infectious episodes did not come to medical attention by his pediatrician.The patient was born in Mashhad City and has a brother and a sister. His brother had liver abscess 5 years ago, which treated by antibiotics and surgical drainage of abscess.His sister and parents are in a normal condition. His vaccination programme is complete.On admission, his temperature was 38.5 C, heartbeats 89, and respiration rate 20, with blood pressure 90/50. Some enlarged lymphnodes was palpable in submaxillary region, at the left side of his neck. Ears at otoscopy were normal. A bad smelling breath with sever infection and exudate was seen over .the tonsils and a coated tongue and poor dentition. On physical examination of trunk and extremities, there was no rash, discoloration of skin, jaundice and no lymphadenopathies and hepatomegaly, but spleen was felt on deep palpation. Chin-to-chest sign was negative, No vomiting, no abnormality on lung auscultation and heart sounds.Hematologic tests and blood chemical values, on admission were: WBC= 15500 /mm3, Neut 75%, lymph 15%, mono 5%, band cells 5%, Platelets 210000/ mm3, RBC 5000000/ mm3, with nearly normal blood indices, MPXI +8, blood glucose 110, creatinine 0.8, Na 140, K 4, and a normal urinalysis. On chest X. ray the lungs were clear and heart size was normal. Costodiaphragmatic and cardiodiaphragmatic angles were sharp. A blood culture and throat exudate culture was done  with positive results of staphylococcus aurous in both cultures.Cephalotin IV, started and some new tests requested.