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Identification of Newcastle Disease Virus sub-genotype VII 1.1 isolated from chickens in Sabah, Malaysia

Syamsiah Aini S, Leow BL, Faizul Fikri MY, Muhammad Redzwan S, Faizah Hanim MS

Trop Biomed, 2022 Dec 01;39(4):579-586.
PMID: 36602219 DOI: 10.47665/tb.39.4.015

Newcastle disease (ND) is an extremely contagious and fatal viral disease causing huge economic losses to the poultry industry. Following recent ND outbreaks in Sabah in commercial poultry and backyard farms, it was speculated that this could be due to a new introduction of Newcastle Disease Virus (NDV) genotype/sub-genotype. Here we report the genetic characterization of NDVs isolated from Sabah during early 2021. All isolates were amplified and sequenced with primers specific to the viral fusion (F) gene using reverse transcription-polymerase chain reaction (RT-PCR). Nucleotide sequence analysis of the F gene showed that all isolates shared similar homology of 99.4% with NDV strain from Iran isolated in 2018. Amino acid sequences of the F protein cleavage site revealed the motif of 112RRQKRF117 indicating all isolates were of virulent strain. Phylogenetic analysis demonstrated that all isolates were clustered under sub-genotype VII 1.1 and clustered together with isolates from Iran (previously known as subgenotype VIIl). The present findings suggested that there is an emerging of a new sub-genotype into the poultry population in Sabah and this sub-genotype has never been reported before in Malaysia. Therefore, transboundary monitoring and continuous surveillance should be implemented for proper control and prevention of the disease. A further molecular epidemiological analysis of NDV is needed to well understand the circulatory patterns of virulent strains of NDV in the country to prevent future outbreaks.

Matched MeSH terms: Disease Outbreaks/veterinary; Newcastle disease virus/genetics
Effect of osteoarthritis on alveolar bone loss in experimental periodontitis in rats

Al Bayaty FH, Mahmod SA, Jamil Al-Obaidi MM, Emad Ibrahim O, Dahir A, Adam FA, et al.

J Periodontal Res, 2023 Feb;58(1):22-28.
PMID: 36321414 DOI: 10.1111/jre.13064

BACKGROUND: There is scarce information about the relationship between periodontal disease and osteoarthritis. This study investigated the effect of surgically induced osteoarthritis on alveolar bone loss in experimental periodontitis in rats.
METHODS: 12 rats were divided into test and control groups. On day 1, the animals were anaesthetized, and silk ligatures were ligated around 6 maxillary posterior teeth in each animal from both groups. Surgical induction of osteoarthritis was performed on the left knees in the test group. No knee surgeries were performed in the control group. The ligatures were kept in place for 30 days, at which time the animals were euthanatized, and the maxillae and knee joints were harvested and processed for histological analysis. The alveolar bone loss was assessed using a zoom stereomicroscope.
RESULTS: The knee joint histologic sections of the control group showed normal joint features, whereas in the test group there were substantial changes typical of osteoarthritis, including wide joint spaces, prominent monocytic infiltration of the synovium, invasion of periarticular bone, and decreased chondrocyte density. Comparison of the bone height between the groups showed a significantly higher bone loss in the test than in the control group The marginal mean bone height, adjusted for covariates and the intraclass correlation between sites, was 1.19 and 0.78 mm in the test and control groups, respectively (p

Matched MeSH terms: Disease Models, Animal
Fulltext The impacts of COVID-19 on the environmental sustainability: a perspective from the Southeast Asian region

Praveena SM, Aris AZ

Environ Sci Pollut Res Int, 2021 Dec;28(45):63829-63836.
PMID: 33410033 DOI: 10.1007/s11356-020-11774-0

This study examined the impacts of the Coronavirus disease 2019 (COVID-19) on the environment in the Southeast Asia region using qualitative content analysis to analyze the textual data of published studies and other online references such as the organizational reports. Besides, the materiality assessment particularly the Global Reporting Initiative was conducted by analyzing short- and long-term impacts from the stakeholders' (local and regional policymakers) perspective. The positive effects of COVID-19 lockdown and movement restriction on the regional environment identified in this study included a reduction in air pollution, improvement of air and water quality, lower noise levels, and reduced land surface temperature. In contrast, the negative effects encompassed a rise in the use of plastics and the generation of medical waste in Indonesia, Malaysia, Thailand, the Philippines, and Vietnam. Materiality assessment findings have offered insights on the need of stakeholders' importance for further to deal with huge amount of waste, inadequate waste management facilities and system, explore the effectiveness of such sustainable work and lifestyle changes, utilize real-time monitoring air quality data and future prediction responses for climate change mitigation and adaptation policies as well as consideration towards new green technologies for clean energy in each Southeast Asian country and at regional level. It is anticipated that this study will contribute towards a better understanding of the impacts of COVID-19 on environmental sustainability in the Southeast Asia region, particularly from the perspective of the stakeholders.

Matched MeSH terms: Communicable Disease Control
The distinct associations of ingroup attachment and glorification with responses to the coronavirus pandemic: Evidence from a multilevel investigation in 21 countries

McLamore Q, Syropoulos S, Leidner B, Hirschberger G, van Bezouw MJ, Rovenpor D, et al.

Br J Soc Psychol, 2023 Apr;62(2):992-1012.
PMID: 36507575 DOI: 10.1111/bjso.12614

While public health crises such as the coronavirus pandemic transcend national borders, practical efforts to combat them are often instantiated at the national level. Thus, national group identities may play key roles in shaping compliance with and support for preventative measures (e.g., hygiene and lockdowns). Using data from 25,159 participants across representative samples from 21 nations, we investigated how different modalities of ingroup identification (attachment and glorification) are linked with reactions to the coronavirus pandemic (compliance and support for lockdown restrictions). We also examined the extent to which the associations of attachment and glorification with responses to the coronavirus pandemic are mediated through trust in information about the coronavirus pandemic from scientific and government sources. Multilevel models suggested that attachment, but not glorification, was associated with increased trust in science and compliance with federal COVID-19 guidelines. However, while both attachment and glorification were associated with trust in government and support for lockdown restrictions, glorification was more strongly associated with trust in government information than attachment. These results suggest that both attachment and glorification can be useful for promoting public health, although glorification's role, while potentially stronger, is restricted to pathways through trust in government information.

Matched MeSH terms: Communicable Disease Control
Fulltext Living through the COVID-19 Pandemic: Impact and Lessons on Dietary Behavior and Physical Well-Being

Gill S, Adenan AM, Ali A, Ismail NAS

Int J Environ Res Public Health, 2022 Jan 06;19(2).
PMID: 35055469 DOI: 10.3390/ijerph19020642

The aim of this review is to highlight the spectrum on which human behavior has been affected by blanket restriction measures and on a wider scale, the COVID-19 pandemic. Some of the human behaviors that have been impacted by the COVID-19 lockdown are dietary behavior and nutrition, food options and food delivery usage, physical activity and sedentary behaviors. This is important in planning effective public health strategies with minimal detriment to all subsets of society as well as improving the distribution of government aid to populations that are more severely affected. Our main purpose is to present the literature from a rapidly growing pool of scientific research to hopefully enable a better and more comprehensive understanding of the effects of this pandemic and the lessons learnt from the accompanying restrictions, as well as policy recommendations that can be made in national pandemic responses in the future.

Matched MeSH terms: Communicable Disease Control
Fulltext The impact of diabetes mellitus on the emergence of multi-drug resistant tuberculosis and treatment failure in TB-diabetes comorbid patients: a systematic review and meta-analysis

Rehman AU, Khattak M, Mushtaq U, Latif M, Ahmad I, Rasool MF, et al.

Front Public Health, 2023;11:1244450.
PMID: 38074769 DOI: 10.3389/fpubh.2023.1244450

BACKGROUND: The existence of Type 2 Diabetes Mellitus (DM) in tuberculosis (TB) patients is very dangerous for the health of patients. One of the major concerns is the emergence of MDR-TB in such patients. It is suspected that the development of MDR-TB further worsens the treatment outcomes of TB such as treatment failure and thus, causes disease progression.
AIM: To investigate the impact of DM on the Emergence of MDR-TB and Treatment Failure in TB-DM comorbid patients.
METHODOLOGY: The PubMed database was systematically searched until April 03, 2022 (date last searched). Thirty studies met the inclusion criteria and were included in this study after a proper selection process.
RESULTS: Tuberculosis-Diabetes Mellitus patients were at higher risk to develop MDR-TB as compared to TB-non-DM patients (HR 0.81, 95% CI: 0.60-0.96, p

Matched MeSH terms: Disease Progression
Fulltext Epidemiology of foot-and-mouth disease outbreaks in Thailand from 2011 to 2018

Chanchaidechachai T, Saatkamp H, de Jong M, Inchaisri C, Hogeveen H, Premashthira S, et al.

Transbound Emerg Dis, 2022 Nov;69(6):3823-3836.
PMID: 36321258 DOI: 10.1111/tbed.14754

Foot-and-mouth disease (FMD) is one of the most important animal diseases hindering livestock production in Thailand. In this study, a temporal and spatial analysis at the subdistrict level was performed on FMD outbreak reports in Thailand from 2011 to 2018. Risk factors associated with FMD outbreaks were furthermore investigated using generalized estimating equations. The results showed that the incidence of FMD outbreaks was the highest in 2016 and was affected by season, with a peak in FMD outbreaks occurring in the rainy-winter season, during October to December. FMD outbreaks were mostly distributed in small clusters within a few subdistricts. Some high-risk areas with repeated outbreaks were detected in the central regions. Risk factors, including the increase of subdistrict's size of the dairy population, beef population or pig population, the low percentage of forest area, subdistricts in the provinces adjacent to Malaysia, the presence of a livestock market and the occurrence of an FMD outbreak in a neighbouring subdistrict in the previous month significantly increased the odds of having an FMD outbreak. The increase in proximity to the nearest subdistrict with an FMD outbreak in the previous month decreased the odds of having FMD outbreaks. This study helped to identify high-risk areas and periods of FMD outbreaks in Thailand. Together with the identified risk factors, its results can be used to optimize the FMD control programme in Thailand and in other countries having a similar livestock industry and FMD situation.

Matched MeSH terms: Disease Outbreaks/veterinary; Foot-and-Mouth Disease Virus*
Fulltext Pan-Asian adapted Clinical Practice Guidelines for the management of patients with metastatic non-small-cell lung cancer: a CSCO-ESMO initiative endorsed by JSMO, KSMO, MOS, SSO and TOS

Wu YL, Planchard D, Lu S, Sun H, Yamamoto N, Kim DW, et al.

Ann Oncol, 2019 Feb 01;30(2):171-210.
PMID: 30596843 DOI: 10.1093/annonc/mdy554

The most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of metastatic non-small-cell lung cancer (NSCLC) was published in 2016. At the ESMO Asia Meeting in November 2017 it was decided by both ESMO and the Chinese Society of Clinical Oncology (CSCO) to convene a special guidelines meeting immediately after the Chinese Thoracic Oncology Group Annual Meeting 2018, in Guangzhou, China. The aim was to adapt the ESMO 2016 guidelines to take into account the ethnic differences associated with the treatment of metastatic NSCLC cancer in Asian patients. These guidelines represent the consensus opinions reached by experts in the treatment of patients with metastatic NSCLC representing the oncological societies of China (CSCO), Japan (JSMO), Korea (KSMO), Malaysia (MOS), Singapore (SSO) and Taiwan (TOS). The voting was based on scientific evidence, and was independent of both the current treatment practices and the drug availability and reimbursement situations in the six participating Asian countries. During the review process, the updated ESMO 2018 Clinical Practice Guidelines for metastatic NSCLC were released and were also considered, during the final stages of the development of the Pan-Asian adapted Clinical Practice Guidelines.

Matched MeSH terms: Disease Management
Fulltext Is it possible to generalise superspreading individuals or events of SARS-CoV-2?

Shrestha S, Kaneda Y, Takahashi K, Ozaki A, Gan SH

Lancet Microbe, 2023 Nov;4(11):e858.
PMID: 37640038 DOI: 10.1016/S2666-5247(23)00253-7
Matched MeSH terms: Disease Outbreaks
The Generalized Pustular Psoriasis Physician Global Assessment (GPPGA) score: online assessment and validation study of a specific measure of GPP disease activity

Burden AD, Bachelez H, Choon SE, Marrakchi S, Tsai TF, Turki H, et al.

Br J Dermatol, 2023 Jul 07;189(1):138-140.
PMID: 37075220 DOI: 10.1093/bjd/ljad071
Matched MeSH terms: Acute Disease
Fulltext Problems in dengue control: a case study

Poovaneswari S, Lam SK

Southeast Asian J Trop Med Public Health, 1992 Dec;23(4):723-5.
PMID: 1298080

The control of dengue outbreak requires a multi-pronged effort by the various government agencies. It requires co-operation of the community in the control activities, strict adherence to existing control procedures and guidelines by health personnel, increased manpower where necessary and strengthening co-operation between various health agencies to prevent delay in instituting control measures.

Matched MeSH terms: Communicable Disease Control/methods; Disease Outbreaks/prevention & control*
Zoonoses as a study in ecology

Heisch RB

Br Med J, 1956;2:669.
DOI: 10.1136/bmj.2.4994.669

The zoonoses, which are defined as infections of man naturally acquired from other vertebrates, are treated as a problem in ecology. This entails studying the interrelation between man, animals, a causative organism, the environment, and sometimes arthropods. Such an approach is holistic or synecological—wholes being regarded as more important than parts. Holism is a dynamic not a static conception. The evolution of the zoonoses is discussed, particularly in relation to plague, relapsing fever, and leishmaniasis. The most important reservoirs of zoonoses and other parasitic infections are usually resistant or relatively insusceptible animals rather than highly susceptible ones. Plague and Chagas's disease illustrate this. Resistant and unduly susceptible animals occupy different “niches“ in nature. By “niche“ is meant the place of an animal in its biotic environment. Zoonoses often have a “focal distribution“ in nature. Thus wild rodents infected with plague may occur in “ pockets,” and the vector mites of scrub typhus congregate in “typhus islands.” An unstable environment often favours the transference of zoonoses to man and animals. Examples are the plague-infected plain of Rongai, in Kenya, the typhus-infected forest clearings in Malaya, and the yellow-fever infected forest edges in Uganda. Ecologically unstable areas are termed “ ecotones.” Zoonoses can also be transmitted in or near relatively stable sites such as huts, rodent burrows, caves, and termite hills. These are known as “habitat niches.” Animals and arthropods in a community are linked by food, and the importance of what are known as “food chains“ and “food cycles“ is discussed in relation to the transference of zoonotic infections from one host to another. Reference is also made to the fluctuations in numbers of various animals in nature, and how this affects the incidence of zoonotic disease. Certain highly susceptible rodents are periodically decimated by plague; this breaks the link with man, and human infections cease for the time being. © 1956, British Medical Journal Publishing Group. All rights reserved.

Matched MeSH terms: Chagas Disease
Fulltext A reference genome of Commelinales provides insights into the commelinids evolution and global spread of water hyacinth (Pontederia crassipes)

Huang Y, Guo L, Xie L, Shang N, Wu D, Ye C, et al.

Gigascience, 2024 Jan 02;13.
PMID: 38486346 DOI: 10.1093/gigascience/giae006

Commelinales belongs to the commelinids clade, which also comprises Poales that includes the most important monocot species, such as rice, wheat, and maize. No reference genome of Commelinales is currently available. Water hyacinth (Pontederia crassipes or Eichhornia crassipes), a member of Commelinales, is one of the devastating aquatic weeds, although it is also grown as an ornamental and medical plant. Here, we present a chromosome-scale reference genome of the tetraploid water hyacinth with a total length of 1.22 Gb (over 95% of the estimated size) across 8 pseudochromosome pairs. With the representative genomes, we reconstructed a phylogeny of the commelinids, which supported Zingiberales and Commelinales being sister lineages of Arecales and shed lights on the controversial relationship of the orders. We also reconstructed ancestral karyotypes of the commelinids clade and confirmed the ancient commelinids genome having 8 chromosomes but not 5 as previously reported. Gene family analysis revealed contraction of disease-resistance genes during polyploidization of water hyacinth, likely a result of fitness requirement for its role as a weed. Genetic diversity analysis using 9 water hyacinth lines from 3 continents (South America, Asia, and Europe) revealed very closely related nuclear genomes and almost identical chloroplast genomes of the materials, as well as provided clues about the global dispersal of water hyacinth. The genomic resources of P. crassipes reported here contribute a crucial missing link of the commelinids species and offer novel insights into their phylogeny.

Matched MeSH terms: Disease Resistance
Case report-Subcorneal pustular dermatosis-A great mimicker of generalized pustular psoriasis

Mohd Affandi A, Baharom ZF

Exp Dermatol, 2023 Aug;32(8):1308-1311.
PMID: 37000973 DOI: 10.1111/exd.14800
Matched MeSH terms: Acute Disease
Pitfalls and biases in neuroepidemiological studies of COVID-19 and the nervous system: a critical appraisal of the current evidence and future directions

Beghi E, Ivashynka A, Logroscino G, de Oliveira FF, Fleisher JE, Dumitrascu OM, et al.

J Neurol, 2023 Nov;270(11):5162-5170.
PMID: 37682315 DOI: 10.1007/s00415-023-11981-y

BACKGROUND: Neurological manifestations frequently occur in individuals with COVID-19, manifesting during the acute phase, persisting beyond the resolution of acute symptoms, and appearing days or weeks after the initial onset of COVID-19 symptoms. However, predicting the incidence, course, and outcome of these neurological manifestations at the individual patient level remains challenging. Biases in study design and limitations in data collection may contribute to the inconsistency and limited validity of the reported findings. Herein, we focused on critically appraising pitfalls and biases of prior reports and provide guidance for improving the quality and standardization of future research. Patients with COVID-19 exhibit diverse demographic features, sociocultural backgrounds, lifestyle habits, and comorbidities, all of which can influence the severity and progression of the infection and its impact on other organ systems. Overlooked or undocumented comorbidities and related treatments may contribute to neurological sequelae, which may not solely be attributable to COVID-19. It is crucial to consider the potential side effects of vaccines in relation to neurological manifestations.
CONCLUSION: To investigate neurological manifestations of COVID-19, it is essential to employ valid and reliable diagnostic criteria and standard definitions of the factors of interest. Although population-based studies are lacking, well-defined inception cohorts, including hospitalized individuals, outpatients, and community residents, can serve as valuable compromises. These cohorts should be evaluated for the presence of common comorbidities, alongside documenting the primary non-neurological manifestations of the infectious disease. Lastly, patients with COVID-19 should be followed beyond the acute phase to assess the persistence, duration, and severity of neurological symptoms, signs, or diseases.

Matched MeSH terms: Disease Progression
Fulltext Surrogate Biomarkers of Disease Progression in Human Pegivirus Seropositive Human Immunodeficiency Virus-Infected Individuals

Vimali J, Yong YK, Murugesan A, Ashwin R, Balakrishnan P, Raju S, et al.

Viral Immunol, 2023 Jan;36(1):55-62.
PMID: 36355180 DOI: 10.1089/vim.2022.0144

Scientific observations indicate that an actively prevailing systemic condition could alleviate the pathology of another disease. Human pegivirus (HPgV), a highly ubiquitous flavivirus is believed to be associated with slow human immunodeficiency virus (HIV) disease progression, and has seldom been linked to hepatic pathology. In this study, we investigated whether HPgV seropositivity had any impact on surrogate markers of HIV disease progression in a cohort of HIV-infected HPgV seropositive (n = 28) and seronegative (n = 12) individuals who were prospectively evaluated for absolute CD4+ T cell counts, plasma viral load (PVL), liver enzymes, and plasma cytokine levels. The HIV PVL was relatively lower in HPgV seropositive than in HPgV seronegative HIV-infected subjects. Clinical markers of hepatic injury were significantly low among HPgV seropositive HIV-infected participants. HPgV seropositive individuals showed significantly higher levels of interleukin-7 (IL-7), and although not significant, the levels of IL-6 were lower among HPgV seropositive subjects. Spearman correlation analysis showed that the absolute CD4+T cell count was inversely correlated with HIV PVL. Exposure to HPgV appears to have a positive prognostic impact on the levels of surrogate biomarkers of HIV disease progression.

Matched MeSH terms: Disease Progression
Fulltext Bacterial Persister Cells and Development of Antibiotic Resistance in Chronic Infections: An Update

Kunnath AP, Suodha Suoodh M, Chellappan DK, Chellian J, Palaniveloo K

Br J Biomed Sci, 2024;81:12958.
PMID: 39170669 DOI: 10.3389/bjbs.2024.12958

The global issue of antimicrobial resistance poses significant challenges to public health. The World Health Organization (WHO) has highlighted it as a major global health threat, causing an estimated 700,000 deaths worldwide. Understanding the multifaceted nature of antibiotic resistance is crucial for developing effective strategies. Several physiological and biochemical mechanisms are involved in the development of antibiotic resistance. Bacterial cells may escape the bactericidal actions of the drugs by entering a physiologically dormant state known as bacterial persistence. Recent findings in this field suggest that bacterial persistence can be one of the main sources of chronic infections. The antibiotic tolerance developed by the persister cells could tolerate high levels of antibiotics and may give rise to persister offspring. These persister offspring could be attributed to antibiotic resistance mechanisms, especially in chronic infections. This review attempts to shed light on persister-induced antibiotic resistance and the current therapeutic strategies.

Matched MeSH terms: Chronic Disease
Fulltext Chronic respiratory disease surveys in adults in low- and middle-income countries: A systematic scoping review of methodological approaches and outcomes

Hanafi NS, Agarwal D, Chippagiri S, Brakema EA, Pinnock H, Sheikh A, et al.

J Glob Health, 2021 Jun 19;11:04026.
PMID: 34221357 DOI: 10.7189/jogh.11.04026

BACKGROUND: Chronic respiratory diseases (CRDs) contribute significantly towards the global burden of disease, but the true prevalence and burden of these conditions in adults is unknown in the majority of low- and middle-income countries (LMICs). We aimed to identify strategies - in particular the definitions, study designs, sampling frames, instruments, and outcomes - used to conduct prevalence surveys for CRDs in LMICs. The findings will inform a future RESPIRE Four Country ChrOnic Respiratory Disease (4CCORD) study, which will estimate CRD prevalence, including disease burden, in adults in LMICs.
METHODS: We conducted a scoping review to map prevalence surveys conducted in LMICs published between 1995 and 2018. We followed Arksey and O'Malley's six-step framework. The search was conducted in OVID Medline, EMBASE, ISI Web of Science, Global Health, WHO Global Index Medicus and included three domains: CRDs, prevalence and LMICs. After an initial title sift, eight trained reviewers undertook duplicate study selection and data extraction. We charted: country and populations, random sampling strategies, CRD definitions/phenotypes, survey procedure (questionnaires, spirometry, tests), outcomes and assessment of individual, societal and health service burden of disease.
RESULTS: Of 36 872 citations, 281 articles were included: 132 from Asia (41 from China). Study designs were cross-sectional surveys (n = 260), cohort studies (n = 11) and secondary data analysis (n = 10). The number of respondents in these studies ranged from 50 to 512 891. Asthma was studied in 144 studies, chronic obstructive pulmonary disease (COPD) in 112. Most studies (100/144) based identification of asthma on symptom-based questionnaires. In contrast, COPD diagnosis was typically based on spirometry findings (94/112); 65 used fixed-ratio thresholds, 29 reported fixed-ratio and lower-limit-of-normal values. Only five articles used the term 'phenotype'. Most studies used questionnaires derived from validated surveys, most commonly the European Community Respiratory Health Survey (n = 47). The burden/impact of CRD was reported in 33 articles (most commonly activity limitation).
CONCLUSION: Surveys remain the most practical approach for estimating prevalence of CRD but there is a need to identify the most predictive questions for diagnosing asthma and to standardise diagnostic criteria.

Matched MeSH terms: Chronic Disease*; Pulmonary Disease, Chronic Obstructive*
Fulltext Determinants of the demand for using preventive medical care among adults in penang, malaysia

Cheah YK

Malays J Med Sci, 2013 Jan;20(1):46-55.
PMID: 23613658 MyJurnal

In light of the fact that chronic diseases were becoming more prevalent recently, the primary objective of the study was to examine the socio-demographic, health, and lifestyle determinants of the use of preventive medical care in Penang, Malaysia.

Matched MeSH terms: Chronic Disease
Fulltext A report of three cases of untreated Graves' disease associated with pancytopenia in Malaysia

Rafhati AN, See CK, Hoo FK, Badrulnizam LB

Electron Physician, 2014;6(3):877-82.
PMID: 25763162 DOI: 10.14661/2014.877-882

Generally, clinical presentations of Graves' disease range from asymptomatic disease to overt symptomatic hyperthyroidism with heat intolerance, tremor, palpitation, weight loss, and increased appetite. However, atypical presentation of Graves' disease with hematological system involvement, notably pancytopenia, is distinctly uncommon. Hereby, we present and discuss a series of three untreated cases of Graves' disease clinically presented with pancytopenia and the hematological abnormalities that responded well to anti-thyroid treatment. With resolution of the thyrotoxic state, the hematological parameters improved simultaneously. Thus, it is crucial that anti-thyroid treatment be considered in patients with Graves' disease and pancytopenia after a thorough hematological evaluation.

Matched MeSH terms: Graves Disease*

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