Cow's milk is widely considered a fundamental component of early childhood nutrition in India and frequently represents the primary daily beverage for toddlers. However, cow's milk contains minimal bioavailable iron and may inhibit intestinal iron absorption, thereby increasing the risk of iron deficiency. Iron deficiency remains the most prevalent micronutrient deficiency in India and is the leading cause of anemia among young children. Despite national nutrition initiatives, anemia prevalence in this age group continues to be substantial, largely driven by inadequate dietary iron intake, prolonged milk-dominant feeding, suboptimal complementary feeding practices, and socioeconomic determinants. In urban and semi-urban Indian populations, excessive cow's milk consumption has emerged as a clinically relevant yet frequently overlooked contributor to iron deficiency in toddlers. In addition to its low iron content, high intake of cow's milk may impair iron utilization and predispose children to occult gastrointestinal blood loss. We describe five Indian children (age range: 48-84 months) presenting with severe iron deficiency anemia (IDA) associated with high daily intake of cow's milk (≥600 to 1,000 mL) and inadequate consumption of iron-rich complementary foods. All patients presented with marked pallor and lethargy. Three children had poor weight gain, while two demonstrated tachycardia with clinical features suggestive of early cardiac decompensation. Hematologic investigations revealed severe microcytic hypochromic anemia with markedly reduced serum ferritin and elevated total iron-binding capacity. Three children required hospital admission, and one required pediatric intensive care unit management with packed red blood cell transfusion due to hemodynamic instability. Management included blood transfusion when clinically indicated, therapeutic oral iron supplementation, dietary modification, and restriction of cow's milk intake to age-appropriate levels. Follow-up at 8-12 weeks demonstrated substantial hematologic recovery in all cases. This case series highlights the ongoing burden of nutritional IDA among Indian toddlers and underscores the importance of caregiver education, routine dietary assessment during pediatric visits, and counseling on appropriate milk intake to prevent severe anemia and its complications.

Thalassemia is a relatively common monogenic inherited blood disorder in southern China. This study aims to evaluate the additional diagnostic yield of targeted sequencing for thalassemia gene compared to traditional mainstream methods, providing evidence to support clinical decision-making and application. A total of 449 specimens with the negative common thalassemia test result were randomly selected for next-generation sequencing(NGS) testing. For rare thalassemia genotypes and abnormal hemoglobin variants detected by NGS, hematological information such as mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and hemoglobin electrophoresis was summarized and statistically analyzed. Through targeted sequencing for thalassemia, an additional 42 cases of rare thalassemia genotypes and 10 cases of abnormal hemoglobin variants were detected in the traditional test-negative groups (Neg_70 and Neg_80). Compared with traditional gene testing, the overall additional positive rate for NGS was 9.35% (42/449). In the traditional test-positive group (Pos_80), 2 cases of abnormal hemoglobin variants were identified, with an additional positive rate of 0.88% (2/226). The most frequently detected rare genotypes were the α-thalassemia variant -[THAI] and the δβ-thalassemia variant Chinese([G]γ + ([A]γδβ)[0]), found in 20 and 7 cases, respectively. Additionally, a novel heterozygous variant of the HBA2 gene was identified: NM_000517.6:c.16delG. NGS demonstrates superior detection efficacy and higher detection rates in individuals with low mean corpuscular volume, particularly in those with severe microcytic hypochromic anemia. It effectively identifies rare mutations and reduces the misdiagnosis rate of thalassemia.

Hodgkin Lymphoma (HL) is a heterogeneous malignant disorder in the human body's lymphatic system with distinct clinical and molecular features. The objective of this research was to assess the hematological and molecular status of HL patients in Palestine and explore potential prognostic indicators and potential targets requiring further evaluation. Certain hematological factors, i.e., anemia, increased levels of lactate dehydrogenase, and inflammatory markers, are included in the International Prognostic Score (IPS) for HL. This study highlights the clinical value of accessible hematological biomarkers in resource-limited healthcare settings. A retrospective cohort study was conducted on 557 HL lymph node biopsies (2017-2023) from Palestinian Health Information Center (PHIC) database and hospital medical records. Hematological parameters (hemoglobin, MCV) and biochemical markers (ESR, LDH) were analyzed. Claudin-6 (CLDN6) mRNA expression was quantified in lymph node tissues from HL patients (n = 25) and healthy donors (n = 25) via qRT-PCR, while protein levels were assessed by Western blot. Serum GATA-4 concentrations were measured by ELISA. Nodular Sclerosis was the most common form, which predominantly occurred in young patients with a relatively equal sex distribution. The highest frequency was found in Hebron. Hemoglobin levels differed between subtypes, with the lymphocyte-depleted subtype showing the lowest mean hemoglobin values; the Lymphocyte-Depleted (LD) subtype exhibited the lowest hemoglobin and MCV (74.77 fL), indicating microcytic anemia. ESR was elevated across subtypes, with the highest levels observed in the NOS (63.5 mm/h), reflecting aggressive disease. Male mortality was highest in Mixed Cellularity (87.5%) and NS (75%), while LD and Lymphocyte-Predominant subtypes showed no male deaths. Molecularly, CLDN6 mRNA and GATA-4 levels were significantly elevated in HL tissues (P < 0.001), though Claudin-6 protein expression remained unchanged, suggesting post-transcriptional regulation. This study represents the first combined hematological and molecular characterization of Hodgkin lymphoma in Palestine and provides preliminary evidence for CLDN6-GATA4 regulatory involvement in HL pathogenesis. The hematological changes in Palestinian HL patients are unique. The roles of CLDN6 and GATA-4 as potential markers remain preliminary and require further validation in the context of Hodgkin lymphoma.

Parkinson's Disease is on the rise over the coming decades with expectations that more patients will be prescribed levodopa therapy. This case presents a patient with Parkinson's Disease who presented with severe symptomatic microcytic anemia. He was transfusion dependent during his extensive work up that occurred during both inpatient hospitalization and outpatient hematology visits. This was negative for iron deficiency, infectious etiology, hemolysis, active bleeding, bone marrow failure, myelodysplasia or hematologic malignancy. However, patient was found to have a critically low vitamin B6 level. Following initiation of vitamin B6 supplementation, patient's anemia resolved and was no longer transfusion dependent.