Biomedical subjects

F Ahmed

Publications and source records attributed to F Ahmed.

At least 73 records · Page 4Linked to original sources

PubMed1998

Peroxynitrite formation and apoptosis in transgenic sickle cell mouse kidneys.

BACKGROUND: In a previous study, nitric oxide synthases (NOS) were found to be strongly expressed in the tubular epithelium of kidneys of a transgenic mouse model of sickle cell disease (alphaHbetaS[betaMDD]). Because NOS activity is often associated with peroxynitrite formation when superoxide radical (.O-2) is present in abundance, we examined the kidneys of sickle cell mice for nitrotyrosine, considered to be a footprint of ONOO-. METHODS: Western blot and immunohistochemistry for nitrotyrosine was carried out. Since peroxynitrite and other reactive oxygen radicals are capable of causing apoptosis, we also performed agarose gel electrophoresis of kidney DNA and TUNEL staining of nuclei, indicators of apoptosis. RESULTS: Nitration of tyrosine residues of three proteins (kD 66, 57 and 22) was found on Western blot of kidney protein extracts of the sickle cell mice. The degree of tyrosine nitration of the 66 kD protein was not significantly different in the control versus transgenic mice, whereas tyrosine nitration of the 57 and 22 kD proteins was clearly increased in transgenic mice. Strong immunostaining for nitrotyrosine was seen in tubular epithelial cells of the sickle cell mice, in close proximity to positive immunostaining of iNOS. Neither iNOS nor nitrotyrosine was expressed in the control mice. DNA "laddering" was found localized to the same zones of the kidney as nitrotyrosine and iNOS immunostaining. TUNEL assay on mouse kidney tissue sections showed minimal tubular cell apoptosis in normal mouse with hypoxia, mild tubular cell apoptosis in sickle cell mouse in room air, and moderate tubular cell apoptosis in sickle cell mouse with hypoxia. CONCLUSIONS: The observations suggest that ONOO- and perhaps other reactive oxygen species are being produced in the sickle cell kidney. The mechanism may be ischemia/reperfusion due to intermittent vascular occlusion by sickle cells. The resulting hypoxia could result in iNOS activation, superoxide radical and peroxynitrite formation. Two consequences of these reactions appear to be nitration of tyrosine residues of some renal proteins and enhanced apoptosis.

Anemia, Sickle Cell↗

PubMed1998

Dietary pattern, nutrient intake and growth of adolescent school girls in urban Bangladesh.

OBJECTIVE: To investigate the dietary pattern and nutritional status of adolescent girls attending schools in Dhaka city and to examine the association with various social factors. DESIGN: Cross-sectional study. SETTING: Girls high schools in Dhaka city. SUBJECTS: A total of 384 girls, aged from 10 to 16 years, who were students of classes VI to IX of 12 girls high schools in Dhaka city were selected by systematic random sampling. Nutrient intake was assessed using the 24-h recall method and the usual pattern of food intake was examined using a 7-day food frequency questionnaire. RESULTS: The prevalence of undernutrition among the participants assessed as stunting was 10% overall with younger girls being less stunted (2%) than older girls (16%), whereas 16% were thin with relatively more of the younger girls (21%) being thin than of the older girls (12%). Based on the usual pattern of food intake, a substantial proportion of the girls did not consume eggs (26%), milk (35%) or dark green leafy vegetables (20%). By comparison, larger proportions consumed meat (50%) and fish (65%) at least four times a week. For the intake of energy and protein, only 9 and 17% of the girls, respectively, met the recommended daily allowance (RDA). For nearly 77% of the girls, the intake of fat was less than the recommendation. Intakes less than the RDA were found for iron (77% of the girls), calcium (79%), vitamin A (62%), vitamin C (67%), and riboflavin (96%). Based on the food consumption data, cereals were the major source of energy (57%), thiamin (67%), niacin (63%) and iron (37%). Animal sources supplied 50% of dietary protein. Cooking fats were the principal source of fat (67%) in the diet. Milk was the major contributor for riboflavin and preformed vitamin A (retinol). Leafy vegetables and fruits were the main sources of provitamin A (carotenes). The girls from families with less educated parents were more likely to be thin and short for their age. Those girls from families with lower incomes and less educated parents had a dietary pattern which tended to be poor with regard to egg, milk, meat and fruit, with lower intakes of protein, fat and riboflavin. CONCLUSION: The findings indicate that the diets of these girls tended to be inadequate both for macronutrients and micronutrients, with significant health implications. There was also a relationship between the family income and the education of the parents with the nutritional status of the girls.

Adolescent↗

PubMed1998

Early postpartum discharge versus traditional length of stay: patient preferences.

BACKGROUND: Despite a vast body of literature on postpartum safety issues, little has been written about patients' preferences for hospitalized versus home-based support and reasons for those choices. METHODS: A questionnaire was offered to obstetric patients at a prenatal class. Data were analyzed using chi-square analysis and logit modeling, searching for factors accounting for the patient's choice of discharge plan. RESULTS: Neither demographic nor style-of-care variables affected patient choice significantly. Personal issues like comfort with child care were highly correlated, both individually and as a group, with choice of length of stay. Less than 25% of the group studied expressed a desire for early discharge. CONCLUSIONS: Women with a high internal locus of control and/or distrust of the medical system expressed a desire for early postpartum discharge. Few women in our study exhibited those qualities; over 75% of those who had a preference wanted a longer period of hospitalization. Although our sample has both negative and positive skews in terms of other available social supports, it is a well-educated and economically well-supported group. We conclude that many women do not believe they would be ready to leave the hospital at less than 24 hours postpartum.

Adolescent↗

PubMed1997

Prediction of pKa values of phenolic and nitrogen-containing compounds by computational chemical analysis compared to those measured by liquid chromatography.

The pKa values of 64 phenolic and 50 nitrogen-containing compounds were obtained by reversed-phase liquid chromatography and computational chemical calculation. The chromatographically obtained values of phenolic compounds were equal to pKa values from references and Hammett's equation, and those of nitrogen-containing compounds were lower than the reference values. It appeared difficult to calculate the properties of the ortho effect and nitro group by the computational calculation method. However, the calculation was simpler than selecting different constants of Hammett's equation for a variety of compounds.

Computer Simulation↗

PubMed1997

Vitamin A deficiency among adolescent female garment factory workers in Bangladesh.

OBJECTIVE: To investigate the prevalence of vitamin A deficiency among adolescent female factory workers in Bangladesh, and examine the association between various factors and vitamin A status. DESIGN: A cross-sectional study. SETTING: Garment factories in Dhaka city, Bangladesh. SUBJECTS: Three hundred and eighty eight adolescent girls aged 12-19 y from ten garment factories were selected randomly for the present study. Information on socio-economic conditions and usual pattern of dietary intake were obtained by interview. Anthropometric data and blood samples were collected following the interview. RESULTS: By NCHS reference standard, 15.5% of the participants were thin (< 90% Wt/Ht) and about 7% overweight (> 120% Wt/Ht). In about 56%, serum vitamin A level was below the adequate level of 1.05 mumol/l, with 14% having vitamin A deficiency (< 0.70 mumol/l). Forty four per cent of the participants were found to be anaemic (haemoglobin < 120 g/l). Food frequency data on vitamin A rich foods revealed that a large percentage of the participants do not take eggs (41%), milk (64%), liver (85%) and sweet pumpkin (85%); while about 40% of the girls take dark green leafy vegetables (DGLV) and 17% take small fish at least four servings a week. The girls who consumed four or more servings per week of DGLV had significantly higher serum vitamin A level than the girls who took three servings or less. There was a significant positive association between the level of serum vitamin A and frequency of intake of DGLV (r = 0.12; P = 0.023). When age, level of education, percapita income, haemoglobin concentration, serum protein concentration, menstruation at the time of blood collection, prevalence of current morbidity, frequency of intake of egg, milk, small fish, DGLV, liver and sweet pumpkin were accounted for by multiple regression analysis, a strong relationship was found for serum vitamin A concentration with age, menstruation, haemoglobin level and frequency of intake of DGLV. For every unit change in the frequency of consumption of DGLV, there was 0.013 mumol/l change in serum vitamin A level whilst taking other factors into account. CONCLUSION: The data show that there is a high prevalence of subclinical vitamin A deficiency among the adolescent female garment factory workers in Bangladesh, although the anthropometric indices suggest that they do not suffer from acute under nutrition. Consumption of DGLV appears to have an important relation with the vitamin A status of these girls.

Adolescent↗

PubMed1997

Epidemiology of shigellosis among children exposed to cases of Shigella dysentery: a multivariate assessment.

We followed 1,756 young, rural Bangladeshi children less than five years of age for one month after identification of sentinel Shigella patients in their neighborhoods. Two hundred nineteen (12%) children developed Shigella diarrhea (shigellosis) and 227 (13%) developed culture-negative dysentery. Shigella flexneri (60%) and S. dysenteriae, type 1 (15%) were the most common isolates among shigellosis cases. Within individual neighborhoods, there was poor agreement (Kappa = 0.21) between Shigella species isolated from sentinel patients and from additional cases detected during surveillance. The risk of shigellosis increased substantially after infancy and peaked in the second year of life. Severe stunting, as assessed by height-for-age, was associated with an increased risk of shigellosis (adjusted odds ratio [ORa] = 1.67, 95% confidence interval [CI] = 1.09-2.57, P < 0.05), while breast-feeding was protectively associated (ORa = 0.40, 95% CI = 0.24-0.69, P < 0.001). Only 43% of the shigellosis cases reported bloody stools; frank dysentery occurred more frequently in S. dysenteriae 1 infections than in S. flexneri infections (ORa = 5.04, 95% CI = 1.76-14.48, P < 0.01), and was also associated with severe stunting (ORa = 2.16, 95% CI = 1.01-4.58, P < 0.05). Our findings show that the high risk of shigellosis in residentially exposed Bangladeshi children results from multiple Shigella strains circulating concurrently within the same neighborhood; demonstrate that the risk is notably modified by host age, nutritional status, and dietary patterns; and illustrate that the classic picture of dysentery is relatively infrequent and is correlated with the infecting species and with host nutritional status.

Adolescent↗

PubMed1997

Activation of hexokinase by mild insulin dependent diabetes mellitus in rat erythrocytes.

In order to reveal sequel of events responsible for increase in red cell cytosolic glucose-6 phosphate (G-6P) content of diabetic patients the enzyme producing and transforming G-6P were assayed. Increase in the activity of hexokinase and decrease in phosphoglucoisomerase activity was observed in mild insulin dependent diabetes mellitus (mIDDM) rat erythrocytes. Increase and decrease in activity of hexokinase and phosphoglucoisomerase respectively will increase the cytosolic glucose-6 phosphate content. Thus any substance which autoregulate the activity of hexokinase and maintains critical level of G-6P necessary for generation of ATP and coenzymes (NADPH & NAD+) in the prevailing hyperglycemic state can be a potential therapeutic agent for diabetic patients.

Animals↗

PubMed1996

IFN-gamma-independent production of IL-12 during murine endotoxemia.

We examined whether IFN-gamma deficiency alters the in vivo IL-12 response occurring in the mouse model of acute endotoxemia. C57BL/6 IFN-gamma knockout mice (IFN-gamma 0/0) produced as much circulating IL-12 p40 and IL-12 p70 as did IFN-gamma +/+ mice following injection with S. enteritidis LPS, despite sustaining 11-fold reductions in circulating TNF-alpha. Pretreatment of IFN-gamma 0/0 mice with recombinant mouse IFN-gamma (rIFN-gamma) enhanced circulating TNF-alpha by as much as sixfold, but serum IL-12 p40 and IL-12 p70 responses increased by only twofold or less. Compared with IFN-gamma +/+ mice, the spleens of endotoxemic IFN-gamma 0/0 mice generated two- to threefold fewer IL-12 p40-secreting cells following in vitro or in vivo exposure to endotoxin. The addition of rIFN-gamma to IFN-gamma 0/0 splenocyte culture restored normal levels of LPS-stimulated IL-12 p40 production. Removal of Mac-1+ or F4/80+ cells from endotoxin-stimulated spleen reduced both TNF-alpha and IL-12 p40 production, but 33D1+ dendritic cell removal only affected IL-12 synthesis. These data suggest that the aggregate IL-12 p40 and p70 response to endotoxemia in vivo is IFN-gamma-independent and distinct from IFN-gamma-dependent serum TNF-alpha and splenic IL-12 responses. The cellular and/or cytokine basis for the unexpected preservation of IL-12 production in IFN-gamma-deficient mice may be relevant to normal and pathologic immune responses.

Animals↗

PubMed1996

Microbial transformations of steroids--X. Cytochromes P-450 11 alpha-hydroxylase and C17-C20 lyase and a 1-ene dehydrogenase transform steroids in Nectria haematococca.

Nectria haematococca contains four enzymes that metabolise exogenous steroids. Two of these are microsomal cytochromes P-450 which act sequentially on progesterone producing firstly, by side-chain cleavage, the C19 steroid androstenedione (C17-C20 lyase), and then, in a subsequent set of transformations, 11 alpha-hydroxylated derivatives (11 alpha-hydroxylase). Two other conversions occur after side-chain cleavage. Unsaturation, in the form of a double bond at C1-C2, is introduced into the A ring by a catalytically self-sufficient microsomal 1-ene dehydrogenase. This enzyme is specific for C19 substrates. A C17-specific oxidoreductase is also involved in the production of androstenedione and testosterone from progesterone. The lyase, 11 alpha-hydroxylase and 1-ene dehydrogenase were purified to homogeneity.

Androstenedione↗

PubMed1996

Effect of human immunodeficiency virus type 1 infection on the antibody response to a glycoprotein conjugate pneumococcal vaccine: results from a randomized trial.

Adults (n = 282) were randomized to receive either a pneumococcal glycoprotein conjugate vaccine, composed of pneumococcal serotypes 6B, 14, 18C, 19F, and 23F linked to CRM197, or a 23-valent pneumococcal polysaccharide vaccine. Among human immunodeficiency virus (HIV)-uninfected persons, conjugate vaccine elicited significantly higher IgG antibody geometric mean titers (GMTs) than did polysaccharide vaccine for serotypes 6B, 18C, and 23F: IgG GMTs were 9.0 versus 4.8, 23.2 versus 5.9, and 15.3 versus 4.4 micrograms/mL, respectively. In contrast, the two vaccines elicited similar antibody GMTs in HIV-infected persons: GMTs ranged from 1.3 to 10.8 micrograms/mL for all serotypes. Of note, among persons receiving polysaccharide vaccine, antibody GMTs in HIV-uninfected and -infected persons with CD4 lymphocytes > or = 500/microL were similar. These data underscore the importance of controlled clinical evaluations of newer pneumococcal vaccines in all high-risk groups for whom pneumococcal immunization is recommended and highlight the need for early immunization of HIV-infected persons with currently available polysaccharide vaccines.

AIDS-Related Opportunistic Infections↗

PubMed1996

Relationship between birth weight and biochemical measures of maternal nutritional status at delivery in Bangladeshi urban poors.

A cross-sectional study was carried out to investigate relationship of birth weight with selected biochemical indices of nutritional status of mothers at delivery in poor urban population of Dhaka, Bangladesh. One hundred and fifty one pregnant women of known gestational length, aged 20-30 years, who attended a local maternity hospital for delivery participated in this study. All of them were free from any pregnancy complications or diseases, and delivered a singleton fullterm baby. Socio-economic and obstetric history were taken by interview. Anthropometric data and blood samples were collected on the same day. Twenty per cent of the participants were anaemic (Hb < 11.0 g dl-1), 49% had subnormal (< 4.0 g dl-1) serum albumin and 32.5% had serum vitamin A lower than adequate level (< 30.0 micrograms dl-1). Mothers who gave birth to low birth weight babies had lower levels of haemoglobin (P = 0.06), serum albumin (P = 0.02) and serum vitamin A (P = 0.05) at delivery compared with the mothers who gave birth to normal weight babies. After adjustment for various confounding factors, only serum albumin level remained significantly lower in the mothers of low birth weight babies. Using multiple regression analysis for birth weight, the overall F-ratio was calculated to be 12.5 and was highly significant (P = 0.0000). The adjusted R2 was 0.32. Gestational age, father's occupation, mother's body weight and serum albumin level were found to have significant independent effect on birth weight.

Adult↗

PubMed1996

Serum retinol and biochemical measures of iron status in adolescent schoolgirls in urban Bangladesh.

OBJECTIVE: To examine the relationship between serum retinol and biochemical indices of iron nutritional status amongst adolescent girls in urban Bangladesh. DESIGN: A cross-sectional study. SETTING: Girls' high schools in Dhaka City, Bangladesh. SUBJECTS: Adolescent girls, n = 225, aged between 12 and 15 years, from four urban schools participated in the study. Information on socio-economic conditions were obtained using a questionnaire. The height and weight of each girl were measured and a sample of blood was taken for biochemical analyses. RESULTS: Twenty-two per cent of the participants were found to be anaemic (Hb < 120 g/l), 15% had subnormal serum iron ( < 7.16 mumol/l) and about 25% were iron deficient judged by serum transferrin saturation (TS < 15%). Eleven per cent of the participants had low levels of serum retinol ( < 1.05 mumol/l). Anaemic girls (n = 51) were found to have significantly lower serum retinol as well as lower packed cell volume (PCV), mean corpuscular haemoglobin concentration (MCHC), serum iron, TS, and higher serum total iron binding capacity (TIBC) compared with those with normal haemoglobin levels. When the girls were classified by serum retinol, the third with the highest serum retinol had significantly higher levels of haemoglobin, PCV, MCHC and serum iron levels. When age, family size, family income, expenditure on food, education of the parents, supplementation with vitamin A or iron and menstruation at the time of study were accounted for by multiple regression analysis, a strong relationship was found for serum retinol concentration with PCV, MCHC, haemoglobin, serum iron and TS. For 1 mumol/l change in serum retinol concentration there was a 10.1 g/l change in haemoglobin whilst taking other factors into account. CONCLUSION: The data indicate that there is an interaction between serum retinol and biochemical indices of iron nutriture in adolescent girls who do not display any clinical signs of overt deficiency.

Adolescent↗

PubMed1996

Early nutritional origins of hypertension: a hypothesis still lacking support.

PURPOSE: It has been hypothesized that limitations in 'a baby's nourishment before birth', as reflected in reductions in birthweight and other newborn anthropometric measurements, are associated with subsequent elevations in blood pressure. We assess this hypothesis in light of four causal criteria commonly used by epidemiologists: specificity, consistency, strength and biological coherence. We also examine aspects of the methodology used in studies of this hypothesis. METHODOLOGIC PROBLEMS: Two major data sources for testing the hypothesis in Hertfordshire and Preston are flawed by very high attrition. The practice of testing this hypothesis by controlling for adult weight in the analysis overstates the benefit that might accrue from interventions to increase birthweight. CAUSAL CRITERIA: Studies used to support the hypothesis examine a wide variety of exposures and outcomes, without prespecification of which associations are expected. The inverse relationship of birthweight to blood pressure is found inconsistently and, when present, is not strong. Potential confounding variables, especially social class, have not generally been taken into account. Evidence from human nutrition studies, especially of famine exposure and pregnancy nutrition supplementation, are not supportive of the proposition that in industrialized countries variations in the birthweight of the population closely reflect pregnancy nutrition. CONCLUSION: When examined critically, the evidence thus far provided does not support the hypothesis that prenatal nutrition is a major determinant of adult blood pressure.

Fetus↗

PubMed1995

Impaired immune response to natural infection as a correlate of vaccine failure in a field trial of killed oral cholera vaccines.

In a field trial carried out in 1985 in Matlab, Bangladesh, the authors evaluated whether subjects who developed Vibrio cholerae 01 infections during the first year after earlier receipt of B subunit-killed whole cell (BS-WC) or killed whole cell-only (WC) oral cholera vaccines exhibited deficient serum vibriocidal immune responses to these infections. After severe V. cholerae 01 infections (n = 70) in subjects > 5 years of age, the age group in which both vaccines were efficacious, a 6.5 geometric mean-fold rise of serum vibriocidal antibodies was observed among vaccinees, compared with an 18.6 geometric mean-fold rise in placebo-recipients (p < 0.01). Depressions of serum vibriocidal responses among vaccinees were even more marked after asymptomatic infections (n = 30): a 1.1 geometric mean-fold rise in vaccinees versus a 5.9 geometric mean-fold rise in placebo-recipients (p < 0.01). The authors conclude that subjects who failed to be protected by BS-WC and WC, despite being in the age group for which these vaccines were protective, exhibited poor immune responses even to the vigorous stimulus of natural infection. These findings raise the possibility that immune hyporesponsiveness may limit the potential efficacy attainable by cholera vaccines in populations with endemic cholera.

Administration, Oral↗

PubMed1995

Endogenous IL-12 is required for control of Th2 cytokine responses capable of exacerbating leishmaniasis in normally resistant mice.

We investigated the mechanisms by which treatment with anti-IL-12 Ab prevents cure of infection with Leishmania major in resistant C57BL/6 mice. Consistent with delayed production of IL-12, anti-IL-12 Abs could be administered as late as 2 wk after infection to exacerbate disease. Starting at 2 wk of infection, the cultured lymph node cells from mice treated with either polyclonal or monoclonal anti-IL-12 Abs persistently generated 3- to 10-fold more IL-4 and IL-10 in response to L. major Ag compared with cells from mice receiving preimmune goat IgG. Reciprocal decreases in Ag-specific IFN-gamma production were observed in mice receiving anti-IL-12 Abs. A similar reversal of IFN-gamma and IL-4 production accompanied progressive disease induced by pretreatment with a single dose of anti-IFN-gamma mAb. Although IFN-gamma production was suppressed for up to 4 wk in mice treated with monoclonal anti-IL-12 or anti-IFN-gamma, coadministration of neutralizing anti-IL-4 IgG reversed progressive illness. These findings demonstrate that IL-12 produced in vivo is necessary for both the emergence of IFN-gamma producing cells and the down-regulation of Th2 cell responses during murine leishmaniasis. Furthermore, the uninhibited production of IL-4 was required to sustain progressive infection initiated by the decreased IFN-gamma synthesis observed in anti-IL-12 and anti-IFN-gamma-treated mice.

Animals↗

PubMed1995

Microbial transformation of steroids--IX. Purification of progesterone hydroxylase cytochrome P-450 from Phycomyces blakesleeanus.

Progesterone hydroxylase cytochrome P-450 was purified to homogeneity from Phycomyces blakesleeanus microsomes by a four step procedure. An M(r) value of 60,000 was determined for this protein by SDS-PAGE. The DEAE-cellulose and Blue-1 MIMETIC affinity fractions gave major peaks at 452 nm in a dithionite-reduced, carbon monoxide, difference spectrum. NaIO4-dependent progesterone hydroxylation was obtained by the pure enzyme without NADPH and NADPH-cytochrome P-450 reductase. NADPH-dependent hydroxylation required the addition of other Phycomyces microsomal proteins present in the Blue-1 fraction.

Chromatography, Affinity↗

PubMed1995

Relationship between smoking and antioxidant nutrient status.

The present study was designed to investigate the relationship between smoking and antioxidant nutrient intake and status. Smoker (n 44) and non-smoker (n 44) male students attending Dhaka University, aged between 22 and 28 years and living in a University Hall of Residence, were selected for the present study. Mean age, body weight, BMI and blood pressure were similar for both the smokers and non-smokers. Mean energy, protein and fat intakes were similar for both groups. Smokers had lower intakes of dietary vitamin C, carotenes and Zn but only the difference in Zn intake was statistically significant. There was no significant difference between smokers and non-smokers for either serum vitamin A (retinol) or vitamin E (alpha-tocopherol) level. The plasma vitamin C level of smokers was significantly lower than that of non-smokers (P = 0.0004). Smokers had significantly lower serum Cu (P = 0.04) and higher serum Zn levels (P = 0.003). Further, a significant dose-response relationship between smoking and vitamin C status was observed. Linear-regression analysis showed a significantly positive correlation between dietary intake and plasma vitamin C values in non-smokers (r 0.50; P = 0.0005). On the contrary, no such association was observed in smokers. These findings suggest that smoking may cause an imbalance in antioxidant nutrient intake and status.

Adult↗

PubMed1995

Hyperthyroxinemia and elevated lipids as paraneoplastic phenomena in hepatocellular carcinoma. A case report.

In the United States and Western Europe, primary hepato-cellular carcinoma is an uncommon malignancy. Even though many well-defined associations have been reported, paraneoplastic manifestations are rare in North American patients. We describe an adolescent with complaints of weight loss, weakness, and a sensation of ¿fullness in the upper abdomen.¿ On initial laboratory workup a lactescent serum was found, with the following abnormalities; serum cholesterol level of 573 mg/dl (normal 120-260), triglycerides of 1,761 mg/dl (normal 10-190), and serum thyroxine level of 21 microgram/dl (normal 5.5-12.3). Serum albumin, calcium, and thyroid-stimulating hormone levels were also minimally elevated. Liver biopsy confirmed hepatocellular carcinoma. This is a rare hepatoma, which in our case manifested with multiple paraneoplastic phenomena, including hyperthyroxinemia, hypercholesterolemia, hypertriglyceridemia, and hyperalbuminemia. We review the pertinent literature.

Adolescent↗