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Platelet adherence surrounding leucocytes in a rosette formation or platelet satellitism is a rare phenomenon. This finding has been observed almost exclusively in Ethylenediaminetetraacetic acid treated blood at room temperature. The mechanism underlying this phenomenon is not fully understood. In many reports of platelet satellitism platelets clump to polymorphonuclear neutrophils in healthy persons undergoing routine checkup, and sometimes this phenomenon could be a reason for spurious thrombocytopenia. Herein, we report a case of platelet rosetting around monocytes in a patient who was admitted with acute hemolysis due to G6PD deficiency with normal platelet count. Keywords: Platelet satellitism, monocyte, G6PD deficiency.

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Background: Oral mucositis afflicts more than 3/4 of patients with cancer under chemotherapy. In acute cases it could lead to brain damage caused by hypoxia and even death due to airway obstruction and reduction of chemotherapy drug dose. We aimed to compare the effects of topical mouth rinse and chamomile mouthwash in prevention of oral mucositis caused by chemotherapy in children with cancer.
Methods: The study was a randomized double-blind clinical trial on 62 children aged 6-15 years with acute lymphoblastic leukemia under chemotherapy. The participants were divided randomly into two groups. The first group used topical mouth rinse and the second group started to use chamomile mouthwash a day before chemotherapy through 14 days. Mucous membrane status was assessed before starting the treatment (one day before chemotherapy), 7th and 14th day and it was reviewed based on WHO oral mucositis check list assessment and then registered by the researcher. 
Results: The results showed that the frequency of severity of oral mucositis in both groups did not have any significant difference 7 days after chemotherapy (P=0.46). The severity of oral mucositis in those who had used chamomile mouthwash 14 days after chemotherapy was significantly lower than those who used topical mouth rinse (Z=3.23, P=0.001).
Conclusion: In short term, using chamomile mouthwash and topical mouth rinse to prevent oral mucositis is effective in children with cancer. 
Iranian Registry of Clinical Trials: IRCT2015040821658N1.

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Juvenile xanthogranuloma (JXG), is the most common form of non-Langerhans cell histiocytosis. It is a rare and usually benign, monoclonal proliferative disorder of histiocytic cells. The occurrence of multiple brain lesions is extremely rare. Due to the rarity of CNS disease, the preferred treatment and overall prognosis of these patients remain unclear. In this case report, authors present their experience about a patient with isolated multiple cerebral JXG which yields considerable outcomes. The patient was an eleven-year-old boy with anorexia and recurrent vomiting. Brain MRI demonstrated multiple lesions involving right lateral ventricle wall and periventricular white matter, the right side of splenium, mammillary body and tuber cinereum, fourth ventricle floor and roof, and cerebellar tonsil. After initial response to chemotherapy, the lesions recurred and radiotherapy was done. Consequent to good response after radiotherapy and despite the occurrence of a seizure attack, long term follow-up showed the marked resolution of the lesions and a good general status. 

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Cytomegalovirus (CMV) is the leading cause of viral-associated congenital infections. Moreover, it can also be acquired. Between 50 to 80 percent of the world’s population is seropositive for CMV and most clinical disease occurs in individuals previously infected with CMV. Rarely, serious CMV infection has occurred in individuals with healthy immune system. In contrast to immunocompetent patients, higher morbidity and mortality of CMV end organ disease is considered in immunocompromised patients. According to available evidence, gastrointestinal (GI) disease has lower prevalence in case of CMV-induced organ involvement, especially in pediatric non-transplant acute leukemia. In this report, we present a 12-year-old girl, known case of acute lymphoblastic leukemia (ALL) receiving maintenance chemotherapy with manifestations of gastroenteritis and significant weight loss. Initial laboratory data, demonstrated mild pancytopenia especially lymphopenia and thrombocytopenia. After excluding more common etiologies, colonoscopy with multiple biopsies were taken which was indicative of CMV-colitis. Intravenous (IV) ganciclovir for 3 weeks and oral valganciclovir for about 9 months were initiated. Follow-up courses for CMV surveillance included blood qualitative CMV polymerase chain reaction (PCR) and colonoscopy with biopsy which were negative for CMV but tissue qualitative CMV PCR was positive for CMV in about 7 months after initiation of treatment. Oral treatment was decided to be continued. To sum up, plenty of guidelines have been developed in stem cell transplantation and human immunodeficiency virus (HIV) patients but non-transplant leukemic setting, is a neglected area in the field of CMV infection management.