A few days ago Bob asked the following question in the health forums:

Hi Guys,
My mother, after having a mild stroke, was said to have "Hyperviscosity" of her blood.
The doctors are still not sure, but they say she has "Waeldenstrom’s Macroglobulinemia" or something like that.
Is it common? Never heard of it. BTW she’s 68 YO.
I would really like to know if there’s a cure for it.
Thanks DAD dudes!!
Bob

 

Read on, Bob, to find out about the disease.

Danger level: High

Health forums category: Cancer

What is it?

Waldesntrom’s macroglobulinemia (WM) is a type of cancer in the blood.

Who gets it?

The disease is quite rare – only about 1,500 cases are diagnosed in the US each year (in the UK, about 10 people out of a million get it each year).

It’s more common in white people (only about 5% of patients are of African origin).

WM is a little more common in men than in women, and it tends to happen around age 65.

What causes it?

Our blood contains many types of cells. One of these types is white blood cells. These cells belong to our immune system and are meant to fight infections.

Like there are many types of cells in the blood, there also several types of white blood cells (five types, actually). One of these types is lymphocytes. To make things even more complicated, lymphocytes themselves are divided into T cells and B cells (and that’s where the complication stops).

Lymphocytes. In WM, this cell goes bad.

WM is a disease of B cell lymphocytes. There are 2 problems these cells cause in this disease:

1. B cells produce molecules called antibodies. Think of them as the weapons used by these cells to kill the bad guys. There is a type of antibody called IGM, which looks something like this:
    
   In WM B cells create too much of this antibody. The blood is then filled with these IGMs floating about. Because of their large structure, they cause the blood to become less liquid and more sticky, or viscous. The condition is then called hyperviscosity syndrome. This can lead to things such as nosebleed, dizziness, gum bleeding and blurred vision.
2. In WM, like in other cancers, B cells multiply uncontrollably. They start infiltrating organs in the body.

How does it feel?

Some people don’t feel anything when they have WM. When people do have symptoms, they can include:

a. Weakness

b. Fatigue

c. Bleeding from the nose or gums

d. Weight loss

e. Bruises in the skin

When the condition is more severe (meaning the blood is thicker) other things which may occur include:

a. Blurring or loss of vision

b. Neurological problems – These include headaches, dizziness, and vertigo.

c. Sometimes a stroke or coma may also ensue.

How is it discovered?

A few tests are done to discover WM:

1. Blood tests: They discover, among other things, the high level of IGM in the blood.
2. A bone marrow biopsy: A sample of bone from the back of the pelvis is taken using a needle. It is then examined under a microscope.

How is it treated?

There’s no cure for WM. If someone doesn’t have any symptoms, usually no treatment is needed. If symptoms are present, though, usually chemotherapy is used.

In cases of hyperviscosity syndrome, where high levels of IGM are present in the blood, a treatment called plasmapharesis is used. In it blood from the patient is removed and circulated through a machine that separates the plasma (which contains the IGMs) from other parts of the blood (such as red and white blood cells). The blood cells are then returned to the patient, along with a plasma substitute.

What happens after treatment?

With treatment, people may live with the disease for longer than 10 years (this is considered good, since in the past people only survived for about 5 years after the diagnosis).

The bottom line – How do I avoid It?

Unfortunately, there is no known way to prevent WM.

Related posts:

1. Neuroblastoma – The Most Common Cancer in Infants
2. Multiple Myeloma – Bone Marrow Cells Taking Over
3. TTP – Thrombotic Thrombocytopenic Purpura – A Rare Disease That Could Kill You

Danger level: Medium

What is it?

Iron deficiency anemia is a type of anemia caused by a lack of iron in the body.

Who gets it?

Iron deficiency anemia is common. In the United States it affects about 1-2% of people.

There are groups of people more likely to have iron deficiency anemia:

1. Women – Women of childbearing age lose blood monthly in their period. This puts them at risk for iron deficiency anemia. Pregnancy also causes a higher demand for iron, which may bring about iron deficiency anemia.
2. Infants and children – Newborn infants have stores of iron which should last for their first months of life, after which a supplementation is recommended if they are breast fed, or iron-fortified formulas are recommended if they are formula fed. Children need extra iron during growth spurts (it’s important for muscle development).
3. Vegetarians – Our main source of iron is meat. Since vegetarians don’t eat meat, they are at greater risk of iron deficiency anemia. (The iron in grains and vegetables isn’t absorbed as well as the iron in meat).
4. People with decreased absorption of iron in the intestines – Such as people with celiac disease.

Unless you’re a hamster, eating only vegetables can bring about iron deficiency anemia. Photo by shhexycorin.

If you have iron deficiency anemia and you are not included in one of those groups, the cause may be a hidden source of bleeding within your body, such as a peptic ulcer, hemorrhoids, cancer or other causes.

What causes it?

Iron is needed by the body to make hemoglobin. As you can read in our anemia article, hemoglobin carries oxygen in our red blood cells to reach all parts of the body. When there’s not enough iron, hemoglobin cannot be formed, which leads to iron deficiency anemia.

How does it feel?

As with all cases of anemia, iron deficiency anemia causes you to feel weak and tired easily. You may look pale. If it is severe, you may feel short of breath. Other things which can appear are headaches and irritability.

Other, less common things which can occur in iron deficiency anemia include:

1. Pica – This is a phenomenon in which people eat things that aren’t considered food, such as clay, coal, soil, ice.
2. Spoon-shaped nails
3. Angular Chelitis – These are wounds in the corners of the mouth.
4. Glossitis – This is an inflammation of the tongue, which causes it to swell and change color.

And others…

How is it discovered?

There are blood tests which can discover if you have iron deficiency anemia:

1. Complete blood count (CBC) – It checks, among other things, the level of hemoglobin. It also allows the doctor to see the blood under a microscope, which gives clues to the cause of the anemia.
2. Blood tests to check your levels of iron

If the doctor suspects you have a bleeding somewhere in your body which causes the anemia, they may check your stool for blood or examine your digestive tracts to look for a cause.

How is it treated?

The treatment is simple: iron. It may be taken as a pill or given as an injection (in people who can’t absorb the iron properly due to a problem in their intestines, or those who have side effects when taking the pill).

What happens after treatment?

Most people begin to feel better after a few days of treatment. The treatment is needed for several months, though, to build up the iron in the body.

The bottom line – How do I avoid it?

You can avoid it by eating foods rich in iron, such as red meat, pork, seafood, poultry, eggs, iron fortified cereals/bread/pasta, beans, peas, dark green leafy vegetables (such as spinach), nuts and seeds, and dried fruit (like raisins and apricots). Iron coming from meat is absorbed better than the other types.

It’s also known that drinking citrus juice while eating iron containing foods helps with its absorption.

Related posts:

1. Anemia – All About It
2. Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency – When Certain Conditions Can Destroy Blood Cells
3. Ornithine Transcarbamylase Deficiency– What If You Couldn’t Eat Steaks? (As Seen on House MD)

First of all – What is anemia?

Anemia, according to Wikipedia’s definition, is “a decrease in normal number of red blood cells or less than the normal quantity of hemoglobin in the blood”.

What does this mean, in plain English?

First, red blood cells: Our body needs oxygen to function. This oxygen has to reach each and every organ in our body. The oxygen is placed inside our red blood cells, which travel throughout the body in our blood vessels and deliver the oxygen to all organs. The oxygen in the blood cells is carried in a special molecule called hemoglobin

Hemoglobin. Oxygen is delivered in it to all body parts. Photo by Zephyris.

As the definition above says, anemia can happen if one of these two things occurs:

1. When you don’t have enough red blood cells – This can happen if you have less than the normal amount of blood (for example, when you bleed from somewhere in your body).
2. When you have the normal amount of red blood cells, but not enough hemoglobin

How does anemia feel?

When you have anemia, not enough oxygen is delivered to your organs. This can cause fatigue, difficulty breathing when you do physical activity, and if you have a heart condition, it can even bring about angina pectoris.

People with anemia look pale. Their heart rates can be faster (the heart is trying to move more oxygen to the body, so it will move the blood faster). The blood pressure of people with anemia can change as well – it tends to fall when they stand up (“dizzy spells”).

According to the type of anemia (we’ll get to that later), other things can happen as well. This picture sums it up:

What are the causes?

There are many types of anemia. Its causes can be divided into two main groups:

Here’s a rundown of what’s in each group. Please note: Each of the diseases below will be featured in future posts and linked back here, so it’s worth bookmarking this page and returning to it from time to time.

Group 1 – Problems in the production of blood cells

There are a few diseases in this group:

1. Iron deficiency anemia: This is a common cause of anemia. Iron is needed by the body to make hemoglobin. If you don’t have enough of it, the body can’t produce enough hemoglobin. Reasons for this include bleeding from somewhere in your body (such as when you have a period), not eating enough foods that contain iron or problems in absorbing the iron, and times at which more iron is needed (such as during pregnancy).
2. Thalassemia: This is a genetic disease in which there is a problem with the production of hemoglobin.
3. Anemia of chronic inflammation: Sometimes, people with chronic diseases may have anemia due to their illness. Examples of such illnesses include chronic infections, HIV, cancers and others.
4. Folate or vitamin B12 deficiency: Folate (folic acid) and B12 are needed for the production of red blood cells (as well as other cells in the body). If you have a deficiency in any of these, you’ll have anemia. Folate is present in leafy green vegetables and fruit, and B12 is present in foods of animal origin (such as meat. This is why vegetarians can have a deficiency).
5. Other reasons: Other things can also cause problems in the production of red blood cells. These include liver diseases, alcoholism, problems with the thyroid gland, certain medications and others.

Group 2 – Increased destruction or loss of blood cells

1. Blood loss – When you are injured and lose blood, such as after a car accident or a gunshot wound, you lose blood. This causes anemia and your body will not be able to transfer oxygen to your organs efficiently. That is why blood transfusions are often given after an injury.
2. Hemolysis – This is a Greek word (hemo = blood, lysis = to break open) which means the destruction of red blood cells. There are a few diseases which cause this:

   a. G6PD Deficiency – A genetic problem which causes the red blood cells to be more susceptible to damage, which causes their destruction.

   b. Sickle cell anemia – Another genetic disease. It causes the hemoglobin to have a strange shape, which causes the red blood cells to get destroyed.

   c. Hereditary spherocytosis – Yet another genetic disease. In this disease there’s a change of shape in the cover of the red blood cells, which causes them to be more susceptible to destruction.

   d. Paroxysmal nocturnal hemoglobinuria – A disease in which there’s a problem with the cells from which red blood cells are created.

   e. Autoimmune hemolytic anemia – In this disease, antibodies (the molecules in our body responsible for fighting infections) attack the red blood cells and destroy them, for unknown reasons.

   f. Microangiopathic hemolytic anemia – This is a complicated name for a groups of diseases. The common thing they all have is that the red blood cells are destroyed inside our blood vessels. Diseases here include thrombotic thrombocytopenic purpura (TTP), hemolytic uremic syndrome (HUS), and disseminated intravascular coagulation (DIC).

   g. Hypersplenism – Our red blood cells don’t live forever. They live for about 120 days, and then get destroyed, mainly in the spleen. When our spleen gets bigger it tends to trap more red blood cells and so they get destroyed even when they are not old. Reasons for that includes tumors, infections and others.

How can the doctor tell if you have anemia?

First of all, if you have the right symptoms mentioned above, such as feeling tired and being pale.

Second, they will run a blood test, in which the hemoglobin will be low. (The normal values are 12-14 in women and 14-16 in men). Other lab tests help the doctor understand which anemia you have.

Related posts:

1. Iron Deficiency Anemia – A Common Type of Anemia
2. Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency – When Certain Conditions Can Destroy Blood Cells
3. Multiple Myeloma – Bone Marrow Cells Taking Over

Danger level: Medium

What is it?

G6PD deficiency is a hereditary disease causing anemia in certain situations.

Who gets it?

G6pd deficiency is an inherited disease. Its mode of inheritance is X-linked. This means that the mutation is caused in the X chromosome (one of our 46 chromosomes). For reasons beyond the scope of this article, this means that it almost always occurs only in males.

It’s most common in people of Mediterranean (Italian, Greek, Arab, Sephardic Jewish) or African origin (in the US, it occurs in about 10% of African Americans). It affects about 200 million people worldwide.

What causes it?

G6PD is an enzyme in our body which helps the body produce gluthatione. Gluthatione is a molecule which helps to protect the body against free radicals, which are harmful molecules. These molecules can damage our red blood cells under certain conditions.

In G6PD deficiency, like the name says, there’s a deficiency in the G6PD enzyme. This means that people with the disease don’t produce enough gluthatione to fight the free radicals, which puts their red blood cells at risk.

The bright side – the red blood cells aren’t at risk all the time, but only in certain situations which raise the level of free radicals:

1. Taking certain drugs – Such as dapsone, primaquine, sulfamethoxazole, doxorubicin, methylene blue.
2. Infections
3. Certain foods – Such as fava beans. The interesting thing is that people with G6PD deficiency don’t even have to eat the beans in order to cause damage to the blood cells – it’s enough that they inhale their pollen.
4. Diabetic ketoacidosis – This is a condition that can happen to people with diabetes.

How does it feel?

Most of the time, people with G6PD deficiency are well. When the conditions mentioned above occur, there is a destruction of red blood cells, which leads to anemia and sometimes jaundice (yellowing of the skin). The destruction of red blood cells is called hemolysis. It can happen within hours of exposure to the condition (drug, food, etc.).

The level of the deficiency in G6PD (meaning how much of it exists in the body) will determine how bad the condition will get. Sometimes the hemolysis can stop once you stop taking the drug (this is more common in people of African origin), but it can also continue after you’ve stopped taking it. In severe cases, damage to the kidneys can occur.

The most important thing here is what can happen to babies with G6PD deficiency. A lot of babies have jaundice on their first days. In G6PD deficiency, this jaundice can be prolonged, which can cause damage to the brain.

How is it discovered?

There are a few things that can be done to discover the disease:

1. A blood smear – In which some drops of blood are smeared against a piece of glass and then looked at under a microscope. Certain things can be seen in G6PD deficiency because of the destruction of blood cells.
2. Checking the level of G6PD – To see that it’s indeed low.

How is it treated?

Since the destruction of blood cells usually stops by itself, no treatment is usually necessary. In severe cases, blood transfusions might be necessary.

In babies with jaundice, usually a treatment with a special kind of light helps to resolve the problem.

The bottom line – How do I avoid it?

You can’t prevent having the defect in the gene which causes the deficiency in G6PD. What you can do is avoid the things mentioned above which can trigger the destruction of blood cells (not eat any fava beans (or smell their pollens), avoid the dangerous drugs, avoid infections).

Related posts:

1. Iron Deficiency Anemia – A Common Type of Anemia
2. Multiple Myeloma – Bone Marrow Cells Taking Over
3. Ornithine Transcarbamylase Deficiency– What If You Couldn’t Eat Steaks? (As Seen on House MD)

A few days ago a court decision was made that ruled in favor of treating Daniel Hauser’s Hodgkin’s lymphoma, in spite of his parents’ objections. Since then, his mother took him and fled, putting the boy at risk.

We’ll explain the disease here, as well as the implications of treatment and of not treating it.

Danger level: High

What is it?

Hodgkin’s disease is a type of lymphoma – a cancer of the lymphatic system. The lymphatic system in our body is involved in draining fluid and waste products from the body, as well as producing white blood cells which protect the body from infections.

Who gets it?

In the US there are about 7,500 new cases of Hodgkin’s each year. It happens to about 3 out of 100,000 people. It’s more common in America and Europe than in Japan and China.

Hodgkin’s disease is more common in males than females, especially in children.

It tends to occur in two age groups: in people 15-35 years old and in those age 50 and more.

What causes it?

The white blood cells which are created in the lymphatic system are called lymphocytes. Their role is to fight infections. In lymphoma, these cells begin to multiply uncontrollably, which produces malignant cells. These cells can invade other tissues in the body.

A lymphocyte. These cells take over the body in lymphoma.

How does it feel?

Our lymphatic system contains organs called lymph nodes. They are found throughout the body, and act as “traps” for germs and other foreign things. When germs enter the body, some of them reach the lymph nodes. There they are presented to the lymphocytes, which learn that the body has an infection, and start multiplying in order to fight the infection in other places in the body. When they multiply, the lymph nodes enlarge. This is why, for example, when we have an inflammation in our throat, a lump can be felt in our neck – the white blood cells there multiply, which causes the lymph node to enlarge.

The lymphatic system. The green circles are the lymph nodes (you can click the picture for a bigger version).

Since in Hodgkin’s the lymphocytes multiply as well, the lymph nodes will get bigger. They are usually not painful, but one interesting feature is that they might hurt after you drink alcohol (for unknown reasons).

Other things which happen in the disease:

1. Enlargement of the spleen – As you can see in the picture above, the spleen is also part of our lymphatic system (in the picture it’s the oval shaped green mass on the right of the picture). It gets larger too in the disease. In some cases, the liver can enlarge as well.
2. “B symptoms” – This is a group of symptoms which characterize lymphomas. They include 3 things:
   a. Weight loss – Usually of more than 10% of the body weight over 6 months.
   b. Fever – Of more than 38 degrees Celsius (or 100.4 Fahrenheit).
   c. Night sweats – This doesn’t mean the sweat you usually experience on hot days. This sweating is profuse, often causing you to change sheets during the night.
   Sometimes an itchy skin may be present as well.
3. Cyclical fever – Some people will have fever that goes up for a few days, then goes down for several days or weeks, and then up again, in cycles. This phenomenon is called “Pel-Ebstein” Fever.

Since the lymphatic organs grow, they can press other organs in the body, which may cause:

1. Difficulty breathing – If the tumor presses the airways.
2. Back pain and even paralysis – When the tumor presses the spinal cord.

And others.

How is it discovered?

When one of the lymph nodes is enlarged and the doctor suspects you have Hodgkin’s disease, they will take a sample of that node, in a process called a biopsy. It can be done by cutting a piece of that node or taking the whole node out.

The sample of the node will be looked at under the microscope. One of the most characteristic things that can be seen under the microscope in Hodgkin’s are cells called Reed-Sternberg cells, which look like the eyes of an owl (if you have good enough imagination), as in this picture:

Once the microscope shows it’s Hodgkin’s, additional tests are done, including blood tests, and images of the body (X-rays, CT scans, etc.) to see where the tumor has spread to.

How is it treated?

Therapy for Hodgkin’s disease may include the following, depending on how severe the disease is:

1. Chemotherapy
2. Radiation therapy
3. Sometimes bone marrow transplantation

What happens after treatment?

In patients in whom the disease is discovered early, more than 90% are cured as a result of treatment. Even in people with an advanced disease, more than 75% of them can live for years without the disease.

There is currently no known way to prevent the disease.

Related posts:

1. In The News – Plague – The Next Swine Flu?
2. Kawasaki Disease – A Childhood Disease That Can Endanger The Heart
3. TTP – Thrombotic Thrombocytopenic Purpura – A Rare Disease That Could Kill You

Danger level: High

What is it?

Multiple myeloma is a blood cancer involving cells called plasma cells, in the bone marrow.

Who gets it?

In the US, 4 out of 100,000 people are found to have it each year. It’s a little more common in men than women, and almost twice as common in African American than in white people.

It’s usually found around the ages 65-70.

What causes it?

The bone marrow is the place within our bones where blood is produced. All types of blood cells (red blood cells, white blood cells and platelets) are produced there. 

One of the types of white blood cells (cells that are usually responsible for fighting infections) is plasma cells. They are responsible for producing antibodies – molecules that fight infections. In multiple myeloma, plasma cells divide in an uncontrolled manner and take over the bone marrow. They mass together and create tumors in different areas of the body, especially the bone marrow.

The bone marrow in multiple myeloma – Every purple round cell here is a plasma cell. They’ve taken over the bone marrow in this picture.

How does it feel?

Multiple myeloma can cause any of the following things:

1. Bone problems – The tumors of plasma cells in the bone can cause pain, usually in the back or chest, but it can also happen in the arms or legs. The other thing that happens to bone here is bone loss, which can lead to fractures. If these fractures happen in the spine, it can also cause neurologic problems.
2. High blood calcium levels – Bone here is lost. But the lost bone doesn’t just disappear. Bone contains calcium (among other things). When the bone is lost here, the calcium in it is released to the blood, which in high levels can cause loss of appetite, nausea, vomiting, constipation, thirst, weakness, confusion and even coma.
3. Anemia – Since more white cells are produced here, less red cells are produced – causing anemia and weakness (the red cells are responsible for delivering oxygen to our body).
4. Kidney problems – There are many reasons for this, such as the high levels of antibodies the many plasma cells here produce, and also the high calcium level in the blood. This causes the kidneys to fail.
5. Thickened blood – The many antibodies created here cause the blood to be thick, which causes flow problems, leading to bleeding from the mouth or nose, blurred vision, heart failure and neurologic problems.
6. More infections – We said that more plasma cells (which fight infections) are created here. But they are defective, and are created on the account of normal cells – this causes problems with fighting infections.

To better understand all of these complex symptoms you can watch this movie, which tells the story of 3 patients who found out they have multiple myeloma:

How is it discovered?

There are a few tests that can be done:

1. Blood tests and urine tests – They can find the high level of antibodies created by the plasma cells.
2. Bone marrow examination – This is done by a biopsy (cutting a piece of bone) or aspiration (“sucking” bone marrow with a needle). A picture similar to the one above will show. It takes an excess of more than 10% of plasma cells to prove that there is multiple myeloma.
3. X-rays: The bone destruction here causes “holes” in the bone, which are called “lytic lesions”. They will show on x-ray.

How is it treated?

There are several things that can be done to treat it:

1. Chemotherapy – It doesn’t cure the disease,but controls it.
2. Bone marrow transplantation – From the patient’s own body (the usual treatment) or from a donor.
3. Other types of drugs

What happens after treatment?

The disease tends to recur, and should be treated again. The survival in the disease can change according to many criteria, but it can go between years to months.

Unfortunately, there is no known way to prevent it. If you do feel any of the symptoms described above and you’re the right age, seeking medical help early might be the best course of action.

Have you encountered the disease yourself, or in someone you know? Share in the comments.

Related posts:

1. Paget Disease of Bone – Bone Deformity For An Unknown Reason
2. Waldenström’s macroglobulinemia – A Rare Blood Cancer That Can Lead To Strokes
3. Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency – When Certain Conditions Can Destroy Blood Cells

Danger Level: High

What is it?

TTP is a life threatening disease in which the platelets (the cells in the blood responsible for blood clotting) are missing and the red blood cells are destroyed.

Who gets it?

It’s a rare disease: 1 person out of 4 million a year will have the disease. It usually affects men more than women (but not by much), and it usually happens in the ages of 30-40.

What causes it?

When a blood clot is formed, those platelets mentioned above aggregate together to seal the wound out of which blood is coming out. They do this with the help of many small molecules, one of them is VWF – or by its long name: Von-Willebrand Factor.

In TTP there is a problem with VWF – it’s getting larger and larger because the mechanism responsible for cutting it to its appropriate size is defective. That’s why platelets are aggregating like crazy and block blood vessels. This causes the destruction of normal blood cells and the other things mentioned below.

How does it feel?

5 things happen to you if you get TPP:

1. Confusion, seizure and even coma: Because those platelets that block blood vessels won’t allow blood to go to your brain properly.
2. Renal failure: Your kidneys will stop working, because blood won’t go to your kidneys as well.
3. Fever
4. The number of platelets goes down: Because they’re all clumped together
5. Anemia: Which is loss of your red blood cells. It happens because they are destroyed when bumping into those clumps.

How is it discovered?

Whenever someone comes to the ER with those 5 things (or some of them), the doctor will quickly take some blood out and do 2 things:

1. Look under the microscope: Where they will see those destroyed blood cells. They will look something like the picture below.
2. Let the lab count it: The count will show that the number of platelets is down, and things that go up whenever blood is destroyed will go up.

You can see that some of the cells are round, but some are deformed. (Photo by Ed Uthman, MD, Some Rights Reserved)

How is it treated?

The best way to answer that: FAST! Without the proper treatment, there is about 100% chance of dying from TTP.

The treatment involves a process called plasmapharesis, in which blood is removed from the body and blood from a donor is returned back, this way taking out the elements in the blood that caused the disease.

What happens after treatment?

In 3 weeks up to 90% of people will be mostly disease free. But: The disease can come back in 1/3 of people in the months and years that follow. They should get their blood checked periodically!

The Bottom Line: How do I avoid it?

Unfortunately, there is really nothing you can do to avoid it. If you fear that you have TTP, according to the information above, you should go to the emergency department immediately.

Related posts:

1. Waldenström’s macroglobulinemia – A Rare Blood Cancer That Can Lead To Strokes
2. Naphthalene Poisoning – When Mothballs Kill More Than Just Moths (As Seen on House MD)
3. Carcinoid Tumors – A Rare Tumor Often Not Found On Time