A case of a 66-years-old male with iron deficiency anemia for more than 16 years, refractory to management with iron therapy is reported. Fecal occult blood test done several times was found to be negative. Upper and lower endoscopy revealed no source of bleeding. Capsule enterscopy showed no vascular malformations in the jejunum and ileum. The patient was managed with repeated blood transfusions. Abdominal ultrasound followed by CT scan abdomen revealed right renal soft tissue lesion. A CT-guided biopsy was then taken; the histopathology revealed a clear cell renal cell carcinoma. Right radical nephrectomy was done; the patient's hemoglobin showed a dramatic increase to 14 g/dL within one month. The dramatic response of the anemia to surgery mandates considering renal cell carcinoma in the workup of the possible causes of iron deficiency anemia. Only one similar case has been previously reported.

Renal transplantation provides the best long-term treatment for chronic renal failure. Singlenucleotide polymorphisms (SNPs) play a major role in the understanding of the genetic basis of many complex human diseases. Also, the genetics of human phenotype variation could be understood by knowing the functions of these SNPs. It is still a major challenge to identify the functional SNPs in a disease-related gene. This work explored how SNPs mutations in HLA-DRB1 gene could affect renal transplantation rejection. This study was carried out in Ahmed Gasim Hospital, Renal Dialysis Center during the period, from September 2012 to November 2013. Blood samples from five Sudanese patients (different families) with known renal transplantation rejection were collected before hemodialysis, furthermore one blood sample for control. DNA sequences results and detected SNPs were analyzed using bioinformatics tools (BLAST, SIFT, nsSNP Analyzer, PolyPhen, I-mutant, BioEdit, CPH, Chimera, Box shade and Project Hope). In addition, international databases were used for datasets [NCBI, Uniprot]. Results showed that, three SNPs were detected; two of three SNPs were predicted as tolerant or benign (rs1059575, novel) and one was deleterious (rs17885437). This study concluded that the identification of pathological SNPs could be an answer to unknown causes for a lot of organ transplantation rejection cases. * Corresponding author. M. M. Hassan et al. 223

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