1
|
Yılmaz Çelebi M, Şahinkaya Ş, Cem E, Akaslan Kara A, Özdağ E, Ayhan FY, Karakaya N, Odaman Al I, Gözmen S, Hilkay Karapınar T, Oymak Y, Bayram SN, Devrim İ. A hidden burden of disease in a specific group: Evaluation of COVID-19 seroconversion rates in pediatric patients with leukemia. Am J Infect Control 2024; 52:320-323. [PMID: 37726054 DOI: 10.1016/j.ajic.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/09/2023] [Accepted: 09/09/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND SARS-CoV-2, a respiratory viral disease, is thought to have a more severe course in patients with malignancy and low immune systems. METHODS This prospective single-center study was conducted at the University of Health Sciences Dr Behçet Uz Children's Hospital from September 22 to December 31, 2021. Asymptomatic COVID-19 transmission rates were assessed using SARS-CoV-2 serology in patients with leukemia who had no history of COVID-19 infection. RESULTS Among the 54 patients, 19 (35.2%) were females and 35 (64.8%) were males. The median age was 5.5 years (min 6 months, max 17 years). Forty-nine (90.5%) of the leukemia patients had acute lymphoblastic leukemia, while 5 (9.5%) had acute myeloid leukemia. Five of the 54 patients had a history of COVID-19 or contact with a positive person. SARS-CoV-2 IgG positivity was detected in 18 (36.7%) of 49 patients with no history of COVID-19 infection. DISCUSSION Leukemia patients have a high seroconversion for SARS-CoV-2 without showing any symptoms supporting the asymptomatic course of COVID-19 infection in this risk group. CONCLUSION As a result, patients with leukemia may have a high rate of COVID-19 seroconversion without showing symptoms.
Collapse
Affiliation(s)
- Miray Yılmaz Çelebi
- Department of Pediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz, Children's Hospital, İzmir, Turkey.
| | - Şahika Şahinkaya
- Department of Pediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz, Children's Hospital, İzmir, Turkey
| | - Ela Cem
- Department of Pediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz, Children's Hospital, İzmir, Turkey
| | - Aybüke Akaslan Kara
- Department of Pediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz, Children's Hospital, İzmir, Turkey
| | - Eda Özdağ
- Department of Pediatrics, University of Health Sciences Dr. Behçet Uz, Children's Hospital, İzmir, Turkey
| | - Fahri Y Ayhan
- Department of Microbiology, University of Health Sciences Dr. Behçet Uz, Children's Hospital, İzmir, Turkey
| | - Nurgül Karakaya
- Department of Pediatric Hematology and Oncology, University of Health Sciences Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Işık Odaman Al
- Department of Pediatric Hematology and Oncology, University of Health Sciences Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Salih Gözmen
- Department of Pediatric Hematology and Oncology, University of Health Sciences Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Tuba Hilkay Karapınar
- Department of Pediatric Hematology and Oncology, University of Health Sciences Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Yeşim Oymak
- Department of Pediatric Hematology and Oncology, University of Health Sciences Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Süleyman N Bayram
- Department of Pediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz, Children's Hospital, İzmir, Turkey
| | - İlker Devrim
- Department of Pediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz, Children's Hospital, İzmir, Turkey
| |
Collapse
|
2
|
Yıldırım AT, Gülen H, Türkmen H, Özek G, Oymak Y, Durmaz B, Karaca E. Successful Treatment of a Child with Hemoglobin Hammersmith with Hematopoietic Stem Cell Transplantation. Hemoglobin 2023; 47:137-139. [PMID: 37605549 DOI: 10.1080/03630269.2023.2219007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 05/22/2023] [Indexed: 08/23/2023]
Abstract
Hemoglobin (Hb) Hammersmith, formed by serine substitution for phenylalanine at residue 42 in the beta-globin chain, is a very rare variant of unstable hemoglobin with low oxygen affinity. For patients with hemoglobinopathies, it is well-established that hematopoietic stem cell transplantation provides a complete cure, but the literature on its role for those with Hb Hammersmith is limited. A seven-month-old girl who was examined for anemia and splenomegaly was followed up for congenital hemolytic anemia. The patient with visible cyanosis of the lips and whose p50 was low in blood gas was diagnosed with Hb Hammersmith through the DNA sequence analysis. During the follow-up, frequent blood transfusions had to be given due to anemia aggravated by infections. Following a successful hematopoietic stem cell transplant from an HLA-matched sibling, the patient completely recovered from Hb Hammersmith. The case is presented because of its rarity.
Collapse
Affiliation(s)
- Ayşen Türedi Yıldırım
- Department of Pediatric Hematology and Oncology, Manisa Celal Bayar University, Manisa, Turkey
| | - Hüseyin Gülen
- Department of Pediatric Hematology and Oncology, Manisa Celal Bayar University, Manisa, Turkey
| | - Hülya Türkmen
- Department of Pediatric Hematology and Oncology, Manisa Celal Bayar University, Manisa, Turkey
| | - Gülcihan Özek
- Department of Pediatric Hematology and Oncology, Pediatric Bone Marrow Transplant Unit, Ege University, İzmir, Turkey
| | - Yeşim Oymak
- Department of Pediatric Hematology and Oncology, Pediatric Bone Marrow Transplant Unit, Ege University, İzmir, Turkey
| | - Burak Durmaz
- Department of Medical Genetics, Ege University, İzmir, Turkey
| | - Emin Karaca
- Department of Medical Genetics, Ege University, İzmir, Turkey
| |
Collapse
|
3
|
Ozek G, Aksoylar S, Uçar SK, Canda E, Akcan M, Cartı O, Siviş ZO, Oymak Y, Yazıcı H, Bax B, Bulut FD, Yoldaş Çelik M, Erdem F, Çoker M, Kansoy S. Hematopoietic stem cell transplantation with reduced toxicity conditioning regimen in mitochondrial neurogastrointestinal encephalopathy syndrome. Pediatr Blood Cancer 2023; 70:e30334. [PMID: 37046411 DOI: 10.1002/pbc.30334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/05/2023] [Accepted: 03/13/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is a rare autosomal recessive disorder due to mutations in the TYMP gene. Clinical findings are characterized by neurologic manifestations and severe gastrointestinal dysfunction. The syndrome is usually fatal, the most effective treatment appears to be hematopoietic stem cell transplantation (HSCT). PROCEDURE In this retrospective study, we evaluated HSCT that was performed using a reduced toxicity myeloablative conditioning regimen in patients with MNGIE at our center. RESULTS A total of six allogeneic transplant procedures were performed in four patients. Three patients had fully matched donors, and one patient had a haploidentical donor. Treosulfan-based myeloablative conditioning regimen was applied in five of six transplants. Bone marrow was used as a stem cell source. One patient is being followed up in the 4th year of posttransplant with full chimeric and without graft versus host disease (GVHD). One patient died of acute stage IV gastrointestinal system GVHD. Two patients underwent second transplantation due to engraftment failure, one of which was the patient who had a haploidentical transplant. CONCLUSIONS Treosulfan-based regimen is well tolerated, although engraftment failure with this conditioning regimen can be a significant problem. We share our haploidentical transplant experience, which will be the first reported case in the literature.
Collapse
Affiliation(s)
- Gülcihan Ozek
- Department of Pediatrics, Division of Pediatric Hemathology and Oncology, Ege University Medical Faculty, Izmir, Turkey
| | - Serap Aksoylar
- Department of Pediatrics, Division of Pediatric Hemathology and Oncology, Ege University Medical Faculty, Izmir, Turkey
| | - Sema Kalkan Uçar
- Department of Pediatrics, Division of Metabolism and Nutrition, Ege University Medical Faculty, Izmir, Turkey
| | - Ebru Canda
- Department of Pediatrics, Division of Metabolism and Nutrition, Ege University Medical Faculty, Izmir, Turkey
| | - Mediha Akcan
- Department of Pediatrics, Division of Pediatric Hemathology and Oncology, Ege University Medical Faculty, Izmir, Turkey
| | - Ozgür Cartı
- Department of Pediatrics, Division of Pediatric Hemathology and Oncology, Ege University Medical Faculty, Izmir, Turkey
| | - Zuhal Onder Siviş
- Department of Pediatrics, Division of Pediatric Hemathology and Oncology, Ege University Medical Faculty, Izmir, Turkey
| | - Yeşim Oymak
- Department of Pediatrics, Division of Pediatric Hemathology and Oncology, Ege University Medical Faculty, Izmir, Turkey
| | - Havva Yazıcı
- Department of Pediatrics, Division of Metabolism and Nutrition, Ege University Medical Faculty, Izmir, Turkey
| | - Bridget Bax
- Department of Cell Biology, Institute of Molecular and Clinical Sciences, St George's University of London, London, UK
| | - Fatma Derya Bulut
- Department of Pediatrics, Division of Metabolism and Nutrition, Çukurova University Medical Faculty, Adana, Turkey
| | - Merve Yoldaş Çelik
- Department of Pediatrics, Division of Metabolism and Nutrition, Ege University Medical Faculty, Izmir, Turkey
| | - Fehime Erdem
- Department of Pediatrics, Division of Metabolism and Nutrition, Ege University Medical Faculty, Izmir, Turkey
| | - Mahmut Çoker
- Department of Pediatrics, Division of Metabolism and Nutrition, Ege University Medical Faculty, Izmir, Turkey
| | - Savaş Kansoy
- Department of Pediatrics, Division of Pediatric Hemathology and Oncology, Ege University Medical Faculty, Izmir, Turkey
| |
Collapse
|
4
|
Guner Ozenen G, Akaslan Kara A, Boncuoglu E, Kiymet E, Cem E, Sahinkaya S, Yilmaz Celebi M, Gulderen M, Kacar P, Uras M, Hilkay Karapinar T, Oymak Y, Bayram N, Devrim I. Evaluation of antithrombotic prophylaxis and thrombotic events in children with COVID-19 or MIS-C: A tertiary pediatric center experience. Arch Pediatr 2023; 30:172-178. [PMID: 36907731 PMCID: PMC9902296 DOI: 10.1016/j.arcped.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 08/26/2022] [Accepted: 01/15/2023] [Indexed: 02/09/2023]
Abstract
OBJECTIVES COVID-19 and multisystem inflammatory syndrome in children (MIS-C) are associated with a risk of hypercoagulability and thrombotic events. We aimed (a) to evaluate the demographic, clinical, and laboratory findings as well as the incidence of thrombotic events of COVID-19 and MIS-C in children and (b) to determine the role of antithrombotic prophylaxis. METHODS A single-center retrospective study evaluated hospitalized children with COVID-19 or MIS-C. RESULTS The study group consisted of 690 patients, 596 (86.4%) diagnosed with COVID-19 and 94 (13.6%) diagnosed with MIS-C. Antithrombotic prophylaxis was used for 154 (22.3%) patients: 63 patients (10.6%) in the COVID-19 group and 91 (96.8%) patients in the MIS-C group. Use of antithrombotic prophylaxis was statistically higher in the MIS-C group (p<0.001). Patients who received antithrombotic prophylaxis were of older median age, were more commonly male, and had more frequent underlying diseases than those without prophylaxis (p<0.001, p<0.012, p<0.019, respectively). The most common underlying condition was obesity in patients who received antithrombotic prophylaxis. Thrombosis was observed in one (0.2%) patient in the COVID-19 group with a thrombus in the cephalic vein, two (2.1%) patients in the MIS-C group, with a dural thrombus in one patient and a cardiac thrombus in the other patient. The patients with thrombotic events were previously healthy and had mild disease. CONCLUSION In our study, thrombotic events were rare compared with previous reports. We used antithrombotic prophylaxis for most children with underlying risk factors; perhaps for this reason, we did not observe thrombotic events in children with underlying risk factors. We suggest that patients diagnosed with COVID-19 or MIS-C be closely monitored for thrombotic events.
Collapse
Affiliation(s)
- G Guner Ozenen
- Department of Pediatric Infectious Diseases, University of Health Sciences, Dr. Behçet Uz Children's Hospital, İzmir, Turkey.
| | - A Akaslan Kara
- Department of Pediatric Infectious Diseases, University of Health Sciences, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - E Boncuoglu
- Department of Pediatric Infectious Diseases, University of Health Sciences, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - E Kiymet
- Department of Pediatric Infectious Diseases, University of Health Sciences, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - E Cem
- Department of Pediatric Infectious Diseases, University of Health Sciences, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - S Sahinkaya
- Department of Pediatric Infectious Diseases, University of Health Sciences, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - M Yilmaz Celebi
- Department of Pediatric Infectious Diseases, University of Health Sciences, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - M Gulderen
- Department of Pediatric Infectious Diseases, University of Health Sciences, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - P Kacar
- Department of Pediatric Infectious Diseases, University of Health Sciences, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - M Uras
- Department of Pediatrics, University of Health Sciences, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - T Hilkay Karapinar
- Department of Pediatric Hematology and Oncology, University of Health Sciences, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Y Oymak
- Department of Pediatric Hematology and Oncology, University of Health Sciences, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - N Bayram
- Department of Pediatric Infectious Diseases, University of Health Sciences, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - I Devrim
- Department of Pediatric Infectious Diseases, University of Health Sciences, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| |
Collapse
|
5
|
Tüfekçi Ö, Özdemir HH, Malbora B, Özbek NY, Yarali N, Erdem A, Evim M, Baytan B, Güneş AM, Karapinar T, Oymak Y, Töret E, Bör Ö, Yilmaz Ş, Ören H, Özdemir GN, Karapinar DY. Hepatitis-Associated Aplastic Anemia: Etiology, Clinical Characteristics and Outcome. J Pediatr Hematol Oncol 2022; 44:e223-e226. [PMID: 34669357 DOI: 10.1097/mph.0000000000002268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/27/2021] [Indexed: 11/26/2022]
Abstract
Hepatitis-associated aplastic anemia (HAA) is a form of acquired aplastic anemia (AA) in which bone marrow failure develops after an acute attack of hepatitis. Bone marrow failure leading to AA is generally severe in cases of HAA and fatal if left untreated. This retrospective multicenter study investigated clinical and laboratory characteristics, possible causes, treatment, and outcome of HAA in children. Twenty patients from 8 centers were included in the study. Aspartate aminotransferase and alanine aminotransferase were <3 to 5×upper limit of normal (ULN) in 2 patients, <5 to 10×ULN in 2 patients, and >10×ULN in 16 patients. Acute liver failure developed in 5 (29%) patients. Pancytopenia was simultaneously present in 6 of 20 (30%) patients. Eleven of the 20 patients (55%) were alive, in remission and transfusion free. Those who were alive either had undergone hematopoietic stem cell transplantation and/or immunosuppressive treatment, except 1 patient who had received no treatment. Patients with the diagnosis of acute hepatitis should be evaluated and followed up carefully for presence of cytopenia, so that definitive treatment of AA can be initiated in a timely and appropriate manner when needed.
Collapse
Affiliation(s)
- Özlem Tüfekçi
- Department of Pediatric Hematology, Dokuz Eylül University Faculty of Medicine
| | - Hamiyet H Özdemir
- Department of Pediatric Hematology, Ege University Faculty of Medicine
| | - Bariş Malbora
- Department of Pediatric Hematology/Oncology, Ankara City Hospital, The University of Health Sciences, Ankara
| | - Namik Y Özbek
- Department of Pediatric Hematology/Oncology, Ankara City Hospital, The University of Health Sciences, Ankara
| | - Neşe Yarali
- Department of Pediatric Hematology/Oncology, Ankara City Hospital, The University of Health Sciences, Ankara
| | - Arzu Erdem
- Department of Pediatric Hematology/Oncology, Ankara City Hospital, The University of Health Sciences, Ankara
| | - Melike Evim
- Department of Pediatric Hematology, Uludağ University Faculty of Medicine, Bursa
| | - Birol Baytan
- Department of Pediatric Hematology, Uludağ University Faculty of Medicine, Bursa
| | - Adalet M Güneş
- Department of Pediatric Hematology, Uludağ University Faculty of Medicine, Bursa
| | - Tuba Karapinar
- Department of Pediatric Hematology/Oncology, İstinye University Faculty of Medicine, İstanbul, Turkey
| | - Yeşim Oymak
- Department of Pediatric Hematology/Oncology, İstinye University Faculty of Medicine, İstanbul, Turkey
| | - Ersin Töret
- Department of Pediatric Hematology, Osmangazi University Faculty of Medicine, Eskişehir
| | - Özcan Bör
- Department of Pediatric Hematology, Osmangazi University Faculty of Medicine, Eskişehir
| | - Şebnem Yilmaz
- Department of Pediatric Hematology, Dokuz Eylül University Faculty of Medicine
| | - Hale Ören
- Department of Pediatric Hematology, Dokuz Eylül University Faculty of Medicine
| | - Gül N Özdemir
- Department of Pediatric Hematology/Oncology, İstinye University Faculty of Medicine, İstanbul, Turkey
| | - Deniz Y Karapinar
- Department of Pediatric Hematology, Ege University Faculty of Medicine
| |
Collapse
|
6
|
Odaman Al I, Oymak Y, Erdem M, Tahta N, Okur Acar S, Mese T, Yilmazer MM, Gözmen S, Zihni C, Calkavur S, Karapinar TH. Assessment of clinical characteristics and treatment outcomes of pediatric patients with intracardiac thrombosis: a single-center experience. Blood Coagul Fibrinolysis 2022; 33:34-41. [PMID: 34799505 DOI: 10.1097/mbc.0000000000001100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The prevalence of intracardiac thrombus (ICT) is gradually increasing, though it is rare among children. Data related to the occurrence of ICT among children are limited, and treatment recommendations have been made utilizing adult guidelines. The primary objective of this study is to determine associated factors, management, and outcomes of intracardiac thrombosis in children. Between January 2013 and January 2020, patients diagnosed with ICT at the Pediatric Hematology-Oncology and Pediatric Cardiology departments in our hospital were included in the study. Demographic characteristics, clinical and laboratory findings, treatment protocols, and outcomes were analyzed retrospectively. The median age at diagnosis was 10.5 months (2 days to 14.5 years), and the median follow-up period was 6.5 months (1 month to 3.1 years). The most common primary diagnoses of the patients, in order of frequency, were heart disease (n: 8), metabolic disease (n: 3), prematurity and RDS (n: 3), burns (n: 2), pneumonia (n: 2), and asphyxia (n: 2). CVC was present in 19/23 of the patients. The reasons for CVC insertion were the need for plasmapheresis in one patient with a diagnosis of HUS and the need for well tolerated vascular access because of long-term hospitalization in others. LMWH was administered to all patients as first-line therapy. Complete response was achieved in 19 (79%) of 24 patients and 4 patients (16.6%) were unresponsive to medical treatment. It was found out that the thrombus location, type, sepsis, and hemoculture positivity, as well as the presence of CVC, had no impact on treatment response (chi-square P = 0.16, 0.12, 0.3, 0.49, 0.56). Moreover, no correlation was determined between thrombus size and treatment response (Mann Whitney U test P = 0.47). The mortality rate was determined to be 12.5% (3/24). Spontaneous occurrence of ICT is rare in childhood, without any underlying primary disease or associated factor. The presence of CVC, sepsis, and heart disease are factors associated with ICT. The success rate is increased with medical treatment. There was no significant difference in treatment response between the newborn and 1 month to 18-year-old patient group. It has been demonstrated that thrombus size, type, localization; sepsis, and hemoculture positivity had no impact on the treatment response.
Collapse
Affiliation(s)
| | - Yeşim Oymak
- Department of Pediatric Hematology and Oncology
| | - Melek Erdem
- Department of Pediatric Hematology and Oncology
| | | | | | | | | | | | | | - Sebnem Calkavur
- Department of Neonatology, Dr Behçet Uz Traning and Research Hospital, İzmir, Turkey
| | | |
Collapse
|
7
|
Zengin E, Sarper N, Yazal Erdem A, Odaman Al I, Sezgin Evim M, Yaralı N, Belen B, Akçay A, Türedi Yıldırım A, Karapınar TH, Güneş AM, Aylan Gelen S, Ören H, Olcay L, Baytan B, Gülen H, Öztürk G, Orhan MF, Oymak Y, Akpınar S, Tüfekçi Ö, Albayrak M, Tatlı Güneş B, Canpolat A, Özbek N. Thrombolysis with Systemic Recombinant Tissue Plasminogen Activator in Children: A Multicenter Retrospective Study. Turk J Haematol 2021; 38:294-305. [PMID: 34431642 PMCID: PMC8656121 DOI: 10.4274/tjh.galenos.2021.2021.0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 08/18/2021] [Indexed: 12/01/2022] Open
Abstract
Objective This study aimed to evaluate systemic thrombolysis experiences with recombinant tissue plasminogen activator (rtPA). Materials and Methods Retrospective data were collected from 13 Turkish pediatric hematology centers. The dose and duration of rtPA treatment, concomitant anticoagulant treatment, complete clot resolution (CCR), partial clot resolution (PCR), and bleeding complications were evaluated. Low-dose (LD) rtPA treatment was defined as 0.01-0.06 mg/kg/h and high-dose (HD) rtPA as 0.1-0.5 mg/kg/h. Results Between 2005 and 2019, 55 thrombotic episodes of 54 pediatric patients with a median age of 5 years (range: 1 day to 17.75 years) were evaluated. These patients had intracardiac thrombosis (n=16), deep vein thrombosis (DVT) (n=15), non-stroke arterial thrombosis (n=14), pulmonary thromboembolism (PE) (n=6), and stroke (n=4). The duration from thrombus detection to rtPA initiation was a median of 12 h (range: 2-504 h) and it was significantly longer in cases of DVT and PE compared to stroke, non-stroke arterial thrombosis, and intracardiac thrombosis (p=0.024). In 63.6% of the episodes, heparin was initiated before rtPA treatment. LD and HD rtPA were administered in 22 and 33 of the episodes, respectively. Concomitant anticoagulation was used in 90% and 36% of the episodes with LD and HD rtPA, respectively (p=0.0001). Median total duration of LD and HD rtPA infusions was 30 h (range: 2-120 h) and 18 h (2-120 h), respectively (p=0.044). Non-fatal major and minor bleeding rates were 12.5% and 16.7% for LD and 3.2% and 25.8% for HD rtPA, respectively. At the end of the rtPA infusions, CCR and PCR were achieved in 32.7% and 49.0% of the episodes, respectively. The most successful site for thrombolysis was intracardiac thrombosis. HD versus LD rtPA administration was not correlated with CCR/PCR or bleeding (p>0.05). Conclusion Systemic thrombolytic therapy may save lives and organs effectively if it is used at the right indications and the right times in children with high-risk thrombosis by experienced hematologists with close monitoring of recanalization and bleeding.
Collapse
Affiliation(s)
- Emine Zengin
- Kocaeli University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Kocaeli, Turkey
| | - Nazan Sarper
- Kocaeli University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Kocaeli, Turkey
| | - Arzu Yazal Erdem
- University of Health Sciences Turkey, Ankara City Hospital, Department of Pediatrics, Division of Pediatric Hematology, Ankara, Turkey
| | - Işık Odaman Al
- University of Health Sciences Turkey, Dr. Behçet Uz Pediatrics and Pediatric Surgery Training and Research Hospital, İzmir, Turkey
| | - Melike Sezgin Evim
- Uludağ University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Bursa, Turkey
| | - Neşe Yaralı
- University of Health Sciences Turkey, Ankara City Hospital, Department of Pediatrics, Division of Pediatric Hematology, Ankara, Turkey
| | - Burcu Belen
- Başkent University Ankara Hospital, Clinic of Pediatrics, Division of Pediatric Hematology, Ankara, Turkey
| | - Arzu Akçay
- Acıbadem Mehmet Ali Aydınlar University Acıbadem Hospital, Clinic of Pediatric Hematology, İstanbul, Turkey
| | - Ayşen Türedi Yıldırım
- Celal Bayar University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Manisa, Turkey
| | - Tuba Hilkay Karapınar
- University of Health Sciences Turkey, Dr. Behçet Uz Pediatrics and Pediatric Surgery Training and Research Hospital, İzmir, Turkey
| | - Adalet Meral Güneş
- Uludağ University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Bursa, Turkey
| | - Sema Aylan Gelen
- Kocaeli University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Kocaeli, Turkey
| | - Hale Ören
- Dokuz Eylül University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology, İzmir, Turkey
| | - Lale Olcay
- Başkent University Ankara Hospital, Clinic of Pediatrics, Division of Pediatric Hematology, Ankara, Turkey
| | - Birol Baytan
- Uludağ University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Bursa, Turkey
| | - Hüseyin Gülen
- Celal Bayar University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Manisa, Turkey
| | - Gülyüz Öztürk
- Acıbadem Mehmet Ali Aydınlar University Acıbadem Hospital, Clinic of Pediatric Hematology, İstanbul, Turkey
| | - Mehmet Fatih Orhan
- Sakarya University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Sakarya, Turkey
| | - Yeşim Oymak
- University of Health Sciences Turkey, Dr. Behçet Uz Pediatrics and Pediatric Surgery Training and Research Hospital, İzmir, Turkey
| | - Sibel Akpınar
- University of Health Sciences Turkey, Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Pediatrics, Division of Pediatric Hematology, İstanbul, Turkey
| | - Özlem Tüfekçi
- Dokuz Eylül University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology, İzmir, Turkey
| | - Meryem Albayrak
- Kırıkkale University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Kırıkkale, Turkey
| | - Burçak Tatlı Güneş
- University of Health Sciences Turkey, Tepecik Training and Research Hospital, Department of Pediatrics, Division of Pediatric Hematology, İzmir, Turkey
| | - Aylin Canpolat
- İstanbul Medeniyet University Göztepe Training and Research Hospital, Clinic of Pediatrics, Division of Pediatric Hematology, İstanbul, Turkey
| | - Namık Özbek
- University of Health Sciences Turkey, Ankara City Hospital, Department of Pediatrics, Division of Pediatric Hematology, Ankara, Turkey
| |
Collapse
|
8
|
Ünüvar A, Evim MS, Karaman S, Akçay A, Eker İ, Küpesiz FT, Özbek N, Ertem M, Aydın S, Keskin Z, Aral YZ, Gördü Z, Elli M, Karagenç AÖ, Apak BB, Uzel H, Söker M, Karapınar T, Oymak Y, Karadaş N, Özcan A, Töret E, Koçak Ü, Akbayram S, Cangül ŞÜ, Ayhan AC, Celkan T, Tuğcu D, Zülfikar B, Kebudi R, Hacısalihoğlu Ş, Erduran E, Gelen SA, Sarper N, Erbey F, Kürekçi E, Gülen H, Yılmaz B, Doğru Ö, Koç A, Ünal S, Tokgöz H, Albayrak C, Ay Y, Orhan F, Albayrak D, Karakurt N, Orhaner B, Türkkan E, Yıldırmak Y, Geylani H, Koç B, Öner AF, Timur Ç, Ören H. CHILDHOOD IMMUNE THROMBOCYTOPENIA: A MULTICENTER QUESTIONNAIRE STUDY. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.1070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
9
|
Devrim F, Çağlar İ, Acar SO, Akkuş Ş, Dinçel N, Yılmaz E, Tahta N, Demirağ B, Karapınar TH, Gözmen S, Oymak Y, Vergin C, Bayram N, Devrim İ. Evaluation of renal effects of liposomal amphotericin B in children with malignancies with KDIGO and RIFLE criteria. Nephrol Ther 2021; 17:507-511. [PMID: 34535406 DOI: 10.1016/j.nephro.2021.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/23/2021] [Accepted: 06/27/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Amphotericin B is a broad-spectrum antifungal agent and is the backbone of the treatment for medically important opportunistic fungal pathogens in children. This study aimed to compare the nephrotoxicity associated with L-AmB in children with acute lymphoblastic leukemia and acute myeloid leukemia. MATERIALS AND METHODS A total of 112 pediatric acute lymphoblastic leukemia or acute myeloid leukemia patients who received treatment with L-AmB (Ambisome®) at the University of Health Sciences Dr Behcet Uz Children's Hospital over 7 years were included. The incidence of hypokalemia, decreased estimated glomerular filtration rate and presence of acute kidney injury was recorded. RESULTS The average L-AmB treatment duration was 17.1±15.0 days. Five patients (4.4%) of the patients had grade I acute renal injury according to KDIGO criteria and 16 patients (14.2%) had increased risk for kidney injury according to RIFLE criteria. There were no patients with eGFR decrease above 50% and no renal injury and failure were observed during L-AmB treatment. The rate of patients with hypokalemia in the pre-treatment was 17.9% and the post-L-AmB group was 50.0%. The rate of hypokalemia was higher in the post-treatment group (P=0.0015). Among the 112 patients, only two patients (1.7%) required cessation of L-AmB treatment due to resistant hypokalemia despite supplementation. CONCLUSIONS Hypokalemia was more common compared to glomerulotoxicity and acute renal injury (according to KDIGO and RIFLE criteria) in pediatric leukemia patients treated with L-AmB. Hypokalemia developed in nearly half of the patients and the study shows the need for randomized controlled trials and strategies for hypokalemia associated with L-AmB treatment.
Collapse
Affiliation(s)
- Fatma Devrim
- Department of pediatric nephrology, Dr Behçet Uz child disease and pediatric surgery training and research hospital, İzmir, Turkey.
| | - İlknur Çağlar
- Department of pediatric infectious diseases, Dr Behçet Uz children's diseases and surgery training and research hospital, İzmir, Turkey
| | - Sultan Okur Acar
- Department of pediatric hematology and oncology, Dr Behçet Uz children's diseases and surgery training and research hospital, İzmir, Turkey
| | - Şeyma Akkuş
- Department of pediatrics, Dr Behçet Uz children's diseases and surgery training and research hospital, İzmir, Turkey
| | - Nida Dinçel
- Department of pediatric nephrology, Dr Behçet Uz child disease and pediatric surgery training and research hospital, İzmir, Turkey
| | - Ebru Yılmaz
- Department of pediatric nephrology, Dr Behçet Uz child disease and pediatric surgery training and research hospital, İzmir, Turkey
| | - Neryal Tahta
- Department of pediatric hematology and oncology, Dr Behçet Uz children's diseases and surgery training and research hospital, İzmir, Turkey
| | - Bengü Demirağ
- Department of pediatric hematology and oncology, Dr Behçet Uz children's diseases and surgery training and research hospital, İzmir, Turkey
| | - Tuba Hilkay Karapınar
- Department of pediatric hematology and oncology, Dr Behçet Uz children's diseases and surgery training and research hospital, İzmir, Turkey
| | - Salih Gözmen
- Department of pediatric hematology and oncology, Dr Behçet Uz children's diseases and surgery training and research hospital, İzmir, Turkey
| | - Yeşim Oymak
- Department of pediatric hematology and oncology, Dr Behçet Uz children's diseases and surgery training and research hospital, İzmir, Turkey
| | - Canan Vergin
- Department of pediatric hematology and oncology, Dr Behçet Uz children's diseases and surgery training and research hospital, İzmir, Turkey
| | - Nuri Bayram
- Department of pediatric infectious diseases, Dr Behçet Uz children's diseases and surgery training and research hospital, İzmir, Turkey
| | - İlker Devrim
- Department of pediatric infectious diseases, Dr Behçet Uz children's diseases and surgery training and research hospital, İzmir, Turkey
| |
Collapse
|
10
|
Çalışkaner ZO, Abdul Waheed A, Tuzlakoğlu Öztürk M, Oymak Y, Tazebay UH, Akar N, Kandilci A, Torun Özkan D. Identification of novel TUBB1 variants in patients with macrothrombocytopenia. Turk J Med Sci 2021; 51:490-500. [PMID: 32892537 PMCID: PMC8203157 DOI: 10.3906/sag-2003-259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 08/20/2020] [Indexed: 12/27/2022] Open
Abstract
Background/aim Macrothrombocytopenia is an autosomal-dominant disorder characterized by increased platelet size and a decreased number of circulating platelets. The membrane skeleton and the link between actin filaments of the skeleton and microtubules, which consist of alpha and beta tubulin [including the tubulin beta-1 chain (TUBB1)] heterodimers, are important for normal platelet morphology, and defects in these systems are associated with macrothrombocytopenia. Materials and methods In this study, we sequenced the exons of the TUBB1 gene using DNA isolated from the peripheral blood samples of healthy controls (n = 47) and patients with macrothrombocytopenia (n = 37) from Turkey. The TUBB1 expression levels in fractioned blood samples from patients and healthy controls were analyzed by RT-qPCR and Western blot. Microtubule organization of the platelets in the peripheral blood smears of patients, and in mutant TUBB1-transfected HeLa cells, were analyzed by immunofluorescence staining. Results A new TUBB1 c.803G>T (p.T178T) variant was detected in all of the control and patient samples. Importantly, we found 3 new heterozygous TUBB1 variants predicting amino acid substitutions: G146R (in 1 patient), E123Q (in 1 patient), and T274M (in 4 patients); the latter variant was associated with milder thrombocytopenia in cancer patients treated with paclitaxel. Ectopic expression of TUBB1 T274M/R307H variant in HeLa cells resulted in irregular microtubule organization. Conclusion Further clinical and functional studies of the newly identified TUBB1 variants may offer important insights into their pathogenicity in macrothrombocytopenia.
Collapse
Affiliation(s)
- Zihni Onur Çalışkaner
- Department of Molecular Biology and Genetics, Faculty of Science, Gebze Technical University, Kocaeli, Turkey,Department of Bioengineering, Faculty of Engineering and Natural Sciences, Üsküdar University, İstanbul, Turkey
| | - Abdullah Abdul Waheed
- Department of Molecular Biology and Genetics, Faculty of Science, Gebze Technical University, Kocaeli, Turkey
| | - Merve Tuzlakoğlu Öztürk
- Department of Molecular Biology and Genetics, Faculty of Science, Gebze Technical University, Kocaeli, Turkey
| | - Yeşim Oymak
- Department of Pediatric Hematology, Dr. Behçet Uz Children’s Hospital, İzmir, Turkey
| | - Uygar Halis Tazebay
- Department of Molecular Biology and Genetics, Faculty of Science, Gebze Technical University, Kocaeli, Turkey
| | - Nejat Akar
- Department of Pediatrics, Faculty of Medicine, TOBB-ETU University, Ankara, Turkey
| | - Ayten Kandilci
- Department of Molecular Biology and Genetics, Faculty of Science, Gebze Technical University, Kocaeli, Turkey
| | - Didem Torun Özkan
- Medical Laboratory, Vocational School of Health Services, İstanbul Okan University, İstanbul, Turkey
| |
Collapse
|
11
|
Koca Yozgat A, Leblebisatan G, Akbayram S, Çınar Özel S, Karakaş Z, Erduran E, Yılmaz Ş, Koçak Ü, Ünal Ş, Özdemir GN, Albayrak M, Zengin E, Oymak Y, Bör Ö, Çakmaklı HF, Söker M, Gürlek Gökçebay D, Tokgöz H, Malbora B, Karaman S, Celkan T, Şaşmaz İ, Yaralı N, Ören H, Ünüvar A, Özbek NY. Outcomes of Eltrombopag Treatment and Development of Iron Deficiency in Children with Immune Thrombocytopenia in Turkey. Turk J Haematol 2020; 37:139-144. [PMID: 32181630 PMCID: PMC7463208 DOI: 10.4274/tjh.galenos.2020.2019.0380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objective Immune thrombocytopenia (ITP) is a rare autoimmune disease and hematologic disorder characterized by reduced platelet counts that can result in significant symptoms, such as bleeding, bruising, epistaxis, or petechiae. The thrombopoietin receptor agonist eltrombopag (EPAG) is a second-line agent used to treat chronic ITP purpura in adults and children. Materials and Methods The present retrospective study evaluated the efficacy, safety, and side effects of EPAG treatment in pediatric patients with acute refractory and chronic immune thrombocytopenia, particularly focusing on iron-deficiency anemia. Results The diagnosis was chronic ITP in 89 patients and acute refractory ITP in 16 patients. The mean age of patients was 9.5±4.5 years (minimum-maximum: 1.2-18 years) at the beginning of EPAG treatment. The overall response rate was 74.3% (n=78). The mean time for platelet count of ≥50x109/L was 11.6±8 weeks (range: 1-34 weeks). The treatment was stopped for 27 patients (25.7%) at an average of 6.8±9 months (range: 1-38 months). The reason for discontinuation was lack of response in 18 patients, nonadherence in 4 patients, and hepatotoxicity in 2 patients. Response to treatment continued for an average of 4 months after cessation of EPAG in 3 patients. Conclusion Results of the current study imply that EPAG is an effective therapeutic option in pediatric patients with acute refractory and chronic ITP. However, patients must be closely monitored for response and side effects during treatment, and especially for iron deficiency.
Collapse
Affiliation(s)
- Ayça Koca Yozgat
- Ankara City Hospital, Clinic of Pediatric Hematology, Ankara, Turkey
| | - Göksel Leblebisatan
- Çukurova University Faculty of Medicine, Department of Pediatric Hematology, Adana, Turkey
| | - Sinan Akbayram
- Gaziantep University Faculty of Medicine, Department of Pediatric Hematology, Gaziantep, Turkey
| | - Simge Çınar Özel
- İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, Department of Pediatric Hematology, İstanbul, Turkey
| | - Zeynep Karakaş
- İstanbul University, İstanbul Faculty of Medicine, Department of Pediatric Hematology, İstanbul, Turkey
| | - Erol Erduran
- Karadeniz Technical University Faculty of Medicine, Department of Pediatric Hematology, Trabzon, Turkey
| | - Şebnem Yılmaz
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Ülker Koçak
- Gazi University Faculty of Medicine, Department of Pediatric Hematology, Ankara, Turkey
| | - Şule Ünal
- Hacettepe University Faculty of Medicine, Department of Pediatric Hematology, Ankara, Turkey
| | - Gül Nihal Özdemir
- Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Pediatric Hematology, İstanbul, Turkey
| | - Meryem Albayrak
- Kırıkkale University Faculty of Medicine, Department of Pediatric Hematology, Kırıkkale, Turkey
| | - Emine Zengin
- Kocaeli University Faculty of Medicine, Department of Pediatric Hematology, Kocaeli, Turkey
| | - Yeşim Oymak
- Dr. Behçet Uz Children’s Training and Research Hospital, Clinic of Pediatric Hematology, İzmir, Turkey
| | - Özcan Bör
- Eskişehir University Faculty of Medicine, Department of Pediatric Hematology, Eskişehir, Turkey
| | - Hasan Fatih Çakmaklı
- Ankara University Faculty of Medicine, Department of Pediatric Hematology, Ankara, Turkey
| | - Murat Söker
- Dicle University Faculty of Medicine, Department of Pediatric Hematology, Diyarbakır, Turkey
| | - Dilek Gürlek Gökçebay
- Ankara Keçiören Training and Research Hospital, Clinic of Pediatric Hematology, Ankara, Turkey
| | - Hüseyin Tokgöz
- Necmettin Erbakan University Meram Faculty of Medicine, Department of Pediatric Hematology, Konya, Turkey
| | - Barış Malbora
- Yeni Yüzyıl University, Gaziosmanpaşa Hospital, Clinic of Pediatric Hematology, İstanbul, Turkey
| | - Serap Karaman
- İstanbul University, İstanbul Faculty of Medicine, Department of Pediatric Hematology, İstanbul, Turkey
| | - Tiraje Celkan
- İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, Department of Pediatric Hematology, İstanbul, Turkey
| | - İlgen Şaşmaz
- Çukurova University Faculty of Medicine, Department of Pediatric Hematology, Adana, Turkey
| | - Neşe Yaralı
- Ankara City Hospital, Clinic of Pediatric Hematology, Ankara, Turkey
| | - Hale Ören
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Ayşegül Ünüvar
- İstanbul University, İstanbul Faculty of Medicine, Department of Pediatric Hematology, İstanbul, Turkey
| | - Namık Yaşar Özbek
- Ankara City Hospital, Clinic of Pediatric Hematology, Ankara, Turkey
| |
Collapse
|
12
|
Karapınar TH, Durgun E, Oymak Y, Gülez N, Ay Y, Genel F, Gözmen S, Serdaroğlu E, Köker SA, Töret E, Vergin C. Children with chronic-refractory autoimmune cytopenias: a single center experience. Turk J Pediatr 2020; 62:525-532. [PMID: 32779404 DOI: 10.24953/turkjped.2020.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVES Autoimmune cytopenias are a group of heterogeneous disorders characterized by immune-mediated destruction of one or more hematopoietic lineage cells. The differential diagnosis of children with autoimmune cytopenias requires much time and laboratory investigations. The aim of the present study was to evaluate the clinical course and significance of autoimmune cytopenias due to immunodeficiency or autoimmune diseases in children at a single children`s hospital. METHOD Between February 1997 and September 2015, chronic/refractory autoimmune cytopenias patient data were evaluated retrospectively. Twenty-three patients were assessed in this study. RESULTS The median duration of following was 2.6 years (4 months-18.5 years). The median age of diagnosis was 3.1 years (6 months-16 years). A total of 13 patients (56.5%) had single-lineage and 10 (46.5%) had multilineage cytopenias. The most frequent single-lineage cytopenia was thrombocytopenia, followed by anemia. In 22 of the patients, cytopenias was detected before the primary diseases. All of the patients were treated with corticosteroids or intravenous immune globulin as first-line treatment. Ten patients (43.5%) needed second or further-line immunosuppressive therapies that patients diagnosed as systemic lupus erythematosus, hypogammaglobulinemia, or common variable immunodeficiency. A total of 8 patients (34.7%) recovered from autoimmune cytopenias after the treatment of primer disease. Cytopenias were continued in 14 patients. CONCLUSION Cytopenia may be the first finding of an immunodeficiency or autoimmune disease and primary disease may be diagnosed in the clinical course. Taking the new targeted treatment options into consideration; early diagnosis is likely to become more important in the near-future in order to begin the treatment for the underlying disease as early as possible.
Collapse
Affiliation(s)
- Tuba Hilkay Karapınar
- Departments of Pediatric Hematology-Oncology, Dr. Behçet Uz Children Research and Training Hospital, İzmir, Turkey
| | - Ersin Durgun
- Departments of Pediatric Hematology-Oncology, Dr. Behçet Uz Children Research and Training Hospital, İzmir, Turkey
| | - Yeşim Oymak
- Departments of Pediatric Hematology-Oncology, Dr. Behçet Uz Children Research and Training Hospital, İzmir, Turkey
| | - Nesrin Gülez
- Departments of Pediatric Immunology, Dr. Behçet Uz Children Research and Training Hospital, İzmir, Turkey
| | - Yılmaz Ay
- Departments of Pediatric Hematology-Oncology, Dr. Behçet Uz Children Research and Training Hospital, İzmir, Turkey
| | - Ferah Genel
- Departments of Pediatric Immunology, Dr. Behçet Uz Children Research and Training Hospital, İzmir, Turkey
| | - Salih Gözmen
- Departments of Pediatric Hematology-Oncology, Dr. Behçet Uz Children Research and Training Hospital, İzmir, Turkey
| | - Erkin Serdaroğlu
- Departments of Pediatric Nephrology, Dr. Behçet Uz Children Research and Training Hospital, İzmir, Turkey
| | - Sultan Aydın Köker
- Departments of Pediatric Hematology-Oncology, Dr. Behçet Uz Children Research and Training Hospital, İzmir, Turkey
| | - Ersin Töret
- Departments of Pediatric Hematology-Oncology, Dr. Behçet Uz Children Research and Training Hospital, İzmir, Turkey
| | - Canan Vergin
- Departments of Pediatric Hematology-Oncology, Dr. Behçet Uz Children Research and Training Hospital, İzmir, Turkey
| |
Collapse
|
13
|
Aydin Köker S, Oymak Y, Demirağ B, Karapinar TH, Koker A, Genç S, Erdemir G, Vergin RC. Successful Management of l-Asparaginase-Associated Pancreatitis With Octreotide and Pegylated Asparaginase in 2 Patients With Acute Lymphoblastic Leukemia: Is There a Different Rare Warning Sign of Hypoglycemia for l-Asparaginase-Associated Pancreatitis? Clin Ther 2020; 42:e82-e86. [PMID: 32184014 DOI: 10.1016/j.clinthera.2020.02.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 01/13/2020] [Accepted: 02/18/2020] [Indexed: 10/24/2022]
Abstract
l-Asparaginase (l-Asp) is a critical component of chemotherapy for acute lymphoblastic leukemia (ALL). However, toxic effects associated with l-Asp, such as hepatic dysfunction, pancreatitis, hypercholesterolemia, and hyperglycemia, have occurred. In addition, acute pancreatitis is a significant life-threatening adverse event associated with ALL. We describe 2 patients with ALL who had l-Asp-associated pancreatitis (AAP), with one patient presenting with hyperglycemia and the other presenting with hypoglycemia during induction treatment. When octreotide was administered to both of these patients, the clinical findings and laboratory data were improved. AAP was not repeated after treatment with pegylated asparaginase. Although AAP has a high risk of mortality and morbidity in childhood, APP treatment with appropriate agents, such as octreotide, can be successful.
Collapse
Affiliation(s)
- Sultan Aydin Köker
- Division of Pediatric Hematology and Oncology, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Yeşim Oymak
- Division of Pediatric Hematology and Oncology, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Bengü Demirağ
- Division of Pediatric Hematology and Oncology, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Tuba Hilkay Karapinar
- Division of Pediatric Hematology and Oncology, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Alper Koker
- Dokuz Eylul University, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Intensive Care, Izmir, Turkey.
| | - Sinan Genç
- Division of Radiology, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Gülin Erdemir
- Division of Pediatric Gastroenterology, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Raziye Canan Vergin
- Division of Pediatric Hematology and Oncology, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| |
Collapse
|
14
|
Atik T, Işık E, Onay H, Akgün B, Shamsali M, Kavaklı K, Evim M, Tüysüz G, Özbek NY, Şahin F, Salcıoğlu Z, Albayrak C, Oymak Y, Ünal E, Belen FB, Yılmaz Keskin E, Balkan C, Baytan B, Küpesiz A, Culha V, Tahtakesen Güçer TN, Güneş AM, Özkınay F. Factor 8 Gene Mutation Spectrum of 270 Patients with Hemophilia A: Identification of 36 Novel Mutations. Turk J Haematol 2020; 37:145-153. [PMID: 32026663 PMCID: PMC7463214 DOI: 10.4274/tjh.galenos.2020.2019.0262] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective Hemophilia A (HA) is the most severe X-linked inherited bleeding disorder caused by hemizygous mutations in the factor 8 (F8) gene. The aim of this study is to determine the mutation spectrum of the F8 gene in a large HA cohort from Turkey, and then to establish a phenotype-genotype correlation. Materials and Methods All HA cases (270 patients) analyzed molecularly in the Ege University Pediatric Genetics Molecular Laboratory between March 2017 and March 2018 were included in this study. To identify intron 22 inversion (Inv22), intron 1 inversion (Inv1), small deletion/insertions, and point mutations, molecular analyses of F8 were performed using a sequential application of molecular techniques. Results The mutation detection success rate was 95.2%. Positive Inv22 was found in 106 patients (39.3%), Inv1 was found in 4 patients (1.5%), and 106 different disease-causing sequence variants were identified in 137 patients (50.6%). In 10 patients (3.7%), amplification failures involving one or more exonic regions, considered to be large intragenic deletions, were identified. Of 106 different F8 mutations, 36 were novel. The relationship between F8 genotype and inhibitor development was considered significant. Conclusion A high mutation detection rate was achieved via the broad molecular techniques applied in this study, including 36 novel mutations. With regard to mutation types, mutation distribution and their impact on clinical severity and inhibitor development were found to be similar to those previously reported in other hemophilia population studies.
Collapse
Affiliation(s)
- Tahir Atik
- Ege University, School of Medicine, Department of Pediatrics, Division of Pediatric Genetics, Izmir, Turkey,Equal contributors
| | - Esra Işık
- Ege University, School of Medicine, Department of Pediatrics, Division of Pediatric Genetics, Izmir, Turkey,Equal contributors
| | - Hüseyin Onay
- Ege University, School of Medicine, Department of Medical Genetics, Izmir, Turkey
| | - Bilçağ Akgün
- Ege University, School of Medicine, Department of Pediatrics, Division of Pediatric Genetics, Izmir, Turkey
| | - Moharram Shamsali
- Ege University, Institute of Health Sciences, Division of Health Bioinformatics, Izmir, Turkey
| | - Kaan Kavaklı
- Ege University, School of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Izmir, Turkey
| | - Melike Evim
- Uludag University, School of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Bursa, Turkey
| | - Gülen Tüysüz
- Akdeniz University, School of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Antalya, Turkey
| | - Namık Yaşar Özbek
- Health Sciences University Ankara Pediatric Hematology Oncology Training and Research Hospital, Department of Pediatric Hematology, Ankara, Turkey
| | - Fahri Şahin
- Ege University, School of Medicine, Department of Internal Medicine, Division of Hematology, Izmir, Turkey
| | - Zafer Salcıoğlu
- Istanbul Kanuni Sultan Suleyman Education and Research Hospital, Department of Pediatric Hematology and Oncology, Istanbul, Turkey
| | - Canan Albayrak
- Ondokuz Mayis University, Faculty of Medicine, Department of Pediatric Hematology and Oncology, Samsun, Turkey
| | - Yeşim Oymak
- Dr. Behcet Uz Children’s Hospital, Division of Pediatric Hematology, Izmir, Turkey
| | - Ekrem Ünal
- Erciyes University, School of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Kayseri, Turkey
| | - Fatma Burcu Belen
- Katip Celebi University, School of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Izmir, Turkey
| | - Ebru Yılmaz Keskin
- Suleyman Demirel University, School of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Isparta, Turkey
| | - Can Balkan
- Ege University, School of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Izmir, Turkey
| | - Birol Baytan
- Uludag University, School of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Bursa, Turkey
| | - Alphan Küpesiz
- Akdeniz University, School of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Antalya, Turkey
| | - Vildan Culha
- Health Sciences University Ankara Pediatric Hematology Oncology Training and Research Hospital, Department of Pediatric Hematology, Ankara, Turkey
| | - Tuba Nur Tahtakesen Güçer
- Istanbul Kanuni Sultan Suleyman Education and Research Hospital, Department of Pediatric Hematology and Oncology, Istanbul, Turkey
| | - Adalet Meral Güneş
- Uludag University, School of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Bursa, Turkey
| | - Ferda Özkınay
- Ege University, School of Medicine, Department of Pediatrics, Division of Pediatric Genetics, Izmir, Turkey
| |
Collapse
|
15
|
Koker SA, Hazan F, Oymak Y, Soydan E, Karapınar TH, Ay Y, Demirağ B, Vergin RC. Acrocallosal Syndrome First Presenting with Acute Lymphoblastic Leukemia: A Rare Case Report. Neurol India 2019; 67:1386-1387. [PMID: 31744987 DOI: 10.4103/0028-3886.271244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Sultan Aydin Koker
- Divisions of Pediatric Hematology and Oncology, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Filiz Hazan
- Medical Genetics, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Yeşim Oymak
- Divisions of Pediatric Hematology and Oncology, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Ekin Soydan
- Divisions of Pediatric Hematology and Oncology, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Tuba Hilkay Karapınar
- Divisions of Pediatric Hematology and Oncology, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Yılmaz Ay
- Divisions of Pediatric Hematology and Oncology, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Bengü Demirağ
- Divisions of Pediatric Hematology and Oncology, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Raziye Canan Vergin
- Divisions of Pediatric Hematology and Oncology, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| |
Collapse
|
16
|
Çağlar İ, Özkerim D, Tahta N, Düzgöl M, Bayram N, Demirağ B, Hilkay Karapınar T, Sorguç Y, Gözmen S, Dursun V, Oymak Y, Vergin C, devrim İ. 262. Assessment of Serum Galactomannan Test Results of Pediatric Patients with Hematologic Malignancies According to Different Threshold Levels and Consecutive Positivity in Terms of Invasive Aspergillosis Diagnosis: Cross-Sectional Research in a Tertiary Care Hospital. Open Forum Infect Dis 2019. [PMCID: PMC6810359 DOI: 10.1093/ofid/ofz360.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background The aim of this study was to evaluate the diagnostic utility of serum galactomannan (GM) test by investigating the impact of positivity according to different threshold levels and consecutiveness in terms of invasive aspergillosis (IA) in pediatric hematology-oncology patients. Methods Positive GM test results between January 2015 and August 2017 were reviewed, retrospectively. The children with hematological malignancies and GM positivity were included in the study and grouped according to the presence of IA. Impact of single and consecutive (3-day interval) GM positivity on IA diagnosis were evaluated according to different galactomannan index (GMI) threshold values of >0.5, >0.7, >1.0, and >1.5. Results There were 104 positive GM results from 70 patients. Forty-one patients (58.6%) had no clinical evidence of IA and categorized as the non-IA group. Invasive aspergillosis diagnosis was identified in 29 (41.4%) of the patients; 2 of them were proven and 27 were probable. Demographic characteristics and clinical findings of the patients were reviewed in Tables 1 and 2. According to different cutoff GMI values, the number of positive results was 104 for >0.5, 76 for >0.7, 57 for >1.0 and 32 for >1.5. The PPVs were low at a single GMI of >0.5 (39.4%) and reached to 50.0% with single GMI of >1.0. There was not a statistically significant difference between IA and non-IA groups in terms of different thresholds of a single GM positivity (P > 0.05) (Table 3). The number of two consecutive positive results was 34 for GMI of >0.5, 20 for GMI of >0.7, 13 for GMI of >1.0 and 4 for GMI of >1.5. In the IA group, GM positivity of consecutive results was significantly higher than non-IA group (P < 0.05). The PPVs of two consecutive positive results for GMI >0.5, GMI >0.7, GMI >1.0, and GMI >1.5 were 58.8%, 65.0%, 84.6%, and 100.0%, respectively. The effect of the GMI increase between two consecutive GM results on IA diagnosis (GM2-GM1 >0.5) was also evaluated and the PPV was found 53.8% without a statistical significance between two groups (Table 4). Conclusion When evaluated with consecutive GM positivity, the GM assay would have higher PPVs independently from the GMI cutoff value chosen. Since it may be more effective on IA diagnosis, consecutive sampling should be performed in pediatric patients at high risk. ![]()
![]()
![]()
![]()
Disclosures All authors: No reported disclosures.
Collapse
Affiliation(s)
| | | | - Neryal Tahta
- Dr. Behçet Uz Children’s Hospital, Izmir, Turkey
| | - Mine Düzgöl
- Dr. Behçet Uz Children’s Hospital, İzmir, Turkey
| | - Nuri Bayram
- Dr. Behçet Uz Children’s Hospital İzmir, Izmir, Turkey
| | | | | | - Yelda Sorguç
- Dr. Behçet Uz Children’s Hospital, İzmir, Turkey
| | - Salih Gözmen
- Dr. Behçet Uz Children’s Hospital, İzmir, Turkey
| | - Vecihe Dursun
- Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir, Turkey
| | - Yeşim Oymak
- Dr. Behçet Uz Children’s Hospital, İzmir, Turkey
| | | | - İlker devrim
- Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir, Turkey
| |
Collapse
|
17
|
Yılmaz Karapınar D, Patıroğlu T, Metin A, Çalışkan Ü, Celkan T, Yılmaz B, Karakaş Z, Karapınar TH, Akıncı B, Özkınay F, Onay H, Yeşilipek MA, Akar HH, Tüysüz G, Tokgöz H, Özdemir GN, Aslan Kıykım A, Karaman S, Kılınç Y, Oymak Y, Küpesiz A, Olcay L, Keskin Yıldırım Z, Aydoğan G, Gökçe M, İleri T, Aral YZ, Bay A, Atabay B, Kaya Z, Söker M, Özdemir Karadaş N, Özbek U, Özsait Selçuk B, Özdemir HH, Uygun V, Tezcan Karasu G, Yılmaz Ş. Homozygous c.130-131 ins A (pW44X) mutation in the HAX1 gene as the most common cause of congenital neutropenia in Turkey: Report from the Turkish Severe Congenital Neutropenia Registry. Pediatr Blood Cancer 2019; 66:e27923. [PMID: 31321910 DOI: 10.1002/pbc.27923] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 06/18/2019] [Accepted: 06/26/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND Severe congenital neutropenia is a rare disease, and autosomal dominantly inherited ELANE mutation is the most frequently observed genetic defect in the registries from North America and Western Europe. However, in eastern countries where consanguineous marriages are common, autosomal recessive forms might be more frequent. METHOD Two hundred and sixteen patients with severe congenital neutropenia from 28 different pediatric centers in Turkey were registered. RESULTS The most frequently observed mutation was HAX1 mutation (n = 78, 36.1%). A heterozygous ELANE mutation was detected in 29 patients (13.4%) in our cohort. Biallelic mutations of G6PC3 (n = 9, 4.3%), CSF3R (n = 6, 2.9%), and JAGN1 (n = 2, 1%) were also observed. Granulocyte colony-stimulating factor treatment was given to 174 patients (80.6%). Two patients died with infectious complications, and five patients developed myelodysplastic syndrome/acute myeloblastic leukemia. The mean (± mean standard error) follow-up period was 129.7 ± 76.3 months, and overall survival was 96.8% (CI, 94.4-99.1%) at the age of 15 years. In Turkey, severe congenital neutropenia mostly resulted from the p W44X mutation in the HAX1 gene. CONCLUSION In Turkey, mutation analysis should be started with HAX1, and if this is negative, ELANE and G6PC3 should be checked. Because of the very high percentage of consanguineous marriage, rare mutations should be tested in patients with a negative mutation screen.
Collapse
Affiliation(s)
| | - Türkan Patıroğlu
- Department of Pediatric Immunology, Erciyes University Faculty of Medicine, İzmir, Turkey
| | - Ayşe Metin
- Department of Pediatric Immunology, Ankara Children's Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Ümran Çalışkan
- Department of Pediatric Hematology-Oncology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Tiraje Celkan
- Department of Pediatric Hematology, Cerrahpaşa Medical Faculty, İstanbul University, Istanbul, Turkey
| | - Barış Yılmaz
- Department of Pediatric Hematology, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Zeynep Karakaş
- Department of Pediatric Hematology-Oncology, İstanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Tuba H Karapınar
- Department of Pediatric Hematology-Oncology, Dr. Behçet Uz Children Research and Training Hospital, İzmir, Turkey
| | - Burcu Akıncı
- Department of Pediatric Hematology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Ferda Özkınay
- Department of Pediatric Genetic, Ege University Faculty of Medicine, İzmir, Turkey
| | - Hüseyin Onay
- Department of Medical Genetic, Ege University Faculty of Medicine, İzmir, Turkey
| | - Mehmet Akif Yeşilipek
- Pediatric Bone Marrow Transplantation Unit, Medical Park Göztepe Hospital, Istanbul, Turkey
| | - Himmet Haluk Akar
- Department of Pediatric Immunology, Erciyes University Faculty of Medicine, İzmir, Turkey
| | - Gülen Tüysüz
- Department of Pediatric Hematology, Akdeniz University Medical School, Antalya, Turkey
| | - Hüseyin Tokgöz
- Department of Pediatric Hematology-Oncology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Gül Nihal Özdemir
- Department of Pediatric Hematology, Cerrahpaşa Medical Faculty, İstanbul University, Istanbul, Turkey
| | - Ayça Aslan Kıykım
- Department of Pediatric Allergy and Immunology, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Serap Karaman
- Department of Pediatric Hematology-Oncology, İstanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Yurdanur Kılınç
- Department of Pediatric Hematology, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Yeşim Oymak
- Department of Pediatric Hematology-Oncology, Dr. Behçet Uz Children Research and Training Hospital, İzmir, Turkey
| | - Alphan Küpesiz
- Department of Pediatric Hematology, Akdeniz University Medical School, Antalya, Turkey
| | - Lale Olcay
- Department of Pediatric Hematology, Başkent University Faculty of Medicine, Ankara, Turkey
| | - Zuhal Keskin Yıldırım
- Department of Pediatric Hematology, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Gönül Aydoğan
- Department of Pediatric Hematology, Kanuni Sultan Süleyman Research and Training Hospital, Istanbul, Turkey
| | - Müge Gökçe
- Department of Pediatric Bone marrow Transplantation Unit, Yeni Yüzyıl Üniversitesi, Gaziosmanpaşa Hastanesi, Istanbul, Turkey
| | - Talia İleri
- Department of Pediatric Hematology, Ankara University Medical Faculty, Ankara, Turkey
| | - Yusuf Ziya Aral
- Department of Pediatric Hematology, Adnan Menderes University Faculty of Medicine, Aydın, Turkey
| | - Ali Bay
- Department of Pediatric Hematology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Berna Atabay
- Department of Pediatric Hematology, Tepecik Teaching and Research Hospital, İzmir, Turkey
| | - Zuhre Kaya
- Department of Pediatric Hematology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Murat Söker
- Department of Pediatric Hematology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | | | - Uğur Özbek
- Department of Genetics, İstanbul University Faculty of Medicine, Istanbul, Turkey
| | - Bilge Özsait Selçuk
- Department of Genetics, İstanbul University Faculty of Medicine, Istanbul, Turkey
| | - Hamiyet Hekimci Özdemir
- Department of Pediatric Hematology and Oncology, Faculty of Medicine, Fırat University, Elazığ, Turkey
| | - Vedat Uygun
- Pediatric Bone Marrow Transplantation Unit, Medical Park Antalya Hospital, Antalya, Turkey
| | - Gülsün Tezcan Karasu
- Pediatric Bone Marrow Transplantation Unit, Medical Park Antalya Hospital, Antalya, Turkey
| | - Şebnem Yılmaz
- Department of Pediatric Hematology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| |
Collapse
|
18
|
Töret E, Karadaş NÖ, Gökçe NÖ, Kaygusuz A, Karapınar TH, Oymak Y, Gözmen S. Quality of Life and Depression in Turkish Patients with β-Thalassemia Major: A Cross-Sectional Study. Hemoglobin 2019; 42:326-329. [DOI: 10.1080/03630269.2018.1551231] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Ersin Töret
- Clinic of Pediatric Hematology-Oncology, Balıkesir Atatürk Şehir Hastanesi, Balıkesir, Turkey
| | - Nihal Ö. Karadaş
- Clinic of Pediatric Hematology-Oncology, Balıkesir Atatürk Şehir Hastanesi, Balıkesir, Turkey
| | - Nazlı Ö. Gökçe
- Clinic of Pediatric Hematology-Oncology, Sağhk Bakanlığı Üniveristesi, İzmir Dr. Behçet Uz Çocuk Sağlığı ve Cerrahisi Eğitim Araştırma Hastanesi, İzmir, Turkey
| | - Arife Kaygusuz
- Clinic of Pediatric Hematology-Oncology, Sağhk Bakanlığı Üniveristesi, İzmir Dr. Behçet Uz Çocuk Sağlığı ve Cerrahisi Eğitim Araştırma Hastanesi, İzmir, Turkey
| | - Tuğba H. Karapınar
- Clinic of Pediatric Hematology-Oncology, Sağhk Bakanlığı Üniveristesi, İzmir Dr. Behçet Uz Çocuk Sağlığı ve Cerrahisi Eğitim Araştırma Hastanesi, İzmir, Turkey
| | - Yeşim Oymak
- Clinic of Pediatric Hematology-Oncology, Sağhk Bakanlığı Üniveristesi, İzmir Dr. Behçet Uz Çocuk Sağlığı ve Cerrahisi Eğitim Araştırma Hastanesi, İzmir, Turkey
| | - Salih Gözmen
- Clinic of Pediatric Hematology-Oncology, Sağhk Bakanlığı Üniveristesi, İzmir Dr. Behçet Uz Çocuk Sağlığı ve Cerrahisi Eğitim Araştırma Hastanesi, İzmir, Turkey
| |
Collapse
|
19
|
Güler Kazancı E, Uğur MC, Oymak Y, Kavakli K. The Effect of Self-infusion and Patient Education on Treatment Compliance in Hemophilia Patients. BUCH 2019. [DOI: 10.5222/buchd.2019.80269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
20
|
Antmen B, Karakaş Z, Yeşilipek MA, Küpesiz OA, Şaşmaz İ, Uygun V, Kurtoğlu E, Oktay G, Aydogan G, Akın M, Salcioglu Z, Vergin C, Kazancı EG, Ünal S, Çalışkan Ü, Aral YZ, Türkkan E, Meral Güneş A, Tunç B, Gümrük F, Ayhan AC, Söker M, Koç A, Oymak Y, Ertem M, Timur Ç, Yıldırmak Y, İrken G, Apak H, Biner B, Eren TG, Işık Balcı Y, Koçak Ü, Karasu G, Akkaynak D, Patıroğlu T. Deferasirox in children with transfusion‐dependent thalassemia or sickle cell anemia: A large cohort real‐life experience from Turkey (REACH‐THEM). Eur J Haematol 2018; 102:123-130. [DOI: 10.1111/ejh.13180] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 09/24/2018] [Accepted: 09/25/2018] [Indexed: 01/01/2023]
Affiliation(s)
| | | | | | | | - İlgen Şaşmaz
- Çukurova University Medical Faculty Adana Turkey
| | - Vedat Uygun
- Antalya Training and Research Hospital Antalya Turkey
| | | | | | - Gonul Aydogan
- Kanuni Sultan Suleyman Training and Research Hospital Istanbul Turkey
| | | | - Zafer Salcioglu
- Kanuni Sultan Suleyman Training and Research Hospital Istanbul Turkey
| | - Canan Vergin
- Dr. Behcet Uz Child Disease and Surgery Training and Research Hospital Izmir Turkey
| | | | - Selma Ünal
- Mersin University Medical Faculty Mersin Turkey
| | - Ümran Çalışkan
- Necmettin Erbakan University Meram Medical Faculty Konya Turkey
| | | | - Emine Türkkan
- Okmeydanı Training and Research Hospital Istanbul Turkey
| | | | - Bahattin Tunç
- Ankara Child Health and Disease, Hematology Oncology Training and Research Hospital Ankara Turkey
| | - Fatma Gümrük
- Hacettepe University Medical Faculty Ankara Turkey
| | | | - Murat Söker
- Dicle University Medical Faculty Diyarbakır Turkey
| | - Ahmet Koç
- Harran University Medical Faculty Şanlıurfa Turkey
| | - Yeşim Oymak
- Harran University Medical Faculty Şanlıurfa Turkey
| | - Mehmet Ertem
- Faculty of Medicine Ankara University Ankara Turkey
| | - Çetin Timur
- Goztepe Training and Research Hospital Istanbul Turkey
| | | | | | - Hilmi Apak
- Istanbul University Cerrahpasa Medical Faculty Istanbul Turkey
| | - Betül Biner
- Trakya University Medical Faculty Edirne Turkey
| | | | | | - Ülker Koçak
- Gazi University Medical Faculty Ankara Turkey
| | - Gülsün Karasu
- Istanbul Zeynep Kamil Women and Children's Diseases raining and Research Hospital Istanbul Turkey
| | - Diyar Akkaynak
- Novartis Saglık, Gıda ve Tarım Ürünleri San. ve Tic. A.S Istanbul Turkey
| | | |
Collapse
|
21
|
Töret E, Karapınar T, Bulut M, Aksay A, Ay Y, Oymak Y, Devrim İ, İnce D. Kanserli Çocuklarda Febril Nötropeni Ataklarının İncelenmesi. Mustafa Kemal Üniversitesi Tıp Dergisi 2018. [DOI: 10.17944/mkutfd.489213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
22
|
İnce D, Demirağ B, Özek G, Erbay A, Ortaç R, Oymak Y, Kamer S, Yaman Y, Kundak S, Vergin C. Pediatric langerhans cell histiocytosis: single center experience over a 17-year period. Turk J Pediatr 2017; 58:349-355. [PMID: 28276205 DOI: 10.24953/turkjped.2016.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
This study aimed to analyze children with the diagnosis of Langerhans cell histiocytosis (LCH) who were diagnosed and treated between 1998-2015. Medical records were evaluated retrospectively for clinical and laboratory features, treatment details, and outcome. There were 20 patients, the median age of diagnosis was 37 months, M/F ratio: 1.5. Nine had single system (SS), 11 had multisystem (MS) LCH. Spontaneous regression occurred in three infants with skin limited LCH. Eight patients had risk organ involvement in MS-LCH group. The curettage alone was performed in only one case. Patients received LCH-II/ LCH-III based chemotherapy schema. Radiotherapy was performed to vertebral disease and residual craniofacial bone disease in four cases. The regression and relapse rates were 100% and 33% for SS-LCH. The regression and relapse rates were 73%, and 18% for MS-LCH. Two infants with MS-LCH died despite chemotherapy. Pulmonary and liver involvements affected outcome adversely in MS-LCH. Multidisciplinary treatment approaches are needed.
Collapse
Affiliation(s)
- Dilek İnce
- Department of Pediatric Oncology, Dokuz Eylül University Institute of Oncology, İzmir
| | - Bengü Demirağ
- Department of Pediatric Hematology-Oncology Clinic, Dokuz Eylül University Institute of Oncology, İzmir
| | - Gülcihan Özek
- Department of Pediatric Hematology-Oncology Clinic, Dokuz Eylül University Institute of Oncology, İzmir
| | - Ayşe Erbay
- Division of Pediatric Oncology, Başkent University Faculty of Medicine, Adana, Turkey
| | - Ragıp Ortaç
- Department of Pathology, İzmir University Faculty of Medicine, İzmir
| | - Yeşim Oymak
- Department of Pediatric Hematology-Oncology Clinic, Dokuz Eylül University Institute of Oncology, İzmir
| | - Serra Kamer
- Department of Radiation Oncology, Ege University Faculty of Medicine, İzmir
| | - Yöntem Yaman
- Department of Pediatric Hematology-Oncology Clinic, Dokuz Eylül University Institute of Oncology, İzmir
| | - Selcen Kundak
- Dermatology Clinic, Dr Behçet Uz Children's Hospital, İzmir
| | - Canan Vergin
- Department of Pediatric Hematology-Oncology Clinic, Dokuz Eylül University Institute of Oncology, İzmir
| |
Collapse
|
23
|
Koker SA, Gözmen S, Oymak Y, Karapinar TH, Can D, Genç S, Vergin RC. Idiopathic Pulmonary Hemosiderosis Mimicking Iron Deficiency Anemia: A Delayed Diagnosis? Hematol Rep 2017; 9:7048. [PMID: 28670434 PMCID: PMC5477471 DOI: 10.4081/hr.2017.7048] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 03/21/2017] [Indexed: 11/22/2022] Open
Abstract
Idiopathic pulmonary hemosiderosis (IPH) is an uncommon chronic disorder in children. It is characterized by recurrent pulmonary hemorrhage and may result in hemoptysis and pulmonary insufficiency. The most common hematologic manifestation of IPH is iron deficiency anemia. The etiology of IPH is not known and its diagnosis may be difficult due to the variable clinical courses. The most helpful signs for identifying IPH are iron deficiency anemia and recurrent or chronic cough, hemoptysis, dyspnea, wheezing. We report here 5 pediatric cases of IPH presenting with iron deficiency anemia and without pulmonary symptoms. Mean corpuscular volume was low in all patients; iron was low in 4 out of 5 cases; total iron binding capacity was high in all of them; ferritin was low in 3 patients. At follow up, none of them had responded successfully to the iron therapy. Although they didn’t present with pulmonary symptoms, chest radiographs incidentally revealed diffuse reticulonoduler shadows in all of them. Computed tomography revealed diffuse ground-glass opacities, consolidation, increased density. The diagnosis was confirmed by the detection of hemosiderin-laden macrophages in bronchoalveolar lavage fluid and gastric aspirate. If patients with iron deficiency anemia don’t respond to iron therapy, they should be examined for IPH. Chest radiographs should be taken even in absence of pulmonary symptoms. Early diagnosis is important for a timely management of IPH.
Collapse
Affiliation(s)
- Sultan Aydin Koker
- Division of Pediatric Hematology, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Salih Gözmen
- Division of Pediatric Hematology, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Yeşim Oymak
- Division of Pediatric Hematology, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | | | - Demet Can
- Division of Pediatric Allergy, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Sinan Genç
- Division of Pediatric Radiology, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Raziye Canan Vergin
- Division of Pediatric Hematology, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| |
Collapse
|
24
|
Katipoğlu N, Karapinar TH, Demir K, Aydin Köker S, Nalbantoğlu Ö, Ay Y, Korkmaz HA, Oymak Y, Yıldız M, Tunç S, Hazan F, Vergin C, Ozkan B. Infantile-onset thiamine responsive megaloblastic anemia syndrome with SLC19A2 mutation: a case report. ARCH ARGENT PEDIATR 2017; 115:e153-e156. [PMID: 28504500 DOI: 10.5546/aap.2017.eng.e153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 12/05/2016] [Indexed: 11/12/2022]
Abstract
BACKGROUND Thiamine-responsive megaloblastic anemia syndrome (TRMA), also known as Rogers syndrome, is characterized by megaloblastic anemia, sensorineural hearing loss, and diabetes mellitus. Disturbances of the thiamine transport into the cells results from homozygous or compound heterozygous mutations in the SLC19A2 gene. CASE PRESENTATION We report a girl which presented with sensorineural deafness treated with a hearing prosthesis, insulin requiring diabetes, macrocytic anemia, treated with thiamine (100 mg/day). Hemoglobin level improved to 12.1 g/dl after dose of thiamine therapy increased up to 200 mg/day. CONCLUSION Patients with TRMA must be evaluated for megaloblastic anemia, sensorineural hearing loss, and diabetes mellitus. They must be followed for response of hematologic and diabetic after thiamine therapy. It should be kept in mind that dose of thiamine therapy may be increased according to the clinical response. Genetic counseling should be given.
Collapse
Affiliation(s)
- Nagehan Katipoğlu
- Department of Pediatrics, Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Tuba H Karapinar
- Department of Pediatric Hematology and Oncology, Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Korean Demir
- Department of Pediatric Endocrinology, Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Sultan Aydin Köker
- Department of Pediatric Hematology and Oncology, Dr. Behcet Uz Children's Hospital, Izmir, Turkey.
| | - Özlem Nalbantoğlu
- Department of Pediatric Endocrinology, Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Yılmaz Ay
- Department of Pediatric Hematology and Oncology, Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Hüseyin A Korkmaz
- Department of Pediatric Endocrinology, Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Yeşim Oymak
- Department of Pediatric Hematology and Oncology, Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Melek Yıldız
- Department of Pediatric Endocrinology, Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Selma Tunç
- Department of Pediatric Endocrinology, Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Filiz Hazan
- Department of Medical Genetics, Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Canan Vergin
- Department of Pediatric Hematology and Oncology, Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Behzat Ozkan
- Department of Pediatric Endocrinology, Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| |
Collapse
|
25
|
Aydınok Y, Oymak Y, Atabay B, Aydoğan G, Yeşilipek A, Ünal S, Kılınç Y, Oflaz B, Akın M, Vergin C, Sezgin Evim M, Çalışkan Ü, Ünal Ş, Bay A, Kazancı E, İleri T, Atay D, Patıroğlu T, Kahraman S, Söker M, Akcan M, Akdeniz A, Büyükavcı M, Alanoğlu G, Bör Ö, Soyer N, Özdemir Karadaş N, Uysalol E, Türker M, Akçay A, Ocak S, Güneş AM, Tokgöz H, Ünal E, Tiftik N, Karakaş Z. A National Registry of Thalassemia in Turkey: Demographic and Disease Characteristics of Patients, Achievements, and Challenges in Prevention. Turk J Haematol 2017; 35:12-18. [PMID: 28404539 PMCID: PMC5843769 DOI: 10.4274/tjh.2017.0039] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: The Turkish Society of Pediatric Hematology set up a National Hemoglobinopathy Registry to demonstrate the demographic and disease characteristics of patients and assess the efficacy of a hemoglobinopathy control program (HCP) over 10 years in Turkey. Materials and Methods: A total of 2046 patients from 27 thalassemia centers were registered, of which 1988 were eligible for analysis. This cohort mainly comprised patients with β-thalassemia major (n=1658, 83.4%) and intermedia (n=215, 10.8%). Results: The majority of patients were from the coastal areas of Turkey. The high number of patients in Southeastern Anatolia was due to that area having the highest rates of consanguineous marriage and fertility. The most common 11 mutations represented 90% of all β-thalassemia alleles and 47% of those were IVS1-110(G->A) mutations. The probability of undergoing splenectomy within the first 10 years of life was 20%, a rate unchanged since the 1980s. Iron chelators were administered as monotherapy regimens in 95% of patients and deferasirox was prescribed in 81.3% of those cases. Deferasirox administration was the highest (93.6%) in patients aged <10 years. Of the thalassemia major patients, 5.8% had match-related hemopoietic stem cell transplantation with a success rate of 77%. Cardiac disease was detected as a major cause of death and did not show a decreasing trend in 5-year cohorts since 1999. Conclusion: While the HCP has been implemented since 2003, the affected births have shown a consistent decrease only after 2009, being at lowest 34 cases per year. This program failure resulted from a lack of premarital screening in the majority of cases. Additional problems were unawareness of the risk and misinformation of the at-risk couples. In addition, prenatal diagnosis was either not offered to or was not accepted by the at-risk families. This study indicated that a continuous effort is needed for optimizing the management of thalassemia and the development of strategies is essential for further achievements in the HCP in Turkey.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Şule Ünal
- Hemoglobinopathy Study Group, Turkey
| | - Ali Bay
- Hemoglobinopathy Study Group, Turkey
| | | | | | | | | | | | | | | | | | | | | | - Özcan Bör
- Hemoglobinopathy Study Group, Turkey
| | - Nur Soyer
- Hemoglobinopathy Study Group, Turkey
| | | | | | | | | | | | | | | | - Elif Ünal
- Hemoglobinopathy Study Group, Turkey
| | | | | |
Collapse
|
26
|
Karapınar TH, Yılmaz Karapinar D, Oymak Y, Ay Y, Demirağ B, Aykut A, Onay H, Hazan F, Aydınok Y, Özkınay F, Vergin C. HAX1 mutation positive children presenting with haemophagocytic lymphohistiocytosis. Br J Haematol 2017; 177:597-600. [PMID: 28169428 DOI: 10.1111/bjh.14574] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 12/05/2016] [Indexed: 11/26/2022]
Abstract
The genetic basis of haemophagocytic lymphohistiocytosis (HLH) has not been elucidated in 10% of affected patients. In this study, we report four HLH episodes in three patients with HAX1 gene mutations. We screened the mutations associated with congenital neutropenia (CN) because the neutropenia persisted following HLH treatment. There were homozygous HAX1 mutations detected in all patients. This is the first case series of patients with CN caused by HAX1 mutation who presented with HLH. We hypothesize that severe neutropenia persists after an HLH episode in children without HLH mutations (especially infants) because these patients have CN caused by HAX1 mutations.
Collapse
Affiliation(s)
- Tuba H Karapınar
- Department of Paediatric Haematology-Oncology, Dr. Behçet Uz Children Research and Training Hospital, Izmir, Turkey
| | - Deniz Yılmaz Karapinar
- Department of Paediatric Haematology-Oncology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Yeşim Oymak
- Department of Paediatric Haematology-Oncology, Dr. Behçet Uz Children Research and Training Hospital, Izmir, Turkey
| | - Yılmaz Ay
- Department of Paediatric Haematology-Oncology, Dr. Behçet Uz Children Research and Training Hospital, Izmir, Turkey
| | - Bengü Demirağ
- Department of Paediatric Haematology-Oncology, Dr. Behçet Uz Children Research and Training Hospital, Izmir, Turkey
| | - Ayça Aykut
- Department of Medical Genetics, Ege University Faculty of Medicine, Izmir, Turkey
| | - Hüseyin Onay
- Department of Medical Genetics, Ege University Faculty of Medicine, Izmir, Turkey
| | - Filiz Hazan
- Department of Medical Genetics, Dr. Behçet Uz Children Research and Training Hospital, Izmir, Turkey
| | - Yeşim Aydınok
- Department of Paediatric Haematology-Oncology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Ferda Özkınay
- Department of Medical Genetics, Ege University Faculty of Medicine, Izmir, Turkey
| | - Canan Vergin
- Department of Paediatric Haematology-Oncology, Dr. Behçet Uz Children Research and Training Hospital, Izmir, Turkey
| |
Collapse
|
27
|
İnce D, Demirağ B, Ataseven E, Oymak Y, Tuhan H, Karakuş OZ, Hazan F, Abacı A, Özer E, Mutafoglu K, Olgun N. Child with RET proto-oncogene codon 634 mutation. Turk J Pediatr 2017; 59:590-593. [PMID: 29745123 DOI: 10.24953/turkjped.2017.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
İnce D, Demirağ B, Ataseven E, Oymak Y, Tuhan H, Karakuş OZ, Hazan F, Abacı A, Özer E, Mutafoglu K, Olgun N. Child with RET proto-oncogene codon 634 mutation. Turk J Pediatr 2017; 59: 590-593. Herein we reported a 7-year-old child with RET proto-oncogene c634 mutation. Her mother had been diagnosed with medullary thyroid carcinoma (MTC), and treated six years ago. Heterozygous mutation of the RET proto-oncogene at c634 had been detected in her mother. Genetic analysis showed the presence of the same mutation in our patient. Thyroid functions were normal. Serum calcitonin level was found mildly elevated. Parathormone (PTH) and carcinoembrionic antigen (CEA) levels were normal. Prophylactic thyroidectomy and sampling of cervical lymph nodes were performed. Histopathologic examination revealed hyperplasia in thyroid C cells, and reactive lymphadenopathy. The risk of MTC has been reported 100% through the life of patients with RET proto-oncogene mutation. It has been reported that particularly patients with c634 mutation have more risk of occurence of metastatic and progressive/recurrent MTC. Prophylactic `thyroidectomy, cervical lymph node dissection` before 5-years-of-age should be considered for these patients.
Collapse
Affiliation(s)
- Dilek İnce
- Departments of Pediatric Oncology, Dokuz Eylül University Faculty of Medicine
| | - Bengü Demirağ
- Departments of Hematology Oncology, Dr. Behçet Uz Children's Hospital
| | - Eda Ataseven
- Departments of Pediatric Oncology, Dokuz Eylül University Faculty of Medicine
| | - Yeşim Oymak
- Departments of Hematology Oncology, Dr. Behçet Uz Children's Hospital
| | - Hale Tuhan
- Departments of Endocrinology, Dokuz Eylül University Faculty of Medicine
| | | | - Filiz Hazan
- Departments of Medical Genetics, Dr. Behçet Uz Children's Hospital
| | - Ayhan Abacı
- Departments of Endocrinology, Dokuz Eylül University Faculty of Medicine
| | - Erdener Özer
- Departments of Pathology, Dokuz Eylül University Faculty of Medicine
| | - Kamer Mutafoglu
- Department of Pediatric Oncology, İzmir University of Economics School of Medicine, İzmir, Turkey
| | - Nur Olgun
- Departments of Pediatric Oncology, Dokuz Eylül University Faculty of Medicine
| |
Collapse
|
28
|
İnce D, Demirağ B, Karapınar TH, Oymak Y, Ay Y, Kaygusuz A, Töret E, Vergin C. Assessment of sleep in pediatric cancer patients. TurkJPediatr 2017; 59:379-386. [DOI: 10.24953/turkjped.2017.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
29
|
Düzgöl M, Özek G, Bayram N, Oymak Y, Kara A, Demirağ B, Karapınar TH, Ay Y, Vergin C, Devrim İ. Varicella-Zoster Virus Infections in Pediatric Malignancy Patients: A Seven-Year Analysis. Turk J Haematol 2016; 33:346-348. [PMID: 27751970 PMCID: PMC5204192 DOI: 10.4274/tjh.2016.0046] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Primary varicella-zoster virus (VZV) infection is a benign self-limited disease. In this study, we review our experience in focusing on the outcome and treatment of VZV infection in pediatric malignancy patients. During the study period, a total of 41 patients with pediatric malignancy had been hospitalized with the diagnosis of VZV infection. All the patients were treated with intravenous acyclovir for a median of 7 days (ranging from 5 to 21 days). The calculated attributable delay of chemotherapy due to VZV infections was 8 days (ranging from 2 to 60 days). VZV-related complications were observed in 3 of 41 patients (7%) who suffered from acute respiratory distress syndrome, and one of them with hemophagocytic lymphohistiocytosis died due to respiratory failure despite acyclovir and broad-spectrum antimicrobial treatment plus supportive treatment. VZV infections are still important contagious diseases in pediatric cancer patients, because they cause not only significant mortality but also a delay in chemotherapy.
Collapse
Affiliation(s)
- Mine Düzgöl
- Dr. Behçet Uz Children Training and Research Hospital, Clinic of Pediatric Infectious Diseases, İzmir, Turkey, Phone: +90 232 489 56 56, E-mail:
| | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Ünal S, Oktay G, Acıpayam C, İlhan G, Gali E, Celkan T, Bay A, Malbora B, Akar N, Oymak Y, Toptaş T. Hemoglobin H Disease in Turkey: Experience from Eight Centers. Turk J Haematol 2016; 33:56-9. [PMID: 26376738 PMCID: PMC4805343 DOI: 10.4274/tjh.2014.0461] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
The purpose of this study was to research the problem of hemoglobin H (HbH) disease, to reveal the distribution patterns among different health centers, and to emphasize the importance of this disease for Turkey. A total of 273 patients were included from 8 hemoglobinopathy centers. The Antakya Hemoglobinopathy Center reported 232 patients and the remaining 7 centers reported 41 patients. PubMed was also searched for published articles related to Turkish patients with HbH disease, and we found 16 articles involving a total of 198 HbH patients. Most of the patients were reported from Antakya; thus, special attention should be paid to this region. This is a preliminary study to investigate the extent of the problem of HbH disease and it emphasizes the need for hematology associations or the Ministry of Health to record all cases of HbH disease in Turkey.
Collapse
Affiliation(s)
- Selma Ünal
- Mersin University Faculty of Medicine, Department of Pediatric Hematology, Mersin, Turkey. E-mail:
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Yaman Y, Gözmen S, Özkaya AK, Oymak Y, Apa H, Vergin C, Devrim İ. Secondary hemophagocytic lymphohistiocytosis in children with brucellosis: report of three cases. J Infect Dev Ctries 2015; 9:1172-6. [PMID: 26517495 DOI: 10.3855/jidc.6090] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 03/16/2015] [Accepted: 03/23/2015] [Indexed: 10/31/2022] Open
Abstract
Brucellosis is a systemic zoonotic infectious disease that may cause fever, fatigue, sweating, arthritis, hepatosplenomegaly, cytopenia, and lymphadenopathy. It continues to be an important health problem worldwide. Hemophagocytic lymphohistiocytosis (HLH) is characterized by fever, hepatosplenomegaly, cytopenias, high serum levels of ferritin and triglycerides, low serum fibrinogen levels, and hemophagocytosis in bone marrow, lymph nodes, spleen, or liver. Hemophagocytic lymphohistiocytosis associated with brucellosis is a very rare condition in the pediatric age group. Here, three pediatric cases of secondary HLH associated with brucellosis are reported. Hemophagocytic lymphohistiocytosis should be considered in patients with brucellosis having cytopenias. Hemophagocytosis in brucellosis seems to be cured with appropriate antibiotics and intravenous immunoglobulin.
Collapse
Affiliation(s)
- Yöntem Yaman
- Sütçü Imam University Medical School, Kahramanmaraş, Turkey.
| | | | | | | | | | | | | |
Collapse
|
32
|
Oymak Y, Karapınar TH, Ay Y, Özcan E, Müminoğlu N, Aydın Köker S, Töret E, Berdeli A, Serdaroğlu E, Vergin C. Thrombotic Microangiopathy with Complement Factor H Gene Mutations Unassociated with Atypical Hemolytic Uremic Syndrome. Turk J Haematol 2015; 32:275-6. [PMID: 26376595 PMCID: PMC4563206 DOI: 10.4274/tjh.2015.0084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Yeşim Oymak
- Dr. Behçet Uz Children's Hospital, Clinic of Hematology, İzmir, Turkey Phone: +90 532 355 42 28 E-mail:
| | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Abuhandan M, Güzel B, Oymak Y, Çiftçi H. Antibiotic sensitivity and resistance in children with urinary tract infection in Sanliurfa. Turk J Urol 2015; 39:106-10. [PMID: 26328090 DOI: 10.5152/tud.2013.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Accepted: 12/24/2012] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study aimed to evaluate antibiotic resistance in the province of Şanliurfa and to observe any difference between antibiotic resistance rates. MATERIAL AND METHODS The study comprised 107 children who presented at the pediatric polyclinic with complaints of urinary tract infection with the diagnosis of urinary tract infection and whose urine cultures exhibited bacterial growth. The patients were analyzed with respect to the frequency of proliferating pathogens, sensitivity to the antibiotics used and the rates of developed resistance to the antibiotics. RESULTS A total of 107 patients aged between 1 year and 15 years were included in the study, encompassing 14 (13.1%) males and 93 (86.9%) females. According to the urine culture results, proliferation of Escherichia coli (E. coli) was observed in 69 (64.5%), Klebsiella spp. in 13 (12.1%), Proteus mirabilis in 9 (8.4%), Staphylococcus aureus in 5 (4.7%), Pseudomonas aeruginosa in 5 (4.7%), Acinetobacter spp. in 3 (2.8%) and Enterococcus spp. in 3 (2.8%) patients. For proliferating E. coli, high resistance rates to ceftriaxone (39.5%), nitrofurantoin (19.7%), ampicillin-sulbactam (64.1%), co-trimoxazole (41.5%), amoxicillinclavulanate (51.7%) and cefuroxime (38.1%) were observed. All of isolated microorganisms were resistant to ampicillin-sulbactam, amoxicillin-clavulanate, co-trimoxazole, ceftriaxone, cefuroxime and cefoxitin in decreasing frequencies. The most effective antimicrobial agents were determined to be imipenem, sulpera-zone, quinolone and aminoglycosides. CONCLUSION In our region, parenteral antibiotics that should be selected for the empirical treatment of UTIs in all age groups are the aminoglycosides and 3(rd) generation cephalosporines. In contrast to other studies, these results suggest that co-trimoxazole should be used for children aged 0-1, and 2(nd) generation cephalosporins should be used for the oral treatment of children aged 1-5 due to the low rate of resistance to nitrofurantoin in patients aged over 5 years.
Collapse
Affiliation(s)
- Mahmut Abuhandan
- Department of Pediatrics, Faculty of Medicine, Harran University, Şanlıurfa, Turkey
| | - Bülent Güzel
- Department of Pediatrics, Faculty of Medicine, Harran University, Şanlıurfa, Turkey
| | - Yeşim Oymak
- Department of Pediatrics, Faculty of Medicine, Harran University, Şanlıurfa, Turkey
| | - Halil Çiftçi
- Department of Urology, Faculty of Medicine, Harran University, Şanlıurfa, Turkey
| |
Collapse
|
34
|
Devrim İ, Demirağ B, Yaman Y, Bayram N, Özdemir F, Kara A, Özek G, Ayhan Y, Gülfidan G, Oymak Y, Vergin C. A 7-year study of the distribution of nosocomial candidemia in children with cancer. Turk J Pediatr 2015; 57:225-229. [PMID: 26701939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Candidemia is an important cause of morbidity and mortality in cancer patients. The incidence of candidemia has been reported to have shifted toward nonalbicans species. The aim of this study was to determine the distribution of Candida species resulting in bloodstream infections or catheter-related blood stream infections (CRBSIs) in pediatric hematology-oncology (PHO) patients over a 7-year-period. Medical and computerized microbiology laboratory records of all positive blood fungal cultures during the study period were analyzed retrospectively. The ratio of non-albicans Candida species (81.4%) was nearly four times higher than that of C. albicans candidemia (18.5%). Overall, C. parapsilosis caused the majority (61.4%) of candidemia episodes, followed by C. tropicalis (14.8%), C. famata (2.9%), C. ciferrii (1.4%) and C. glabrata (0.7%). The rate of CRBSIs was significantly higher in C. Parapsilosis candidemia. The overall rate of 30-day mortality in 135 candidemia episodes was 4.44%. Nearly half of the C. parapsilosis candidemia was associated with CRBSIs, suggesting its importance in PHO, in which several types of central venous catheters have been used.
Collapse
Affiliation(s)
- İlker Devrim
- Division of Pediatric Infectious Diseases Dr. Behçet Uz Children's Hospital, İzmir, Turkey.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Devrim F, Gülfidan G, Gözmen S, Demirağ B, Oymak Y, Yaman Y, Oruç Y, Yaşar N, Apa H, Bayram N, Vergin C, Devrim İ. Comparison of the BD GeneOhm VanR assay and a chromogenic agar-based culture method in screening for vancomycin-resistant enterococci in rectal specimens of pediatric hematology-oncology patients. Turk J Pediatr 2015; 57:161-166. [PMID: 26690597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
VRE species are an increasingly important and universal problem in intensive care units and hematology-oncology departments due to the spread of glycopeptide resistance. Rapid and accurate identification of VRE is therefore crucial. The intent of this study was to compare the diagnostic performance of a real-time PCR test, the BD GeneOhm VanR assay (GeneXpert vanA/ vanB, Cepheid, USA), with conventional cultures for screening hospitalized immunocompromised hematology-oncology patients for VRE. Three hundred and six duplicate rectal swab specimens were obtained from 120 pediatric hematology-oncology patients. PCR and conventional culture-based studies were performed. One hundred and twenty patients, 46 female and 74 male, participated in the study. The mean age of the patients was 7.5±4.7 years. A total of 51 specimens from 306 samples were found to be positive for vanA or vanB. Mean turnaround time for PCR was 0.5±0.2 days. Compared to the culture method, the RT-PCR assay had an overall sensitivity of 91.8% (34/37) and a specificity of 93.6%. The positive predictive value and negative predictive value were 66.6% and 98.8%, respectively. This study demonstrates that RT-PCR is a suitable alternative to culture-based procedures for rapid and accurate identification of VRE in hematology-oncology patients, as the overall performance of PCR is comparable to that of a chromogenic agar-based culture method for VRE screening, especially for detection of VRE-negative patients.
Collapse
Affiliation(s)
- Fatma Devrim
- Department of Pediatrics, Dr. Behçet Uz Children's Hospital, İzmir, Turkey.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Oymak Y, Güzel B, Gümüş H, Dağlıoğlu E, Ayçiçek A, Koç A, Özyürük D. Significant differences in thymic index of thalassemia major patients. Turk J Haematol 2014; 31:417-9. [PMID: 25541661 PMCID: PMC4454060 DOI: 10.4274/tjh.2014.0150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Yeşim Oymak
- Dr. Behçet Uz Children's Hospital, Clinic of Hematology, İzmir, Turkey. E-mail:
| | | | | | | | | | | | | |
Collapse
|
37
|
Yıldırım AT, Oymak Y, Yaman Y, Saatçi O, Malatyalı R, Kamer S, Alper H. Akut Lenfoblastik Lösemide İzole Optik Sinir Relapsı: İki Olgu Sunumu. Cukurova Medical Journal 2014. [DOI: 10.17826/cutf.92975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
38
|
Özyörük D, Öner T, Oymak Y, Çelik HT. Comparison of Doppler echocardiographic and tissue Doppler velocity data in beta-thalassaemia major with high and normal NT-proBNP levels of children in the south-east region of Turkey. Transl Pediatr 2014; 3:287-92. [PMID: 26835348 PMCID: PMC4728833 DOI: 10.3978/j.issn.2224-4336.2014.06.02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND It has been reported that N-terminal pro-brain natriuretic peptide (NT-proBNP) is early biomarker of iron- induced cardiomyopathy in β-thalassemia major (β-TM). In this study, we aimed to assess the Doppler echocardiographic, tissue Doppler velocity datas and clinical characteristics in β-TM patients with high and normal NT-proBNP levels who have normal systolic function. MATERIAL AND METHOD Fifty-eight β-TM patients who were on regular transfusion in every 3-4 weeks for more than one year and 20 healthy children were included into the study. According to NT-proBNP levels, β-TM patients are divided in two groups. Group I: the patients with high NT-proBNP levels; Group II: the patients with normal NT-proBNP levels. RESULTS The mean serum NT-proBNP levels were significantly increased in patients with β-TM compared to control group (P<0.05). The serum ferritin levels were ranged between 676-9,476 ng/mL (mean: 3,716±2,003 ng/mL) in β-TM. No correlation was found between ferritin and NT-pro BNP in patients with β-TM. The mean age and body surface area (BSA) were significantly low in group with high NT-proBNP compared to group with normal NT-proBNP (P<0.01). The mean heart rate, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were elevated, but not significantly in group with high NT-proBNP. Also, the mean ferritin and hemoglobin levels were decreased in this group compared to group with normal NT-proBNP, but statistically not significant. The left ventricular end diastole (LVED) diameters and left ventricular mass index (LVMI) values were found significantly decreased in group with high NT-proBNP compared to other group respectively (P<0.001, P<0,05). Right ventricular early diastolic tricuspid inflow velocity/early diastolic tissue Doppler indices (TDI) tricuspid annular velocity (RV E/E') were found increased in group with high NT-proBNP levels and difference was statistically significant (P<0.05). In addition, NT-pro BNP was found correlated with RV E/E' (r: 0.320). CONCLUSIONS According to our result, elevated NT-proBNP level was correlated with RVE/E', but it was not associated with ferritin level. The serum NT-proBNP level may be increased as a response to increased myocardial workload and decreased hemoglobin level in patients who have an increased need for transfusion.
Collapse
Affiliation(s)
- Derya Özyörük
- 1 Health of Ministry, Şanlıurfa Children's Hospital Pediatric Hematooncology Clinic, Şanlıurfa, Turkey ; 2 Health of Ministry, Şanlıurfa Children's Hospital Pediatric Cardiology Clinic, Şanlıurfa, Turkey ; 3 Harran University, Pediatric Hematology Department, Şanlıurfa, Turkey ; 4 Ankalab laboratory, Ankara, Turkey
| | - Taliha Öner
- 1 Health of Ministry, Şanlıurfa Children's Hospital Pediatric Hematooncology Clinic, Şanlıurfa, Turkey ; 2 Health of Ministry, Şanlıurfa Children's Hospital Pediatric Cardiology Clinic, Şanlıurfa, Turkey ; 3 Harran University, Pediatric Hematology Department, Şanlıurfa, Turkey ; 4 Ankalab laboratory, Ankara, Turkey
| | - Yeşim Oymak
- 1 Health of Ministry, Şanlıurfa Children's Hospital Pediatric Hematooncology Clinic, Şanlıurfa, Turkey ; 2 Health of Ministry, Şanlıurfa Children's Hospital Pediatric Cardiology Clinic, Şanlıurfa, Turkey ; 3 Harran University, Pediatric Hematology Department, Şanlıurfa, Turkey ; 4 Ankalab laboratory, Ankara, Turkey
| | - Hüseyin Tuğrul Çelik
- 1 Health of Ministry, Şanlıurfa Children's Hospital Pediatric Hematooncology Clinic, Şanlıurfa, Turkey ; 2 Health of Ministry, Şanlıurfa Children's Hospital Pediatric Cardiology Clinic, Şanlıurfa, Turkey ; 3 Harran University, Pediatric Hematology Department, Şanlıurfa, Turkey ; 4 Ankalab laboratory, Ankara, Turkey
| |
Collapse
|
39
|
Devrim I, Yaman Y, Demirağ B, Oymak Y, Cartı Ö, Özek G, Tulumoğlu S, Erdem T, Gamze G, Gözmen S, Güneş BT, Bayram N, Vergin C. A single center's experience with Candida parapsilosis related long-term central venous access device infections: the port removal decision and its outcomes. Pediatr Hematol Oncol 2014; 31:435-41. [PMID: 24383767 DOI: 10.3109/08880018.2013.862587] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Pediatric cancer patients have an increased risk of potentially life-threatening fungal infections such as Candida parapsilosis, associated with long-term CVADs. The Infectious Diseases Society of America (IDSA) guidelines on Candida catheter-related bloodstream infections recommend systemic antifungal therapy and catheter removal. In this study, we focused on our experience with antifungal failure due to totally implanted catheter-associated C. parapsilosis bloodstream infections. We investigated cases leading to port removal in pediatric malignancy patients and the associated patient outcomes. In the first phase of the study, a retrospective chart review was performed to collect patient information, including primary disease; time from hospitalization to port-related candidemia; antifungal drug choice; and the time at which port removal occurred. During the second phase, antifungal susceptibility tests for C. parapsilosis were performed in our microbiology laboratory. All patients had fevers and were neutropenic at the time of candidemia diagnosis. The mean duration between the first isolation of Candida parapsilosis from the port samples to the port removal was 9.75 ± 5.29 days for 11 patients. Patient fevers lasted for a mean time of 16.22 ± 6.51 days. The median recovery duration from fever after CVC removal was four days (range 2-12 days). The median duration for achieving negative blood cultures, following antifungal treatment was 18 days (range 10-27 days). Our data favored the removal of catheters in the presence of ongoing fever, as suggested by the guidelines, independent of the chosen antifungal treatment. Future studies with large samples are needed to evaluate the effects of catheter removal on mortality rates and patient outcomes.
Collapse
Affiliation(s)
- Ilker Devrim
- 1Division of Pediatric Infectious Disease, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Göncü T, Cakmak S, Akal A, Oymak Y. Severe eyelid injury resulting from necrotic arachnidism in a child with leukemia. Can J Ophthalmol 2013; 48:e164-6. [PMID: 24314434 DOI: 10.1016/j.jcjo.2013.07.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2013] [Revised: 05/30/2013] [Accepted: 07/24/2013] [Indexed: 11/19/2022]
Affiliation(s)
- Tuğba Göncü
- Harran University, School of Medicine, Şanliurfa, Turkey.
| | | | | | | |
Collapse
|
41
|
Karabel M, Söker M, Yıldırım AT, Oymak Y, Kelekçi S, Karabel D. The clinical findings and prophylactic treatment in children with factor X deficiency. Pediatr Hematol Oncol 2013; 30:717-22. [PMID: 23560890 DOI: 10.3109/08880018.2013.782380] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Factor X (FX) is the component of both extrinsic and intrinsic coagulation cascade and is the first enzyme of the common pathway which results in thrombus. Congenital FX deficiency (FXD) is an extremely rare coagulation defect. In this study, we aimed to investigate the clinical and laboratory data of the patients diagnosed with FXD. The files of the 15 patients (7 female, 8 male) diagnosed and followed up for FXD within the last 4 years were evaluated retrospectively. The mean age of the patients was 29 months (min-max:1-144 months). The most presenting complaints were easy bruisability (n = 8; 53%) and epistaxis (n = 8; 53%). FX levels were <1% in six patients, 1-5% in four patients, and >5% in five patients. Heparin added-Protrombin Complex was used for prophlaxy (n = 11; 73%). Any treatment-related complication was not observed. Heparin-added PCC can be used safely for effective prophlaxy. We suggest that family history is important when considering prophlaxy and in patients with life-threatening bleeding or with FXD sibling the prophlaxy should be introduced in the early course.
Collapse
Affiliation(s)
- Müsemma Karabel
- Dicle University, School of Medicine, Department of Pediatrics , Kitilbil, Diyarbakir , Turkey
| | | | | | | | | | | |
Collapse
|
42
|
Yıldırım AT, Oymak Y, Yaman Y, Genel F, Sürücü M, Vergin C. The clinical importance of myeloid antigen coexpression and TEL-AML1 mutation in patients with childhood acute lymphoblastic leukemia. J Clin Exp Invest 2013. [DOI: 10.5799/ahinjs.01.2013.01.0240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|