Browsing by Author "Yildirim, Rahsan"

Filter results by typing the first few letters
Now showing 1 - 2 of 2
  • No Thumbnail Available
    Item
    Neutropenia Related to Valacyclovir and Valganciclovir in 2 Renal Transplant Patients and Treatment With Granulocyte Colony Stimulating Factor: A Case Report
    (Başkent Üniversitesi, 2010-06) Cetinkaya, Ramazan; Polat, Kamil Yalcin; Keles, Mustafa; Yildirim, Rahsan; Uyanik, Abdullah; Turkmen, Meral; Bilen, Yusuf; Aydinli, Bulent
    Objectives: Posttransplant leukopenia is frequently observed in renal transplant. Granulocyte colony-stimulating factor controls the production of functional neutrophils and their release into peripheral blood. Granulocyte colony-stimulating factor has been widely and frequently used for many conditions and disorders in the field of hematology and oncology. Materials and Methods: We present the cases of valacyclovir-related and valganciclovir-related neutropenia in 2 renal transplant recipients. Results: Both cases had renal transplants from live donors. The first one was an 18-year-old man. Laboratory investigations revealed his leukocyte count as 1.7 x 109/L. The patient was using mycophenolate mofetil, cyclosporine, and valganciclovir. Mycophenolate mofetil was stopped because he had neutropenia, and later, valganciclovir was also stopped because the neutropenia persisted. Because the neutropenia did not recover after we discontinued valganciclovir, the patient was administered granulocyte colony-stimulating factor. The neutrophil count increased to 2.2 x 109/L (leucocyte count to 6.5 x 109/L) after 24 hours. The second case was a 37-year-old man and was using mycophenolic acid, tacrolimus, and valacyclovir. Laboratory investigations revealed his leukocyte count to be 1.3 x 109/L. Mycophenolic acid and valganciclovir were stopped owing to neutropenia. The patient was administered granulocyte colony-stimulating factor, and the neutrophil count increased to 3.8 x 109/L (leucocyte count to 5.8 x 109/L). The kidney functions did not deteriorate in either patient, and the patients’ kidney functions were similar to baseline levels 12 months after surgery. Conclusions: We conclude that granulocyte colony-stimulating factor can be used safely and effectively in renal transplant patients.
  • No Thumbnail Available
    Item
    Treatment of Pure Red-Cell Aplasia With Cyclosporine in a Renal Transplant Patient
    (Başkent Üniversitesi, 2013-02) Yildirim, Rahsan; Aydinli, Bulent; Gokbulut, Puren; Uyanik, Abdullah; Keles, Mustafa; Bilen, Yusuf
    Acquired pure red-cell aplasia is a rare disorder that can be either idiopathic or associated with certain autoimmune diseases, pregnancy, lympho­proliferative disorders, nutritional deficiencies, or medicines. We present a deceased-donor renal transplant patient who developed pure red-cell aplasia associated with mycophenolate mofetil or tacrolimus and was treated with cyclosporine. A 20-year-old woman was transplanted from a deceased donor 1 month earlier and presented to us with symptoms of fatigue, prostration, and palpitation. The results of a laboratory examination revealed anemia. A diagnostic work-up resulted in a diagnosis of pure red-cell aplasia. Mycophenolate mofetil was discontinued. Tacrolimus also was replaced with cyclosporine 2 months after mycophenolate mofetil was halted because of a lack of improvement in anemia. Three months later, her anemia improved with cyclosporine. Starting cyclosporine instead of tacrolimus or mycophenolate mofetil showed good improvement in our patient within 6 months of therapy.