Tıp Fakültesi / Faculty of Medicine

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    Red Blood Cell Exchange Followed by Plasma Exchange in Patients with Intrahepatic Cholestasis due to Sickle Cell Disease
    (2016) Buyukkurt, Nurhilal; Kozanoglu, Ilknur; Boga, Can; Ozdogu, Hakan; Yeral, Mahmut; 0000-0002-0895-4787; 0000-0002-5268-1210; 0000-0002-8902-1283; 0000-0002-9580-628X; 0000-0002-9680-1958; AAE-1457-2021; AAE-1241-2021; AAD-6222-2021; AAD-5542-2021; ABC-4148-2020
    Intrahepatic cholestasis, a rare complication of sickle cell anemia, is characterized by marked hyperbilirubinemia, acute hepatic failure, and an often fatal course. In this report, we present patients with homozygous hemoglobin S and one patient with sickle-beta thalassemia disease who have intrahepatic cholestasis. Despite automated red blood cell exchange transfusion, which successfully decreased the hemoglobin S level to less than 30% of total hemoglobin level in the peripheral blood, basic biochemical laboratory examination revealed signs of cholestasis with a serum bilirubin level of up to 50 mg/dL in the first case, 30 mg/dL in the second, and 10 mg/dL in the third. The patients underwent plasma exchange, which improved their clinical condition except one. These cases suggest that plasma exchange may have a role in improving the clinical condition of patients with sickle cell disease complicated with intrahepatic cholestasis (SCIC) that fails to respond to automated red blood cell exchange therapy
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    Red blood cell alloimmunization in patients with sickle cell disease in Turkey: a single center retrospective cohort study
    (2016) Solmaz, Soner; Karacaoglu, Pelin; Gereklioglu, Cigdem; Asma, Suheyl; Korur, Asli; Buyukkurt, Nurhilal; Kasar, Mutlu; Yeral, Mahmut; Kozanoglu, Ilknur; Boga, Can; Ozdogu, Hakan; 0000-0002-5086-5593; 0000-0002-8902-1283; 0000-0003-3856-7005; 0000-0002-0895-4787; 0000-0002-5268-1210; 0000-0002-9680-1958; AAD-5616-2021; AAD-5542-2021; AAL-3906-2021; AAE-1457-2021; ABC-4148-2020; AAD-6222-2021; AAE-1241-2021
    Purpose: We aimed to investigate erythrocyte alloimmunization frequency and related factors in our region where SCD is common Material and Methods: This study was planned as a single center, cross-sectional and retrospective cohort study. A total of 216 patients who had been followed up due to SCD [Hemoglobin (Hb) SS, Hb S-beta thalassemia, Hb S-alpha thalassemia] were included in this study. Patients were divided to two groups according to amount of transfusion. The patients who had received less than 6 transfusions per year and who did not have the history of erythropheresis were allocated to Group 1, and the patients who had received 6 or more simple transfusion per year or who had undergone erythrocyte exchange were allocated to Group 2 Results: Of 216 SCD patients included in the study. Alloimmunization was detected in 67 (31.0%) out of 216 patients who underwent transfusion, and in 17 (30.4%) out of 56 patients in Group 1 and in 50 (31.3%) out of 160 patients in Group 2. When the patients were analyzed according to alloimmunization development, our study revealed that neither SCD complications are a risk factor for alloimmunization nor alloimmunization increases mortality rates Conclusion: High alloimmunization frequency found in our study suggests the insufficient adherence of alloimmunization-prevention policies in RBC transfusions performed except experienced institutions. Therefore alloimmunization may be reduced or prevented through performing extended red cell typing among SCD patients