Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item A Common Problem in Infants: Vitamin B12 Deficiency(2023) Kilci, Ceren; Olcay, Lale; 38204307Background. Nutritional vitamin B12 (VB12) deficiency is characterized by anemia, the inability to gain weight, delay or decline in development. Children of mothers with VB12 deficiency have a risk of nutritional VB12 deficiency. Prevention and early treatment are necessary to prevent irreversible neurological damage. We aimed to conduct a retrospective study to understand the characteristics of patients with VB12 deficiency.Methods. Our study included patients admitted to Baskent University Faculty of Medicine Pediatric Hematology outpatient clinic between January 2015 - February 2020 for VB12 deficiency. Their clinical and laboratory characteristics were retrospectively examined through the hospital automation system.Results. Vitamin B12 deficiency was detected in 129 of the 3198 patients; 100 of them were followed regularly. The mean age at admission of our patients was 10 +/- 12 months (1 month - 7.5 years); 98% of these children were aged 0-2 years. The mean VB12 level of our patients was 171.63 +/- 51.2 pg/ml (83 - 273), mean hemoglobin 11.2 +/- 1.37 g/dl (6.3 - 13.9), mean MCV 74.5 +/- 9.1 fl (54-106.5) and mean iron level was 54 +/- 23 mu g/dl (18 - 94). At the end of one month of loading therapy (oral or intramuscular, IM), the average VB12 level was 769 +/- 537 pg/ml (post loading). One month after the loading therapy (pre-maintenance) the average VB12 level was 426 +/- 156 pg/ml. In seven cases who received IM therapy, the loading treatment was performed for the second time. The mean VB12 level of the mothers of 85 cases was 174 +/- 127 pg/ml (134 - 650). VB12 deficiency was detected in 55% of mothers, VB12 level being between 200 - 300 pg/ml in 76%, and below 200 pg/ml in the 24%. The family members of 35% of our patients (including parents) had VB12 deficiency. Conclusions. In our country, routine screening of VB12 levels in infants is not performed; however, its early diagnosis and treatment can prevent many adverse effects mainly on the central nervous system. The fact that 98% of patients were 0-2 years old indicates that its deficiency may be quite high in the young age, and routine screening of this age group for VB12 deficiency and further studies for prophylaxis may be needed.Item Children with Iron Deficiency Anemia Have a Tendency to Hypercoagulation: An Evaluation by Thromboelastography(2020) Kilci, Ceren; Olcay, Lale; Ozdemir, Beril; Fettah, Ali; Colak, Meric Yavuz; 0000-0002-5684-0581; 0000-0002-0294-6874; 31852173; AAK-3548-2021; AAA-4360-2021Item Hemolytic anemia caused by non-D minor blood incompatibilities in a newborn(2019) Tugcu, Ali Ulas; Ince, Deniz Anuk; Turan, Ozden; Belen, Burcu; Olcay, Lale; Ecevit, Ayse; 31692740Hyperbilirubinemia is one of the most widely seen cause of neonatal morbidity. Besides ABO and Rh isoimmunization, minor blood incompatibilities have been also been identified as the other causes of severe newborn jaundice. We report a newborn with indirect hyperbilirubinemia caused by minor blood group incompatibilities (P1, M, N, s and Duffy) whose hemolysis was successfully managed with intravenous immunoglobulin therapy. A thirty-two gestational weeks of preterm male baby became severely icteric on postnatal day 11, with a total bilirubin level of 14.66 mg/dl. Antibody screening tests revealed incompatibility on different minor groups (P1, M, N, s and Duffy (Fya ve Fyb)). On postnatal day thirteen, the level of bilirubin increased to 20.66 mg/dl although baby was under intensive phototherapy. After the administration of intravenous immunoglobulin and red blood cell transfusion, hemoglobin and total bilirubin levels became stabilised. Minor blood incompatibilities should be kept in mind during differential diagnosis of hemolytic anemia of the newborn. They share the same treatment algorithm with the other types hemolytic anemia. New studies revealed that intravenous immunoglobulin treatment in hemolytic anemia have some attractive and glamorous results. It should be seriously taken into consideration for treatment of minor blood incompatibilities.Item Myelodysplastic features and cellular senescence in autoimmune disorders: a pilot study on patients with collagen tissue disorders and immune thrombocytopenic purpura(2015) Olcay, Lale; Billur, Deniz; Erdemli, Esra; Baskin, Sidika Esra; Balci, Havva Fatma; Yetgin, Sevgi; 26281349Item Neonatal cerebral sinovenous thrombosis: Two cases, two different gene polymorphisms and risk factors(2017) Turan, Ozden; Anuk-Ince, Deniz; Olcay, Lale; Sezer, Taner; Gulleroglu, Kaan; Yilmaz-Celik, Zerrin; Ecevit, Ayse; 0000-0002-4369-2110; 0000-0002-2232-8117; 0000-0002-7707-1881; 0000-0002-2278-1827; 0000-0003-1434-3824; 0000-0002-5684-0581; 29168367; I-6746-2016; AAJ-4616-2021; AAJ-2333-2021; AAJ-5931-2021; AAJ-8833-2021; AAK-3548-2021Cerebral sinovenous thrombosis (CSVT) is a rare disease in the neonatal period and also the greatest risk of neonatal mortality and morbidity. In this report, we presented two cases with CSVT and different risk factors. One of these cases had methylenetetrahydrofolate reductase (MTHFR) C677T homozygous polymorphism and the other case had both MTHFR A1298C homozygous polymorphism, plasminogen activator inhibitor-1 (PAI-1) 4G/5G polymorphism and elevated lipoprotein a. Early diagnosis and prompt initiation of therapy of neonatal CSVT may prevent neonatal mortality and poor long-term neurodevelopmental outcomes.Item Both Granulocytic and Non-Granulocytic Blood Cells Are Affected in Patients with Severe Congenital Neutropenia and Their Non-Neutropenic Family Members: An Evaluation of Morphology, Function, and Cell Death(2018) Olcay, Lale; Unal, Sule; Onay, Huseyin; Erdemli, Esra; Ozturk, Aysenur; Billur, Deniz; Metin, Ayse; Okur, Hamza; Yildirmak, Yildiz; Buyukasik, Yahya; İkinciogullari, Aydan; Falay, Mesude; Ozet, Gulsum; Yetgin, Sevgi; 30040071Objective: To examine granulocytic and non-granulocytic cells in children with severe congenital neutropenia (SCN) and their non-neutropenic parents. Materials and Methods: Fifteen patients with SCN and 21 non-neutropenic parents were evaluated for a) CD95, CD95 ligand, annexin V, propidium iodide, cell cycle, and lymphocyte subsets by flow cytometry; b) rapid cell senescence (of leukocytes) by senescence-associated beta-galactosidase stain; c) aggregation tests by aggregometer; d) in vitro bleeding time by PFA-100 instrument; e) mepacrine-labeled dense granule number of thrombocytes by fluorescence microscope; and f) hematomorphology by light and electron microscope. HAX1, ELANE, G6PC3, CSF3R, and JAGN1 mutations associated with SCN were studied in patients and several parents. Results: Significant increase in apoptosis and secondary necrosis in monocytes, lymphocytes, and granulocytes of the patients and parents was detected, irrespective of the mutation type. CD95 and CD95 ligand results implied that apoptosis was non-CD95-mediated. Leukocytes of 25%, 12.5%, and 0% of patients, parents, and controls showed rapid cell senescence. The cell cycle analysis testable in four cases showed G1 arrest and apoptosis in lymphocytes of three. The patients had HAX1 (n=6), ELANE (n=2), G6PC3 (n=2), and unidentified (n=5) mutations. The CD3, CD4, and NK lymphocytes were below normal levels in 16.6%, 8.3%, and 36.4% of the patients and in 0%, 0%, and 15.4% of the parents (controls: 0%, 0%, 5.6%). The thrombocytes aggregated at low rates, dense granule number/thrombocyte ratio was low, and in vitro bleeding time was prolonged in 37.5%-66.6% of patients and 33.3%-63.2% of parents (vs. 0% in controls). Under electron and/or light microscope, the neutrophils, monocytes, lymphocytes, and thrombocytes in the peripheral blood of both patients and parents were dysplastic and the bone marrow of patients revealed increased phagocytic activity, dysmegakaryopoiesis, and necrotic and apoptotic cells. Ultrastructurally, thrombocyte adhesion, aggregation, and release were inadequate. Conclusion: In cases of SCN, patients' pluripotent hematopoietic stem cells and their non-neutropenic parents are both affected irrespective of the genetic defect.