Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Plasma Exchange in the Treatment of Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis: A Retrospective Analysis(2022) Oguz, Ebru Gok; Paydas, Saime; Hasbal, Nuri Baris; Turgut, Didem; Sahin, Hatice; Kaya, Bulent; Bahcebasi, Zerrin Bicik; Yadigar, Serap; Gok, Serdal; Ayli, Mehmet DenizObjective: Immunosuppressive therapy in anti-neutrophil cytoplasmic antibody-associated vasculitis is indispensable for patient and kidney survival. There is a controversy about whether the risks of plasma exchange treatment override the probability of kidney-related outcomes. Hence, the question arises in which conditions the plasma exchange will be required? In this study, we aimed to evaluate the effect of plasma exchange adding to immunosuppressive therapy in anti-neutrophil cytoplasmic antibody-associated vasculitis patients. Methods: We retrospectively analyzed 57 patients with biopsy-proven anti-neutrophil cytoplasmic antibody-associated vasculitis. We grouped patients according to treatment options with or without plasma exchange. We investigated the 1-year and 5-year patients and kidney outcomes. Results: Thirty-six (63.2%) of 57 patients were treated with plasma exchange besides the routine immunosuppressive treatment. Sixteen (44.5%) of 36 patients were with active pulmonary hemorrhage and the remaining 20 (55.5%) were with vasculitic pulmonary involvement. The survival rate was 80.7% and 68.8% in the first and fifth year, respectively. In the multivariate Cox regression analysis model, risk factors affecting patient survival were age >50 years (hazard ratio = 17.11 P =.034), pulmonary involvement (hazard ratio = 13.25, P =.02), positive perinuclear anti-neutrophil cytoplasmic antibody-associated vasculitis (hazard ratio = 5.93, P =.036), and lower albumin level (hazard ratio = 0.18, P =.014). It is found that C-reactive protein level and plasma exchange did not relate to better patient and kidney outcomes (P >.05). Conclusions: In anti-neutrophil cytoplasmic antibody-associated vasculitis, although pulmonary hemorrhage and pulmonary involvement are serious complications, plasma exchange did not provide additional benefit to standard treatment.Item Plasma Exchange in the Treatment of A Child with West Nile Virus Encephalitis: A Case Report(2022) Ozkale, Yasemin; Ozkale, Murat; Ceylan, Ozgur; Erol, IlknurBackground: West Nile virus (WNV) is a member of the Japanese encephalitis antigenic complex of the family Flaviviridae that can cause a wide range of clinical symptoms, from asymptomatic disease to severe meningitis, encephalitis flaccid paralysis, and death. In immunocompetent children, WNV infection is usually benign and self-limiting. However, this virus is also associated with severe neurological disease in some patients, especially those who are older, have a chronic disease, have undergone organ transplantation, or are immunocompromised. Case Report: A 12-year-old boy with selective immunoglobulin A-deficiency (SIgAD) and refractory seizures due to WNV encephalitis (WNE) was successfully treated with therapeutic plasma exchange (TPE) in conjunction with other immunomodulatory therapies. Conclusion: WNV can progress like autoimmune encephalitis. TPE appears to be safe and effective for treating children with WNE. To our knowledge, this report is the first of a child with WNV infection and SIgAD.Item Could Plasma Based Therapies Still Be Considered in Selected Cases with Atypical Hemolytic Uremic Syndrome?(2021) Ozlu, Sare Gulfem; Gulhan, Bora; Aydog, Ozlem; Atayar, Emine; Delibas, Ali; Parmaksiz, Gonul; Ozdogan, Elif Bahat; Comak, Elif; Tasdemir, Mehmet; Acar, Banu; Ozcakar, Zeynep Birsin; Topaloglu, Rezan; Soylemezoglu, Oguz; Ozaltin, Fatih; 35023648Background. Atypical hemolytic uremic syndrome (aHUS) occurs due to defective regulation of the alternative complement pathway (ACP) on vascular endothelial cells. Plasma based therapy (PT) was the mainstay of the treatment for aHUS for many years until the introduction of therapies targeting blockage of the complement system. The aim of this study was to evaluate patients with aHUS who had been treated with plasma based therapies alone. Methods. The outcomes of seven genetically confirmed aHUS patients (2 girls, 5 males) were evaluated by means of clinical presentation, response to plasma therapy, course of the disease during the follow-up period and last status. Results. The median age of the patients at admission was 6.7 years (IQR 0.7-7.8). Three patients received plasma exchange therapy and the other four patients were treated with plasma infusions. One patient was lost to follow-up after one year; the median duration of follow-up for other patients was 3.7 years (IQR 2.7-6.5). During the follow up, two patients from our historical records when complement blocking therapies had not been in clinical use yet in Turkey, underwent kidney transplantation. One transplant patient experienced an acute rejection episode without graft loss. The remaining five patients had a glomerular filtration rate of more than 90 ml/min./1.73 m(2) at the last visit. Conclusion. Although we had a relatively small patient population, our findings indicate that PT might still be considered in selected patients particularly in countries where complement blocking therapies are difficult to reach due to their unavailability or costs that are not covered by the health care systems.Item Correction to: Overview of therapeutic plasma exchange in pediatric neurology: a single-center experience (Acta Neurologica Belgica, (2018), 118, 3, (451-458), 10.1007/s13760-018-0961-5)(2018) Özkale, M.; Erol, I.; Özkale, Y.; Kozanoğlu, İ.Unfortunately, the immediate following sentences were incorrectly published in Material and Method section of the original article. © 2018, Belgian Neurological Society.