Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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    Evolution of clinical characteristics of patients with paroxysmal nocturnal hemoglobinuria treated with eculizumab in turkey: a multicenter retrospective analysis
    (2021) Karadag, Fatma Keklik; Yenerel, Mustafa Nuri; Yilmaz, Mehmet; Uskudar, Hava; Ozkocaman, Vildan; Tuglular, Tulin Firatli; Erdem, Fuat; Unal, Ali; Ayyildiz, Orhan; Ozet, Gulsum; Comert, Melda; Kaya, Emin; Ayer, Mesut; Salim, Ozan; Guvenc, Birol; Ozdogu, Hakan; Mehtap, Ozgur; Sonmez, Mehmet; Guler, Nil; Hacioglu, Sibel; Aydogdu, Ismet; Bektas, Ozlen; Toprak, Selami Kocak; Kaynar, Lale; Yagci, Munci; Aksu, Salih; Tombak, Anil; Karakus, Volkan; Yavasoglu, Irfan; Onec, Birgul; Ozcan, Mehmet Ali; Undar, Levent; Ali, Ridvan; Ilhan, Osman; Saydam, Guray; Sahin, Fahri; 34322292
    Paroxysmal nocturnal hemoglobinuria (PNH) is a rare X-linked genetic disorder. On the contrary to its name, it is a multisystemic disease and various symptoms other than hemoglobinuria could be occurred. It could be life threatening especially because of thromboembolic events. In the last decade, a terminal complement inhibition with eculizumab approved with promising results for PNH patients. We conducted this study to evaluate the long term experience of eculizumab therapy from Turkey for the first time. Our cohort included 138 patients with PNH treated with eculizumab between January 2008 and December 2018 at 28 centers in Turkey. Laboratory and clinical findings at the time of diagnosis and after eculizumab therapy were recorded retrospectively. The median age was 39 (range 18-84) years and median granulocyte PNH clone size was 74% (range 3.06-99.84%) at the time of diagnosis. PNH with bone marrow failure syndrome was detected in 49 patients and the rest of 89 patients had classical PNH. Overall 45 patients (32.6%) had a history of any prior thrombotic event before eculizumab therapy and only 2 thrombotic events were reported during the study period. Most common symptoms are fatigue (75.3%), hemoglobinuria (18.1%), abdominal pain (15.2%) and dysphagia (7.9%). Although PNH is commonly related with coombs negativity, we detected coombs positivity in 2.17% of patients. Seven months after the therapy, increased hemoglobin level was seen and remarkably improvement of lactate dehydrogenase level during the treatment was occurred. In addition to previous studies, our real life data support that eculizumab is well tolerated with no serious adverse events and improves the PNH related findings.
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    QTc interval is associated with increased inflammatory markers (neutrophil-to-lymphocyte ratio and LDH level) in COVID-19 patients
    (2021) Torun, Serife; Ozer, Nurtac; Celik, Olgun; Akcay, M. Sule; 0000-0002-7190-5443; AAD-5477-2021
    Purpose: This study aimed to investigate the association between QTc interval and laboratory parameters in COVID-19 patients before and after the treatment. Materials and Methods: Forty-three COVID-19 patients who had baseline and follow-up ECG findings and laboratory reports were evaluated and 40 patients were included in the study. Results: Among 40 patients, 16 were women and 24 were men. The neutrophil-to-lymphocyte ratio (NLR) and corrected QT (QTc) interval were significantly higher in females than males. After the treatment, a significant fall in CRP and ferritin values, and significantly prolonged QTc interval were seen. A significant positive correlation was observed between QTc interval and age, LDH levels, neutrophil and leukocyte count, NLR, magnesium levels, and heart rate of the patients prior to treatment. A positive correlation was observed between increased QTc interval and decreased LDH levels and NLR after treatment. Conclusion: QTc prolongation was associated with increased inflammatory markers, increased NLR and LDH levels before and after treatment in COVID-19 patients. The increase in the QTc interval was correlated with the reduction in LDH levels and NLR with treatment.