Thrombosis and bleeding are the main complications of chronic myeloproliferative diseases. Mean platelet volume (MPV) is an important indicator of the platelet activation. The aim of the present study was to assess the interrelationships between MPV, JAK-2 gene mutation and thromboembolic events in patients with ET and PV. Patients with ET (n = 60) and PV (n = 46) were compared to the secondary erythrocytosis group (n = 19); and a control group of age and sex matched healthy volunteers (n = 52). Besides demographic, clinical and laboratory data; thrombotic and hemorrhagic events were recorded for each patient. Platelet counts, MPV and JAK2 mutations were studied; and their relation with thromboembolic events were investigated using SPSS program for statistical analysis. There was no significant difference between groups regarding age ( = 0.188). Mean platelet count was significantly higher in ET group than other groups ( < 0.0001). Mean platelet count in PV group was significantly higher than control ( < 0.0001) and secondary erythrocytosis groups ( < 0.0001). In the ET group, MPV values were significantly lower than the control group and PV group. In the ET group, those with thromboembolia had lower platelet counts. There was no relation between MPV and thromboembolic event rate in PV, ET and secondary erithrocytosis groups; while no event was recorded in the control group. There was no relation between thromboembolic event rate and JAK 2 mutation. The association of JAK-2 mutation and high MPV especially in ET and PV groups does not contribute to the thromboembolic events.
ÖzetAmaç:Bu çalışmanın amacı hipotiroidi ve hipertiroidi tanısı almış, ekokardiyografik ve klinik olarak herhangi bir kardiyak problemi bulunmayan hastalarda NT-proBNP düzeyinin erken dönem kardiyak disfonksiyonunun belirteci olarak kullanımını araştırmaktır. Yöntem: Hastanemizin İç Hastalıkları polikliniklerine başvuran tiroid hastalığı konmuş 13'ü erkek, 40'ı kadın toplam 53 hasta ile 40 sağlıklı kontrol çalışmaya dahil edildi. Çalışmaya alınan hastaların daha öncesine ait bilinen bir hastalık öyküsü yoktu ve yeni tanı almış aşikar hipotiroidi ve hipertiroidi hastalarıydı. Hasta ve kontrol gruplarının kan örneklerinde rutin biyokimyasal parametrelere, tiroid fonksiyon testlerine ve NT-proBNP düzeylerine bakıldı, elektrokardiyogram çekildi ve ekokardiyografi yapıldı. Bulgular: Çalışmaya alınan hastaların 28'inde hipotiroidi, 25'inde hipertiroidi mevcuttu. Hipotiroid grubun yaş ortalaması daha yüksekti. Hipertiroidi ve hipotiroidili hasta grubunda NTproBNP ortalaması kontrol grubuna göre anlamlı derecede yüksekti (p=0.019). Bu iki hasta grubu ayrı ayrı kontrol grubu ile karşılaştırıldığında NT-proBNP düzeyi hipotiroidili (p=0.0096) ve hipertiroidili (p=0.0415) hastalarda kontrol grubuna göre anlamlı olarak yüksek bulundu. Sonuç:Artmış NT-proBNP düzeyi kalp yetersizliği ve koroner arter hastalığında kötü prognozu gösteren önemli bir belirteçtir. Bu nedenle artmış NT-proBNP düzeyi aşikar hipotiroidi ve hipertiroidisi olan hastalarda erken dönem kardiyak disfonksiyonu belirlemede değerli bir belirteç olabilir. Abs tractAim: The aim of this study was to investigate N-terminal probrain natriuretic peptide (NT-proBNP) as a marker of early cardiac dysfunction in patients with hypothyroidism or hyperthyroidism without any clinical and echocardiographic cardiac problem. Methods:A total of 53 patients (13 male and 40 female), who were newly diagnosed with thyroid disease and 40 healthy controls who attended our internal medicine outpatient clinic, were included in the study. The patients had no history of any disease and, all of them were with newly diagnosed overt hypothyroidism or hyperthyroidism. Routine biochemical tests, and thyroid function tests were done and NT-proBNP levels were measured. Electrocardiograms and echocardiograms were performed. Results: There were 28 patients with hypothyroidsm and 25 patients with hyperthyroidism in the study group. The mean age of hypothyroidism group was higher than that of hyperthyroidism group. The mean NT-proBNP levels were significantly higher in the patient group when compared to the control group (p=0.019). When the two groups of patients were compared with the control group separately, the level of NT-proBNP was significantly higher in hypothyroidism group (p=0.0096) and hyperthyroidism group (p=0.0415). Conclusion: Elevated NT-proBNP levels are an important marker that suggests worse prognosis in heart failure and coronary artery disease. Elevated serum NT-proBNP levels might be a valuable marker to detect early cardiac dysfunction in patients with overt hypothyroidism ...
Kronik Lenfositik Lösemi Hastalarında Hipogamaglobulineminin ve Olumsuz Prognostik Faktörler ile İlişkisinin DeğerlendirilmesiAim: Chronic lymphocytic leukemia (CLL) is a heterogenous disease with variable clinical course. Rai staging system is used for at least 40 years to predict prognosis and need for treatment but more prognostic factors are needed. Infections have been known to have a significant impact on patients with CLL. It is postulated that hypogammaglobulinemia accounts for the high infection rate. The severity of hypogammaglobulinemia is correlated with disease stage and duration.Methods: Data of patients who were diagnosed with CLL according to the the National Cancer Institute Working Group criteria were analyzed retrospectively. The patients were classified according to absolute lymphocyte count, immunoglobulin (Ig) levels, Rai stage, organomegaly, mass lymphadenopathy, lymphocyte doubling time (LDT), presence of B symptoms and treatment status. Results:We found that low IgA levels were associated with LDT and splenomegaly indicating disease burden and activity. The patients with low IgA and IgM levels received more treatment than others with normal Ig levels. Conclusion:In our study, we could not find a significant relationship between the stage and Ig levels but low IgA and IgM levels were significantly associated with need for treatment. Therefore, we suggest measuring IgA and IgM levels which is a simple and inexpensive test, to predict which patients may need treatment and should be observed closely. Keywords: Chronic lymphocytic leukemia, hypogammaglobulinemia, chronic lymphocytic leukemia prognosis, immunoglobulinsAmaç: Kronik lenfositik lösemi (KLL) değişik klinik gidiş gösteren heterojen bir hastalıktır. Rai evreleme sistemi 40 yıldan uzun süredir prognozu ve tedavi ihtiyacını belirlemekte kullanılmakla beraber daha fazla prognostik faktöre ihtiyaç vardır. Enfeksiyonların KLL hastalarında önemli etkileri olduğu ve enfeksiyon sıklığındaki artışta hipogamaglobulineminin etkisi olduğu bilinmektedir. Hipogamaglobulineminin şiddeti ile hastalığın evre ve süresi ile ilişkilidir.Yöntemler: Ulusal Kanser Enstitüsü Çalışma Grubu kriterlerine göre KLL tanısı almış olan hastaların verileri retrospektif olarak analiz edilmiştir. Hastalar, mutlak lenfosit sayısı, immünoglobulin (Ig) düzeyleri, Rai evresi, organomegali, lenfadenopati durumu, lenfosit sayısı ikiye katlanma zamanı, B semptomlarının varlığı ve tedavi durumuna göre sınıflandırılmıştır.Bulgular: Düşük IgA düzeylerinin hastalık yükünü ve aktivitesini gösteren lenfosit sayısı ikiye katlanma zamanı ve splenomegali ile ilişkili olduğunu bulduk. Düşük IgA ve IgM düzeylerine sahip olan hastaların normal Ig düzeylerine sahip olanlara göre daha fazla tedavi aldıklarını saptadık.Sonuç: Çalışmamızda, hastalık evresi ile Ig düzeyleri arasında anlamlı bir ilişki bulamadık fakat düşük IgA ve IgM düzeyleri ile tedavi ihtiyacı arasında anlamlı bir ilişki saptadık. Bu nedenle, hastaların tedavi ihtiyacını belirlemede basit ve ucuz birer test olan Ig düzey...
Aim: Retrospective, cross-sectional, observational study to examine the frequency and features of paroxysmal nocturnal hemoglobinuria (PNH) clones in patients with myelodysplastic syndrome (MDS). Methods: Data were analyzed from the medical files of 41 MDS patients diagnosed and followed up in the hematology department of a referral center between 2006 and 2017. Descriptive data, cytogenetic and hematologic characteristics, prognostic features and PNH clone sizes were assessed. PNH clone sizes were evaluated using the fluorescently labeled inactive toxin aerolysin (FLAER) method Results: The study population comprised 22 (53.7%) female and 19 (46.3%) male patients with confirmed MDS; the overall mean±SD age was 68.20±9.84 years (range, 45-85). PNH clones were detected in 8 (19.5%) patients. The numbers of patients with PNH clone sizes >10%, >1%, >0.1% and >0.01% were 1, 1, 1 and 8, respectively (p<0.001 for all subgroups). Conclusion
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