Browsing by Author "Önder, ENA"

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    Predictive Factors of Organ Involvement in Childhood Henoch-Schonlein Purpura
    Önder, ENA; Ertan, P
    Objective: Henoch-Schonlein purpura (HSP) is the most common vasculitis of childhood, presenting with immunoglobulin A-dominant immune deposits. Unless there is an organ involvement, the prognosis of HSP is excellent. In this study, we aimed to evaluate clinical and laboratory risk factors for organ involvement in patients with HSP.Method: Our study sample consisted of 95 children with HSP and 75 healthy controls. Clinical and laboratory parameters recorded at the first admission to the hospital were retrospectively evaluated. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were calculated based on the complete blood counts. Results: Leucocyte, neutrophil and lymphocyte counts, C-reactive protein, PLR, platelet distribution width, and NLR were significantly higher in the HSP group than in the control group (p=0.008, p<0.001, p=0.003, p<0.001, p=0.002, p<0.001, p=0.002, and p<0.001, respectively). In the HSP group, NLR, PLR and lymphocyte were significantly higher among the patients with renal involvement and those with gastrointestinal involvement. Neutrophil levels were correlated with renal involvement. Additionally, the older age onset of the disease and elevated antistreptolysin O (ASO) levels were associated with renal involvement.Conclusion: NLR, PLR and lymphocyte counts may be used as inflammatory indicators of renal and gastrointestinal involvement in HSP. In addition, the neutrophil count is associated with renal involvement. The older age onset of HSP and elevated ASO levels are risk factors for renal involvement in HSP.
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    Transfusion-related Acute Lung Injury: A Case Report
    Polat, AÇ; Yigit, Y; Önder, ENA; Yildirim, AT; Ertan, P; Gülen, H
    Transfusion-related acute lung injury (TRALI) is a non-cardiac pulmonary edema presenting with severe dyspnea, hypoxia and bilateral diffuse infiltrates on chest X-ray. It usually occurs within the first 6 hours following the administration of plasma and plasma rich blood products. Herein, we present a patient who developed TRALI shortly after plasmapheresis due to Hemolytic Uremic syndrome and exhibited a dramatic response with early systemic steroid treatment.
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    Factors Affecting Colchicine Adherence in Pediatric Familial Mediterranean Fever
    Önder, ENA; Ensari, E; Bilaç, Ö; Ertan, P
    Aim: Familial Mediterranean Fever (FMF) is the most frequent monogenetic autoinflammatory disorder. It is characterized by fever and serositis. The first line treatment of FMF is colchicine. Adherence to colchicine is one of the main factors affecting colchicine response. In this study, we aimed to evaluate drug adherence in children with FMF using the medication adherence scale in FMF (MASIF). We also assessed the clinical characteristics of drug-adherent patients and factors affecting drug adherence. Materials and Methods: Eighty-two children with FMF under colchicine therapy were included in this cross-sectional observational study. The patients were divided into two groups according to medication adherence and compared according to their demographic and clinical data. Results: According to MASIF, 31 (38%) patients had non-adherence to colchicine. There was a significant difference between the colchicine-adherent and non-adherent groups in terms of age, disease severity according to the International severity score for FMF, attack rate, colchicine dosage, M694V homozygosity, and family type (p=0.005, p=0.04, p=0.025, p=0.045, p=0.04, and p=0.046, respectively). Conclusion: Patients with FMF should be questioned about their medication adherence at every visit, and children with a high risk of colchicine non-adherence should be followed up more closely.
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    Xanthogranulomatous pyelonephritis due to calculi in a 5-year-old girl
    Önder, ENA; Özkol, M; Nese, N; Taneli, C; Özünan, I
    Background. Xanthogranulomatous pyelonephritis is characterized by the inflammatory destruction of the renal parenchyma and intensive renal fibrosis. It is named because of its pathological appearance; that of its granulomatous inflammatory process with lipid-laden macrophages, which appear yellow, hence 'xantho' which is Greek for yellow. Xanthogranulomatous pyelonephritis is predominantly a disease of adults. In children it is diagnosed sporadically and is extremely rare in infants. The age of onset varies (21 days to 16 years), although 60-75% of cases have been diagnosed before 5 years of age. Recurrent urinary tract infections, obstructive nephropathy caused by renal calculus, malnutrition, abnormal lipid metabolism, altered immunologic response, lymphatic blockage, congenital urinary anomalies have been implicated in the etiology of xanthogranulomatous pyelonephritis in children. Case. We report an unusual case of xanthogranulomatous pyelonephritis in a 5-year-old girl and discuss its clinical features, histopathological findings and treatment. In this article, we also emphasized the importance of diagnostic imaging in urinary tract infections which enabled us not to miss the underlying kidney stone disease. Conclusion. Nephrolithiasis may lead to very serious conditions such as xanthogranulomatous pyelonephritis. This condition can be easily diagnosed by ultrasound, but if not detected, it can lead to complete loss of renal function as in the case.
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    Pediatric kidney care experience after the 2023 Türkiye earthquake
    Bakkaloglu, SA; Delibas, A; Döven, SS; Taner, S; Yavuz, S; Erfidan, G; Vatansever, ED; Aynaci, F; Yílmaz, K; Tasdemir, M; Akaci, O; Akinci, N; Güven, S; Çiçek, N; Dursun, I; Kelesoglu, E; Sancaktar, M; Alaygut, D; Saygili, S; Yavascan, Ö; Yilmaz, A; Gülleroglu, K; Ertan, P; Demir, BK; Poyrazoglu, H; Pinarbasi, S; Gençler, A; Bastug, F; Günay, N; Çelegen, K; Noyan, A; Parmaksiz, G; Avci, B; Çayci, FS; Bayrakçi, U; Özlü, SG; Aksoy, ÖY; Yel, S; Inal, GA; Köse, S; Bayazit, AK; Atmis, B; Saribas, E; Çagli, Ç; Tabel, Y; Elmas, AT; Selçuk, SZ; Kiliç, BD; Kara, MA; Büyükçelik, M; Balat, A; Tiryaki, BD; Erdogdu, B; Aksu, B; Mahmudova, G; Dursun, H; Candan, C; Göknar, N; Mutlubas, F; Çamlar, SA; Basaran, C; Akbulut, BB; Düzova, A; Gülhan, B; Oruç, Ç; Peru, H; Alpay, H; Türkkan, ÖN; Gülmez, R; Çelakil, M; Dogan, K; Bilge, I; Pehlivanoglu, C; Büyükkaragöz, B; Leventoglu, E; Alpman, N; Zeybek, C; Tülpar, S; Gülsan, RYÇ; Kara, A; Gürgöze, MK; Önder, ENA; Atikel, YÖ; Pul, S; Sönmez, F; Yildiz, G; Akman, S; Elmaci, M; Küçük, N; Yüksel, S; Kavaz, A; Nalçacioglu, H; Alparslan, C; Dinçel, N; Elhan, AH; Sever, L
    Background. Two earthquakes on 6 February 2023 destroyed 10 cities in Turkiye. We report our experience with pediatric victims during these catastrophes, with a focus on crush syndrome related-acute kidney injury (Crush-AKI) and death. Method. Web-based software was prepared. Patient demographics, time under rubble (TUR), admission laboratory data, dialysis, and kidney and overall outcomes were recorded. Results. A total of 903 injured children (median age 11.62 years) were evaluated. Mean TUR was 13 h (interquartile range 32.5, max 240 h). Thirty-one of 32 patients with a TUR of >120 h survived. The patient who was rescued after 10 days survived. Two-thirds of the patients were given 50 mEq/L sodium bicarbonate in 0.45% sodium chloride solution on admission day. Fifty-eight percent of patients were given intravenous fluid (IVF) at a volume of 2000-3000 mL/m(2) body surface area (BSA), 40% at 3000-4000 mL/m(2) BSA and only 2% at >4000 mL/m(2) BSA. A total of 425 patients had surgeries, and 48 suffered from major bleeding. Amputations were recorded in 96 patients. Eighty-two and 66 patients required ventilator and inotropic support, respectively. Crush-AKI developed in 314 patients (36% of all patients). In all, 189 patients were dialyzed. Age >15 years, creatine phosphokinase (CK) >= 20 950 U/L, TUR >= 10 h and the first-day IVF volume <3000-4000 mL/m2 BSA were associated with Crush-AKI development. Twenty-two deaths were recorded, 20 of 22 occurring in patients with Crush-AKI and within the first 4 days of admission. All patients admitted after 7 days survived. Conclusions. These are the most extensive pediatric kidney disaster data obtained after an earthquake. Serum CK level was significantly associated with Crush-AKI at the levels of >20 950 U/L, but not with death. Adolescent age and initial IVF of less than 3000-4000 mL/m(2) BSA were also associated with Crush-AKI. Given that mildly injured victims can survive longer periods in the disaster field, we suggest uninterrupted rescue activity for at least 10 days.