Browsing by Author "Gülen H."
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Item Calcinosis cutis in a pediatric patient with Burkitt's lymphoma(2005) Gülen H.; Kazanci E.; Özek D.G.; Erbay A.; Yamaci S.; Aktaş S.; Vergin C.Calcinosis cutis, an uncommon disorder characterized by hydroxyapatite crystals of calcium phosphate deposited in the skin, has been described infrequently in childhood. Cutaneous calcification may be divided into four major categories: dystrophic, metastatic, idiopathic, and iatrogenic. Here, we report an example of iatrogenic type with a 4-year-old boy who diagnosed with Burkitt's lymphoma, and developed calcinosis cutis secondary to a tumour lysis syndrome with induction chemotherapy.Item A rare familial thrombocytopenia: May-Hegglin anomaly report of two cases and review of the literature(2006) Gülen H.; Erbay A.; Kazanci E.; Vergin C.May-Hegglin anomaly is a hereditary thrombocytopenia associated with giant platelets and large basophilic, cytoplasmic inclusion bodies (resembling Döhle bodies) in the granulocytes. Patients may experience easy bruising, recurrent epistaxis, gingival bleeding, menorrhagia and sometimes excessive bleeding associated with surgical procedures. Failure to appropriately diagnose May-Hegglin anomaly could result in inappropriate treatment. In states of chronic thrombocytopenia associated with large platelets, including chronic idiopathic thrombocytopenic purpura, May-Hegglin anomaly should be considered in the differential diagnosis. In this case report, we present a five-year-old girl previously followed as idiopathic thrombocytopenic purpura without bleeding symptoms and a 14-year-old boy who were diagnosed with May-Hegglin anomaly. © Turkish Society of Hematology.Item Coexistence of symptomatic iron-deficiency anemia and duodenal nodular lymphoid hyperplasia due to giardiasis: Case report(2009) Kasirga E.; Gülen H.; Şimşek A.; Ayhan S.; Yilmaz Ö.; Ellidokuz E.Iron-deficiency anemia due to iron malabsorption and duodenal nodular lymphoid hyperplasia (NLH) has been described in children with Giardia intestinalis infection. Also, symptomatic iron-deficiency anemia is rarely encountered in male adolescents. A 14-year-old boy underwent esophagogastroduodenoscopy for investigation of symptomatic iron-deficiency anemia (hemoglobin 5.8 g/dL, mean corpuscular volume 65.3 fL, serum ferritin < 1.5 ng/mL). He had a sufficient diet for iron and recurrent bouts of diarrhea without melena. At upper endoscopy, duodenal mucosa was diffusely nodular. Histopathologic evaluation of biopsy samples from the duodenum revealed infection with Giardia intestinalis. His anemia improved with metronidazole and iron treatment. Copyright © Informa Healthcare USA, Inc.Item Immunophenotyping in acute myeloblastic leukemia: Review; [Akut miyeloblastik lösemide i̇mmünofenotipik deǧerlendirme](2010) Gülen H.Acute myeloid leukemia is a heterogeneous disease, presenting with a high diversity of phenotypes. Immunophenotyping is essential for diagnosis and definition of particular myeloid leukemia subtypes such as M0, M7 and M3 variants which cannot be defined by cytomorphology or cytochemistry alone. M0 blasts show minimally antigenic differentiation and also morphologically resemble to FAB L1/L2 blasts of lymphoblastic leukemia. Additionally, it can express TdT and lymphoid associated antigens such as CD2, CD4, CD7, CD10, CD19 and can be diagnosed falsely as myeloid antigen positive lymphoblastic leukemia. cyCD3, CD5 and cyCD79a antigens are the best markers in differantation of M0 and lymphoblastic leukemia. HLA-DR and CD34 are the best markers in differantation of M3 and other subtypes of myeloid leukemia. In this sense, CD14 is also a valuable marker, because it is not reported in any case of promyelocytic leukemia. M7 subtypes of myeloid leukemia can not be diagnosed by routine cytochemical dyes unless immunophenotyping. The establishing of CD41 (gpIIb) and/or CD61( gpIIIa)positivity and myeloperoxidase negativity on blasts by immunophenotyping can confirm megakaryoblastic leukemia diagnosis. Recently, immunophenotyping of blast cells by flow cytometry plays an increasing role in diagnosis and following of minimal residual disease. The antigens assosciated with poor prognosis in myeloid leukemia are CD7, CD56 and CD34. A phenotype of CD117+CD34+CD15+ is expressed in many myeloid leukemia subgroups and is used in following of minimally residual disease during remission. In conclusion, CD13, CD33, HLA-DR, CD34, CD117, CD11, CD14, CD15, CD41, CD61, MPO, CD65, cyCD3, CD7, cyCD79a, and CD19 markers should be studied in all cases of myeloid leukemia at presentation. Copyright © 2010 by Türkiye Klinikleri.Item Hypohidrotic ectodermal dysplasia associated with glucose-6-phosphate dehydrogenase deficiency(2011) Ermertcan A.T.; Yaşar A.; Çelebi Kayhan T.; Gülen H.; Ertan P.Hypohidrotic ectodermal dysplasia (HED) is a syndrome characterized by hypodontia, hypotrichosis, and partial or total ecrine sweat gland deficiency. The most prevalent form of HED is inherited as an X linked pattern. Glucose-6-phosphate dehydrogenase (G-6-PD) deficiency is an X-linked recessive disease, which leads to hemolytic anemia and jaundice. It is expressed in males, while heterozygous females are usually clinically normal. A 12-year-old boy with the complaints of hair and eyebrow disturbances, teeth disfigurement, decreased sweating, and xerosis presented to the outpatient clinic. Dermatological examination revealed sparse hair and eyebrows, conical- shaped teeth, xerosis, syndactyly, transverse grooves, and discoloration of nails. Laboratory findings indicated anemia. His 3-year-old sister also had sparse hair and eyebrows, xerosis, and syndactyli. We learned that the patient had a previous history of neonatal jaundice and a diagnosis of G-6-PD deficiency. Although it has been shown that loci of ectodermal dysplasia and G-6-PD deficiency genes are near to one another, we did not find any case study reporting on occurrence of these two genetic diseases together. With the aspect of this rare and interesting case, the relationship between HED and G-6-PD deficiency was defined.Item Treatment of intrathecal methotrexate overdose with folinic acid rescue and lumbar cerebrospinal fluid exchange: A report of two cases; [Yüksek doz intratekal metotreksat'ın folinik asit ve beyin omurilik sıvısı deg̈işimi ile tedavisi: Ïki olgu sunumu](Turkish Society of Hematology, 2011) Kazanci E.; Gülen H.; Erbay A.; Vergin C.We report two male cases (4- and 5-years-old) of intrathecal methotrexate overdose. The two boys with acute lymphoblastic leukemia were to receive intrathecal injection of methotrexate. Instead of the prescribed 12 mg, they both received a dose of 120 mg. The initial cerebrospinal fluid samples showed methotrexate concentration of 2.24×10-2M in case 1 and 1.32×10-2M in case 2. The cases were successfully treated with cerebrospinal fluid (CSF) exchange and intravenous folinic acid rescue. The favorable outcome in our cases suggests that CSF exchange is safe and that folinic acid rescue may be adequate to prevent sequelae in patients subjected to intrathecal MTX overdoses up to 120 mg. We propose CSF exchange and intravenous folinic acid as the mainstay of treatment. In addition to the staff 's failure to check the drug label carefully, the marked resemblance of the two dose preparations of MTX may have been contributory.Item Wernicke's encephalopathy in a child with Down syndrome, undergoing treatment for acute lymphoblastic leukemia(Blackwell Publishing, 2016) Yıldırım A.T.; Bilgili G.; Akman B.; Ovalı G.Y.; Özgüven A.A.; Gülen H.[No abstract available]Item A rare case of ascites: Eosinophilic gastroenteritis(Galenos Publishing House, 2020) Doğan G.; Düzgün F.; Yılmaz Ö.; Ayhan S.; Gülen H.; Kasırga E.Eosinophilic gastroenteropathies are rare disorders. An 18-year-old girl presented to the hospital with abdominal pain and distension. Abdominal tenderness and grade 2 ascites, serious peripheral eosinophilia and high immunoglobulin E level were found. Laparoscopic antrum biopsy showed subserosal eosinophilic infiltration. Eosinophilic gastroenteropathy was suspected, diet elimination was given, no steroid treatment was used. © Copyright 2020 by Ege University Faculty of Medicine, Department of Pediatrics and Ege Children's FoundationItem Transfusion-related acute lung injury: A case report(Galenos Publishing House, 2020) Polat A.Ç.; Yiǧit Y.; Önder E.N.A.; Yildirim A.T.; 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. ©Copyright 2020 by Ege University Faculty of Medicine, Department of Pediatrics and Ege Children's Foundation.Item Genetic basis and hematologic manifestations of sitosterolemia in a group of Turkish patients(Elsevier Ltd, 2021) Kaya Z.; Sal E.; Yorulmaz A.; Hsieh Y.-P.; Gülen H.; Yıldırım A.T.; Niu D.-M.; Tekin A.BACKGROUND: Sitosterolemia is a rare lipid disorder caused by mutations in adenosine triphosphate-binding cassette genes (ABCG) 5 and 8. OBJECTIVE: To evaluate the phenotypic/genotypic features of sitosterolemia in a group of Turkish patients. METHODS: Seven probands with unexplained hematologic abnormalities and their 13 relatives were enrolled. Sterol levels were measured by gas chromatography and genetic studies were performed using Sanger sequencing. Individuals were diagnosed with sitosterolemia if they were found to have frankly elevated sitosterol level >15 μg/mL and/or pathogenic variants of the ABCG5/ABCG8. RESULTS: The seven probands and their six relatives were diagnosed with frank sitosterolemia, and all these patients had hematologic abnormalities. The remaining seven relatives were asymptomatic heterozygous carriers. Three novel variants in the ABCG5 gene (c.161G>A, c.1375C>T, IVS10–1G>T), one novel variant in the ABCG8 gene (c.1762G>C) and one known variant in the ABCG5 gene (c.1336 C>T) were identified. No variant was identified in one case. The mean sitosterol level was significantly higher and mean platelet count was significantly lower in patients with homozygous variants compared to heterozygous variants (p<0.05, for all). Diets low in plant sterols were recommended for 13 symptomatic cases. Four homozygotes received ezetimibe, and their splenomegaly, anemia, and thrombocytopenia completely resolved except one. CONCLUSION: The five pathogenic variants identified in this study indicate the genetic heterogeneity of sitosterolemia in Turkish population. Patients with unexplained hematologic abnormalities (specifically macrothrombocytopenia) should have their sterol level measured as initial testing. Ezetimibe can be a good choice for sitosterolemia. © 2021Item Typical hematological findings facilitating the diagnosis of sitosterolemia(John Wiley and Sons Inc, 2021) Gülen H.; Yıldırım A.T.; Yiğit Y.; Yorulmaz A.[No abstract available]Item Thrombolysis with Systemic Recombinant Tissue Plasminogen Activator in Children: A Multicenter Retrospective Study; [Çocuklarda Sistemik Rekombinant Doku Plazminojen Aktivatörü ile Tromboliz: Çok Merkezli Bir Retrospektif Çalışma](Turkish Society of Hematology, 2021) Zengin E.; Sarper N.; Erdem A.Y.; Al I.O.; Evim M.S.; Yaralı N.; Belen B.; Akçay A.; Yıldırım A.T.; Karapınar T.H.; Güneş A.M.; Gelen S.A.; Ören H.; Olcay L.; Baytan B.; Gülen H.; Öztürk G.; Orhan M.F.; Oymak Y.; Akpınar S.; Tüfekçi Ö.; Albayrak M.; Güneş B.T.; Canpolat A.; Özbek N.Objective: This study aimed to evaluate systemic thrombolysis experiences with recombinant tissue plasminogen activator (rtPA). Materials and Methods: Retrospective data were collected from 13 Turkish pediatric hematology centers. The dose and duration of rtPA treatment, concomitant anticoagulant treatment, complete clot resolution (CCR), partial clot resolution (PCR), and bleeding complications were evaluated. Low-dose (LD) rtPA treatment was defined as 0.01-0.06 mg/kg/h and high-dose (HD) rtPA as 0.1-0.5 mg/kg/h. Results: Between 2005 and 2019, 55 thrombotic episodes of 54 pediatric patients with a median age of 5 years (range: 1 day to 17.75 years) were evaluated. These patients had intracardiac thrombosis (n=16), deep vein thrombosis (DVT) (n=15), non-stroke arterial thrombosis (n=14), pulmonary thromboembolism (PE) (n=6), and stroke (n=4). The duration from thrombus detection to rtPA initiation was a median of 12 h (range: 2-504 h) and it was significantly longer in cases of DVT and PE compared to stroke, non-stroke arterial thrombosis, and intracardiac thrombosis (p=0.024). In 63.6% of the episodes, heparin was initiated before rtPA treatment. LD and HD rtPA were administered in 22 and 33 of the episodes, respectively. Concomitant anticoagulation was used in 90% and 36% of the episodes with LD and HD rtPA, respectively (p=0.0001). Median total duration of LD and HD rtPA infusions was 30 h (range: 2-120 h) and 18 h (2-120 h), respectively (p=0.044). Non-fatal major and minor bleeding rates were 12.5% and 16.7% for LD and 3.2% and 25.8% for HD rtPA, respectively. At the end of the rtPA infusions, CCR and PCR were achieved in 32.7% and 49.0% of the episodes, respectively. The most successful site for thrombolysis was intracardiac thrombosis. HD versus LD rtPA administration was not correlated with CCR/PCR or bleeding (p>0.05). Conclusion: Systemic thrombolytic therapy may save lives and organs effectively if it is used at the right indications and the right times in children with high-risk thrombosis by experienced hematologists with close monitoring of recanalization and bleeding. © 2021, Turkish Society of Hematology. All rights reserved.Item Autochthonous Case of Malaria Prediagnosed as Leukemia; [Lösemi Ön Tanılı Yerli Sıtma Olgusu](Ankara Microbiology Society, 2023) Gülen H.; Türedi̇ Yildirim A.; Çavuş İ.; Türkmen H.; Özbilgin A.Malaria is a parasitic disease transmitted by infected female Anopheles mosquitoes. There are five species of Plasmodium species that can infect humans. Of these species, especially P.falciparum and P.vivax pose the greatest threat to human health. In the 2014 report of the World Health Organization, it was reported that there were no locally acquired cases of malaria in 16 countries including Türkiye. Malaria cases originating from outside the country and imported due to migration, travel and working abroad are reported as import cases. In this report, a case of non-imported malaria followed with a preliminary diagnosis of leukemia was presented. A 14-year-old female patient who was admitted to a health institution with complaints of high fever, headache, chills, nausea-vomiting, and diarrhea that had been going on for two weeks, was pre-diagnosed as leukemia and was referred to Manisa Celal Bayar University Faculty of Medicine, Hafsa Sultan Hospital, Department of Pediatric Hematology and after pancytopenia was detected in the complete blood count. The anamnesis of the patient revealed that she had no history of international travel and that she had been prescribed medications such as paracetamol, amoxicillin, and metoclopramide for flu-like complaints while working in the Southeastern Anatolia, Aegean, and Mediterranean Regions of Türkiye. Bone marrow aspiration was performed for the etiological examination of pancytopenia. Giemsa-stained blood smears, rapid diagnostics, and real-time quantative polymerase chain reaction (qRt-PCR) analyses were performed in the medical parasitology laboratory and malaria was suspected in both bone marrow and peripheral blood smears. P.vivax erythrocytic forms and gametocytes were present in abundance in smear preparations stained with Giemsa, and rapid diagnosis kit was positive for P.vivax. The strain was genotyped as P.vivax by qRt-PCR analysis. For the treatment of the patient, airalam (artemether + lumefantrine) tablets were provided with 2 x 4 daily posology for three days after the diagnosis, and primaquine was provided after one week of the diagnosis as 1 x 2 tablets (1 x 15 mg) for 14 days, and the patient was discharged without complications following the treatment regimen. The fight against malaria continues uninterruptedly since the establishment of the Republic of Türkiye. Tropical diseases, especially malaria, is of great importance for Türkiye due to numerous reasons such as its location in the subtropical region where Anopheles mosquitoes are capable of malaria transmission, it is situated at the crossroads on the migration routes between continents where human traffic is busy, there are many people who go abroad for work and most importantly rising temperatures due to climate change. For this reason, this case report is important to emphasize the importance of malaria for the country and to increase the awareness of clinicians and laboratories about malaria and the possibility of autochthonous malaria transmission in Türkiye. © 2023 Ankara Microbiology Society. All rights reserved.Item Successful Treatment of a Child with Hemoglobin Hammersmith with Hematopoietic Stem Cell Transplantation(Taylor and Francis Ltd., 2023) Yıldırım A.T.; Gülen H.; Türkmen H.; Özek G.; Oymak Y.; Durmaz B.; Karaca E.Hemoglobin (Hb) Hammersmith, formed by serine substitution for phenylalanine at residue 42 in the beta-globin chain, is a very rare variant of unstable hemoglobin with low oxygen affinity. For patients with hemoglobinopathies, it is well-established that hematopoietic stem cell transplantation provides a complete cure, but the literature on its role for those with Hb Hammersmith is limited. A seven-month-old girl who was examined for anemia and splenomegaly was followed up for congenital hemolytic anemia. The patient with visible cyanosis of the lips and whose p50 was low in blood gas was diagnosed with Hb Hammersmith through the DNA sequence analysis. During the follow-up, frequent blood transfusions had to be given due to anemia aggravated by infections. Following a successful hematopoietic stem cell transplant from an HLA-matched sibling, the patient completely recovered from Hb Hammersmith. The case is presented because of its rarity. © 2023 Informa UK Limited, trading as Taylor & Francis Group.Item Assessment of Clinical and Laboratory Predictors for Chronic Childhood Immune Thrombocytopenia(Galenos Publishing House, 2023) Alpdoğan S.; Gülen H.Aim: To determine the risk factors associated with chronic childhood immune thrombocytopenia (ITP). Materials and Methods: We retrospectively analyzed the medical records of 123 children with ITP who were admitted to our Department of Pediatric Hematology between May, 2006 and May, 2019. We evaluated their demographic, clinical, and laboratory characteristics, and assessed the risk factors associated with chronic ITP in childhood. Results: Of the 123 children with ITP, 60.2% were male, with an average age of 6.4±4.0 years. At follow-up, 93 (75.6%) of the patients were diagnosed as acute ITP, whereas 30 (24.4%) progressed to chronic ITP with a platelet count of lower than 100×109/L at the end of the 12-month follow-up period. Older age at admission [Odds ratio (OR): 1.4, 95% confidence interval (CI): 1.2-1.6, p<0.001], female gender (OR: 4.1, 95% CI: 1.5-10.3, p=0.003), and insidious onset of the symptoms (OR: 5.0, 95% CI: 1.1-22.6, p=0.03) were determined to be risk factors for chronic ITP. Conclusion: Our study indicates that older age, female gender and insidious onset of the disease at admission may predict chronic ITP in childhood. © 2023 by Ege University Faculty of Medicine, Department of Pediatrics and Ege Children’s Foundation.Item A Rare Complication in a Patient with Acute Promyelocytic Leukemia; ATRA and Posaconazole Associated Hypercalcemia(Galenos Publishing House, 2024) Yiğit Y.; Demiral M.; Yıldırım A.T.; Gülen H.All-trans retinoic acid (ATRA), a derivative of vitamin A, has dramatically altered the treatment landscape for acute promyelocytic leukemia (APL). APL is characterized by the abnormal maturation of myeloid cells, which become arrested at the promyelocyte stage. ATRA effectively induces these cells to differentiate and undergo apoptosis. While generally well-tolerated, ATRA has been associated with rare adverse effects, including hypercalcemia. This case report underscores the importance of vigilant monitoring for ATRA-related side effects, especially when combined with medications which inhibit cytochrome P450 enzymes. Antifungal prophylaxis is common during leukemia treatment. Here, we present a rare instance of hypercalcemia in a pediatric patient attributed to the concurrent use of posaconazole and ATRA. A 15-year-old girl presented with widespread bruising, abnormal uterine bleeding, and pancytopenia. Subsequent investigations led to an APL diagnosis. Classified as standard-risk APL, she received chemotherapy according to the acute myelogenous leukemia-Berlin-Frankfurt-Münster 2004 protocol. After an ATRA course was started in the third month of maintenance treatment, she applied to the hospital with constitutional symptoms of weakness and fatigue on the third day of treatment. In the biochemical tests of the patient, serum Ca concentration was determined to be 16.5 mg/dL. Parathormone was 64.3 pg/mL and the 25-OH D vitamin level was 22 ng/mL and so were within the normal limits. Complete blood count was within the normal range. Although hypercalcemia is a side effect seen in the combined use of ATRA and azole antifungals, to the best of our knowledge, this is the first report in the literature that it was observed in the pediatric age group due to the simultaneous use of posaconazole and ATRA. Copyright© 2024 by Ege University Faculty of Medicine, Department of Pediatrics and Ege Children’s Foundation.Item Common viral respiratory infections in children with cancer during the COVID-19 pandemic: a multicenter study from Türkiye(Turkish National Pediatric Society, 2024) Kaçar D.; Kebudi R.; Özyörük D.; Tuğcu D.; Bahadır A.; Özdemir Z.C.; Özgüven A.A.; Orhan M.F.; Yıldırım A.T.; Albayrak C.; Kartal İ.; Sarı N.; Tokgöz H.; Albayrak M.; Ayhan A.C.; Eroğlu N.; Aydın S.; Üzel V.H.; Zülfikar B.; Yıldırım Ü.M.; Büyükavcı M.; Gülen H.; Töret E.; Bör Ö.; Özbek N.Y.; İlhan İ.E.; Yaralı N.Background. Microbiologic confirmation of respiratory tract infections gained importance during the coronavirus disease 2019 (COVID-19) pandemic. This study retrospectively evaluated seasonal distribution, clinical presentation, and complications of respiratory viral infections (RVIs) other than COVID-19 in children with cancer during and after the pandemic lockdown. Methods. Two hundred and sixty-five inpatient and outpatient RVI episodes in 219 pediatric cancer patients confirmed by multiplex reverse transcriptase polymerase chain reaction (RT-PCR) panels from 13 centers were enrolled. Results. Eighty-six (32.5%) of the total 265 episodes occurred in 16 months corresponding to the lockdowns in Türkiye, and the remaining 67.5% in 10 months thereafter. Human rhinovirus/enterovirus (hRE) (48.3%) was the most common agent detected during and after lockdown. Parainfluenza virus (PIV) (23.0%), influenza virus (9.8%), and respiratory syncytial virus (RSV) (9.1%) were the other common agents. The 28.7% of episodes were lower respiratory tract infections (LRTIs), and complications and mortality were higher than upper respiratory tract infections (URTIs) (25.0% vs 5.3%). Bacteremia was identified in 11.5% of culture-drawn episodes. Treatment delay in one-third and death within four weeks after RVI in 4.9% of episodes were observed. Conclusion. During the pandemic, fewer episodes of RVIs occurred during the lockdown period. Respiratory viruses may cause complications, delays in treatment, and even death in children with cancer. Therefore, increased awareness of RVIs and rapid detection of respiratory viruses will benefit the prevention and, in some cases, abrupt supportive and some antiviral treatment of RVI in children with cancer. © 2024, Turkish National Pediatric Society. All rights reserved.Item The Wolf in Sheep’s Clothing Leishmania tropica: Two Pediatric Visceral Cases; [Kuzu Postuna Bürünmüş Kurt Leishmania tropica: İki Pediyatrik Viseral Olgusu](Ankara Microbiology Society, 2024) Gülen H.; Türedi Yildirim A.; Çavuş I.; Türkmen H.; Özgüven E.; Özbilgin A.According to the World Health Organization (WHO), leishmaniasis is a zoonotic/anthroponotic parasitic disease endemic in 99 countries. It is estimated that approximately 12 million people are infected with Leishmania spp. and 350 million people live at risk. Every year, two million new cases are added to these figures. One and a half million cases of zoonotic/anthroponotic cutaneous leishmaniasis and 500 000 cases of visceral leishmaniasis are reported annually. One person is estimated to to be infected with cutaneous leishmaniasis in every 20 seconds and visceral leishmaniasis causes 60 000 deaths. In this report, two pediatric cases diagnosed with visceral leishmaniasis were presented. In the study, bone marrow aspirations were performed to determine the etiology of the disease in an eight-month-old male patient with fever and hepatosplenomegaly who had been followed up in Manisa Celal Bayar University, Department of Pediatrics, Division of Pediatric Hematology with the diagnosis of severe glucose-6-phosphate dehydrogenase (G-6PD) deficiency since the neonatal period and in a nine-month-old female patient who had had a high fever and bicytopenia for two weeks. Bone marrow aspirations were cultured in NNN medium and their smears were stained and examined with Giemsa. rk-39 and Leishmania IFAT tests were performed by using patients’ sera. Quantitative reverse transcriptase polymerase chain reaction (RT-qPCR) analysis was also performed for Leishmania spp. Leishmania spp. amastigotes were observed in Giemsa-stained smear preparations, Leishmania spp. promastigotes were grown in NNN medium, rk39 rapid diagnostic kit was weakly positive, Leishmania IFAT was positive at a titer of 1/1024 and Leishmania tropica was identified as the causative agent by RT-qPCR analysis for both cases. These two cases suggested that fatal cases of visceral leishmaniasis may increase with the spread of visceralized isolates of L.tropica, the most common causative agent of cutaneous leishmaniasis in Türkiye, and this issue may create a significant public health problem. © 2024 Ankara Microbiology Society. All rights reserved.Item A child with intravascular fasciitis mimicking deep vein thrombosis: a case report(Turkish National Pediatric Society, 2024) Yiğit Y.; Erdoğan O.; Yıldırım A.T.; Özer E.; Gülen H.Background. Intravascular fasciitis (IF) is a benign, reactive, myofibroblastic proliferation that originates from the superficial or deep fascia of small / medium-sized arteries and veins. Case Report. An 8-year-old male patient was admitted to a health center with the complaint of swelling in the inguinal region. Lower extremity venous Doppler ultrasonography showed deep vein thrombosis (DVT) of the femoral vein and anticoagulation with low-molecular weight heparin (LMWH) was initiated. The patient was referred to our center for follow-up. The D-dimer level was detected within normal limits. Doppler ultrasonography was repeated and showed an intraluminal expanding mass lesion with increasing vascularity, without distinct borders and LMWH was discontinued. This lesion at the sapheno-femoral junction was excised surgically and the histopathological examination revealed intravascular fasciitis. Conclusion. Clinicians should be aware that the clinical findings of IF may mimic sarcoma and thrombosis. © 2024, Turkish National Pediatric Society. All rights reserved.