Browsing by Author "Gulen, H"

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    α-Thalassemia Frequency and Mutations in Children with Hypochromic Microcytic Anemias and Relation with β-Thalassemia, Iron Deficiency Anemia
    Gulen, H; Hanimeli, O; Karaca, O; Taneli, F
    The majority of the anemias during childhood are hypochromic and microcytic. The aim of the present study was to determine the status of alpha-thalassemia mutations and its association with other etiologies, such as iron deficiency anemia (IDA) and beta-thalassemia trait, that are frequently seen hypochromic microcytic anemias in children. Children with hypochromic microcytic anemias were included in the study. Serum iron (SI), total iron-binding capacity (TIBC), ferritin levels, and hemoglobin electrophoresis with high-performance liquid chromatography (HPLC) method were analyzed. Reverse hybridization of biotinylated polymerase chain reaction (PCR) product method was used for detection of alpha-globin gene mutations. Of the 46 patients involved in the study, 54.3% (n = 25) were boys, and 45.7% (n = 21) were girls. Iron deficiency anemia and beta-thalassemia trait were diagnosed in 67.4% (n = 31) and 19.5% (n = 9), respectively. In 17.4% there were alpha-thalassemia mutations (in 10.9% 3.7 single-gene heterozygote mutation, in 4.3% 20.5-kb double-gene deletion mutation, and in 2.2% alpha-2 poly-A-1 heterozygote mutation was detected). In 2 patients (4.3%) no etiology was determined. In 2 patients (4.3%) association between iron deficiency anemia and alpha-thalassemia, in 1 patient (2.2%) association between beta and alpha-thalassemia was detected. In conclusion, alpha-thalassemia carrier status and its association with other etiologies are frequently seen in Manisa. So, alpha-thalassemia should be considered in the differential diagnosis of hypochromic microcytic anemias, especially in cases without iron deficiency (ID) and beta-thalassemia carrier state.
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    Diagnostic Yield of Upper Gastrointestinal Endoscopy in the Evaluation of Iron Deficiency Anemia in Older Children and Adolescents
    Gulen, H; Kasirga, E; Yildirim, SA; Kader, S; Sahin, G; Ayhan, S
    Iron deficiency anemia (IDA) is frequent in childhood. Inadequate nutrition and gastrointestinal malabsorption are the frequent causes of IDA in children. But reduced iron absorption and insidious blood loss from the gastrointestinal tract has been identified as the most frequent causes of IDA in older children and adolescents. Therefore the authors evaluated the frequency and etiologies of the upper gastrointestinal system pathologies causing IDA in older pediatric population. Patients with known hematological or chronic diseases, heavy menstrual flow, and obvious blood loss were excluded from the study. Forty-four children between the ages of 9.5 and 17.5 years and diagnosed with IDA were enrolled. They underwent upper gastrointestinal endoscopy and biopsy from esophagus, stomach, and duodenum. Mean age and hemoglobin (Hb) levels of study group (32 boys, and 12 girls) were 14.6 +/- 2.0 years and 7.9 +/- 1.8 g/dL, respectively. Only 1 patient had a positive serology testing with anti-tissue transglutaminase and small bowel biopsy correlating with celiac disease. Endoscopy revealed abnormal findings in 25 (56.8%) patients (21 endoscopic antral gastritis, 2 active duodenal ulcers, and 2 duodenal polyps). Helicobacter pylori (HP) infection was identified by using antral histopathological evaluation in 19 of 44 children (43.2%). In 2 of duodenal samples, one patient had celiac disease, and the other one was diagnosed as giardiasis. In conclusion, there are different etiologies resulting in IDA in older children and adolescents. When older children and adolescents are found to have iron deficiency, HP infection and other gastrointestinal pathologies should be ruled out before iron deficiency treatment.
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    EPISODE OF ACUTE HEMOLYSIS DUE TO UNDIAGNOSED GLUCOSE-6-PHOSPHATE DEHIDROGENASE DEFICIENCY IN AN ADOLESCENT WITH NEWLY DIAGNOSED TYPE 1 DIABETES MELLITUS: CASE REPORT AND REVIEW OF LITERATURE
    Goren, TA; Kilimci, DD; Yigit, Y; Yildirim, AT; Gulen, H; Ersoy, B
    Glucose-6-phosphate dehydrogenase (G6PD) enzyme deficiency is common in the community. The most important clinical manifestation of G6PD deficiency is acute hemolytic anemia due to oxidative stressors. Diabetes Mellitus (DM) can precipitate hemolysis in patients with G6PD deficiency. Here, we described a 15-year-old male with newly diagnosed type 1 DM (T1DM) and unknown G6PD deficiency who suffered from hemolytic anemia during normalization of blood glucose. On admission, the patient did not have ketoacidosis. After the patient's blood sugars were regulated with insulin therapy, he presented five days later with hemolytic anemia. The cause of hemolytic anemia was G6PD deficiency. The patient had no previous episodes of hemolysis and had no relevant family history. Hypoglycemia did not occur during blood glucose regulation. The return of blood sugar to normal after a long period of hyperglycemia was thought to be the possible cause of hemolysis. In conclusion, G6PD deficiency should be considered when there is an episode of hemolysis in newly diagnosed children and adolescents with T1DM, especially in the absence of ketoacidosis and hypoglycemia.
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    Premature labor and leukoerythroblastosis in a newborn with parvovirus b19 infection
    Gulen, H; Basarir, F; Hakan, N; Ciftdogan, DY; Tansug, N; Onag, A
    Leukoerythroblastosis is a rarely observed disease characterized by the presence of leukocytosis, erythroid and myeloid blast cells in peripheral blood. As to our knowledge, it was not diagnosed in a premature newborn before. A female case of 1164 grams who was born prematurely at 29th week of gestation by cesarean section was referred to our newborn intensive care unit due to prematurity and respiratory distress with no prenatal pathological findings. Physical examination revealed tachypnea and hepatosplenomegaly. Routine laboratory measurements of the case showed significant leukocytosis (85.000/mm(3)) and anemia (Hb: 9.6 gr/dL and Hct: 27.6%). Thrombocyte count was normal. Peripheral blood smear suggested leukoerythroblastosis with the presence of nucleated erythrocyte, monocytosis, and 4% blasts. Bone marrow cytogenetic examination was normal. Parvovirus B19 Ig G and M serology were detected to be positive. The etiological factors observed in leukoerythroblastosis occurring during neonatal and early childhood period are congenital-postnatal viral infections, juvenile myelomonocytic leukemia and osteopetrosis. As to our knowledge, no case diagnosed with leukoerythroblastosis in such an early phase is avaliable in literature. As a result, premature delivery and leukoerythroblastosis presentation was thought to develop secondary to intrauterine parvovirus B19 infection.
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    NONCOVID-19 VIRAL RESPIRATORY INFECTIONS IN CHILDREN WITH CANCER DURING THE COVID-19 PANDEMIC: A MULTICENTER OBSERVATIONAL STUDY
    Kebudi, R; Kacar, D; Ozyoruk, D; Tugcu, D; Yarali, N; Ilhan, I; Bahadir, A; Ozdemir, Z; Ozguven, A; Orhan, MF; Yildirim, AT; Albayrak, C; Kartal, I; Ozbek, NY; Sari, N; Tokgoz, H; Albayrak, M; Aydin, AC; Eroglu, N; Aydin, S; Uzel, H; Zulfikar, B; Buyukavci, M; Gulen, H; Toret, E; Bor, O
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    Influence of Paroxysmal Nocturnal Hemoglobinuria Clone Positivity on Outcome of Childhood Acquired Aplastic Anemia: A Multicenter Center Study
    Cangul, SU; Karapinar, DY; Erdem, AY; Yarali, HN; Ozdemir, HH; Gumruk, F; Cakmakli, HF; Ince, EU; Ozdemir, GNN; Gokce, M; Celkan, T; Bahadir, A; Bayhan, T; Oren, H; Gulen, H; Kupesiz, FT; Cetin, M; Ozbek, N
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    THE ASSOCIATION BETWEEN HLA CLASS I AND II ALLELES AND THE OCCURRENCE OF INHIBITORS IN TURKISH PATIENTS WITH HEMOPHILIA A: A PILOT STUDY
    Patiroglu, T; Cansever, M; Akbayram, S; Gulen, H; Oncel, K; Borst, O; Oymak, Y; Aral, YZ; Ay, Y; Kilinc, Y; Oren, H; Kavakli, K