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Children2
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Toxic Skin Reactions2
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A Case Series1
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Allergic Reactions to Chemotherapeutic Drugs1
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Anemi1
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Apical periodontitis, Pulp necrosis, Serum cytokines, Sickle cell disease1
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Hemoglobinopatiler1
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Intestinal Microbiota, Children, Sickle Cell Disease1
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Juvenil sistemik lupus eritematozus1
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Receiving Chemotherapy1
The role of immature granulocyte percentage in predicting acute chest syndrome and the severity of the vaso-occlusive crisis in sickle cell disease
Karahan,Feryal | Ünal,Selma | Bozlu, Gülçin
Background: Sickle cell disease (SCD) is an inflammatory disease that can result in both chronic and acute inflammation. Immature granulocytes (IG) are not-yet-mature white blood cells that can be easily detected in complete blood count (CBC) tests. In recent studies it has been suggested that IG may play a role in determining the prognosis of inflammatory diseases. The aim of our study was to investigate the role of IG percentage on predicting acute chest syndrome (ACS) and the severity of vaso-occlusive crisis (VOC) in patients with SCD. Methods: The study cohort consisted of 49 SCD patients admitted to the emergency department for VOC. If symptoms did not regress despite appropriate treatment including hydration and analgesia, they were hospitalized. Patients whose symptoms regressed...
Toxic Skin Reactions Should Be Differentiated from Allergic Reactions to Chemotherapeutic Drugs in Children: A Case Series and Review of the Literature
Kont Özhan,Aylin | Arikoglu,Tuğba | Karahan,Feryal | Gökalp Satıcı,Fadime Eda | Tokmeci,Nazan | İlhan Yalaki,Aysu | Akbey, Veysi | Yasemin Yuyucu Karabulut | Ünal,Selma | Kuyucu,Semanur
Background: Chemotherapeutic drugs can lead to a wide spectrum of cutaneous findings, ranging from nonimmune toxic reactions to severe immune-mediated hypersensitivity reactions. The aim of this study was to evaluate the clinical, histopathological features, and prognosis of toxic skin reactions to chemotherapeutic drugs and to compare them with characteristics of immune-mediated reactions in children with malignancies. Methods: The medical records of all children with cancer who experienced skin reactions after chemotherapy administration and diagnosed as a toxic skin reaction between 2010 and 2022 were retrospectively analyzed. The diagnosis was re-evaluated and differentiated from other similar disorders by using clinical manifestations, photodocumentation, and histopathological finding...
Evaluation of Intestinal Microbiota in Children With Sickle Cell Disease
Karahan,Feryal | Tezol,Özlem | Kuyucu,Necdet | Türkegün,Merve | Ünal,Selma
Background and Aims: Sickle cell disease (SCD) is a chronic hemolytic anemia that may be life-threatening due to multisystemic effects. Identification of the factors which affect the pathophysiology of the disease is important in reducing mortality and morbidity. This study aimed to determine gut microbial diversity in children and adolescents with SCA compared with healthy volunteers and to evaluate the clinical impact of microbiota. Materials and Methods: The study included 34 children and young adolescents with SCD and 41 healthy volunteer participants. The microbiome was assessed by 16S rRNA sequencing in stool samples. Laboratory parameters of all participants, such as complete blood count and C-reactive protein values and clinical characteristics of SCD patients, were determin...
Sickle Cell Disease and Psychosocial Well-Being: Comparison of Patients With Preclinical and Clinical Avascular Necrosis of the Femoral Head
Tezol,Özlem | Karahan,Feryal | Unal,Selma
Aim: Sickle cell disease (SCD) has significant adverse psychosocial impacts in childhood. Patients with SCD may be affected by avascular necrosis (AVN) and the most commonly involved site is the femoral head. We aimed to conduct a comparative investigation of the psychosocial well-being of pediatric SCD patients with preclinical and clinical femoral head AVN. Materials and Methods: Patients with homozygous SCD and healthy peers aged 7-17 years were included in this cross-sectional study. Psychosocial well-being was assessed by the Strengths and Difficulties Questionnaire (SDQ), parent version. SDQ scores were compared between the groups. Results: A total of 74 mother–child couples were enrolled in this study. The SCD with clinical AVN (stages I-IV) group consisted of 17 patients, SCD with...
Toxic Skin Reactions Should Be Differentiated from Allergic Reactions to Chemotherapeutic Drugs in Children: A Case Series and Review of the Literature
Kont Özhan,Aylin | Demirhan,Ali | Arikoglu,Tuğba | Karahan,Feryal | Gökalp Satıcı,Fadime Eda | Tokmeci,Nazan | İlhan Yalaki,Aysu | Akbey, Veysi | Yuyucu Karabulut,Yasemin | Ünal,Selma | Kuyucu,Semanur
Background: Chemotherapeutic drugs can lead to a wide spectrum of cutaneous findings, ranging from nonimmune toxic reactions to severe immune-mediated hypersensitivity reactions. The aim of this study was to evaluate the clinical, histopathological features, and prognosis of toxic skin reactions to chemotherapeutic drugs and to compare them with characteristics of immune-mediated reactions in children with malignancies. Methods: The medical records of all children with cancer who experienced skin reactions after chemotherapy administration and diagnosed as a toxic skin reaction between 2010 and 2022 were retrospectively analyzed. The diagnosis was re-evaluated and differentiated from other similar disorders by using clinical manifestations, photodocumentation, and histopathological finding...
Increased serum YKL-40 levels in children with sickle cell disease
Akbey,Veysi | Ünal,Selma | Tezol, Özlem | Bahar Taşdelen | Karahan,Feryal
Background: YKL-40 is a glycoprotein secreted by various cell lines during inflammation and vascular dysfunction. Sickle cell disease (SCD) also involves inflammation and endothelial dysfunction processes. Thus, we aimed to assess the levels of YKL-40 in pediatric SCD patients. Methods: We evaluated serum levels of YKL-40 in children with steady state SCD and those with vaso-occlusive crisis (VOC) episodes and compared them with healthy subjects. Results: Overall, 33 children with SCD and 33 healthy controls participated in this study. Serum YKL-40 concentrations of children with steady state SCD were significantly higher than the concentrations found in the healthy controls (median [Q1-Q3]: 71.0 [53.3-133.3] vs. 43.6 [37.9-69.9] ng/mL, p=0.001). Seventeen of the 33 children with SCD...
Orak Hücre Hastalığında Ağrılı Kriz Yönetimi
Karahan,Feryal | Ünal,Selma
Orak hücre hastalığı dünyada en sık görülen hemoglobinopatilerden biridir. Hastalık hayatı tehdit edebilen akut komlikasyonlar ve çeşitli organlarda kronik hasarlar ile sonuçlanabilen kronik hemolitik anemi ile karakterizedir. Orak hücre hastalığının klinik seyri hastalar arasında çeşitlilik gösterir. Bazı hastalarda şiddetli ağrılı krizler ile sağlık kuruluşlarına sık başvuru ve komplikasyonlar gelişirken, diğerleri daha hafif klinik bulgular sergiler. Hastaların karşılaştığı en önemli sorunlardan biri, damar tıkayıcı kriz ve buna bağlı doku iskemisinden kaynaklanan ağrılı krizlerdir. Ağrılı kriz, hastalığın öngörülemeyen, tekrarlayan, sıklıkla kalıcı olan ve tedavi için pek çok kez ağrı kesici kullanımını gerektiren, genellikle zor ve karmaşık bir süreçtir. Bu sürecin en iyi şekilde yöne...
Talasemi ve Hemoglobinopati Taşıyıcılarında Tam Kan Sayımı ve Periferik Kan Yayması
Karahan,Feryal | Ünal,Selma
Hemoglobinopatiler ülkemizde en sık görülen kalıtsal kan hastalıkları arasında yer almaktadır. Yaşam kalitesini düşüren, mortalite ve morbiditeyi arttıran bu hastalık grubu önemli bir halk sağlığı sorunudur. Moleküler patoloji, patofizyoloji ve kalıtsal hemoglobin bozukluklarının kontrolü ve yönetimi konusundaki büyük ilerlemelere rağmen, hemoglobinopatili birçok hasta, yaşamları süresince hastalığa bağlı akut ve kronik komplikasyonlarla mücadele etmek zorunda kalmaktadırlar. Bu nedenle hemoglobinopati ve talasemi taşıyıcısı bireylerin saptanması, genetik danışmanlık ve prenatal tanı yöntemleri ile hasta bireylerin doğumunun önlenmesi toplum sağlığının sürdürülebilirliği için önemlidir. Taşıyıcı bireylerin saptanması aile hikayesi ya da anemi etyolojisinin araştırılması ile başlayan, basit...
Yenidoğanda Talasemi ve Hemoglobinopatilere Yaklaşım
Approach to Thalassemia and Hemoglobinopathies in Newborns
Karahan,Feryal | Ünal,Selma
Hemoglobinopatiler, dünya genelinde kalıtsal aneminin en sık nedeni olmasına rağmen heterojenite göstermesi ve toplumsal demografik yapının son 50 yılda göçler nedeniyle değişmesi nedeniyle geç tanınmakta ya da yanlış tanı alabilmektedir. Yenidoğan döneminde hastaların doğru tanı alabilmesi için, yenidoğan dönemindeki normal hemoglobin fraksiyonları ile bunların zaman içindeki değişimlerinin bilinmesi önem arz etmektedir. Bu bölümde hemoglobinin yapısı ve anormallikleri, hemoglobinopatilerin klinik ve laboratuvar bulguları ile beraber tanı ve tarama testleriyle birlikte yenidoğan döneminde talasemi ve hemoglobinopatilere genel bir bakış açısıyla değineceğiz. Although hemoglobinopathies are the most common cause of hereditary anemia worldwide, they are diagnosed late or misdiagnosed due to ...
Juvenil Sistemik Lupus Eritematozus: Hematolojik Tutulum
Karahan,Feryal | Unal, Selma
Juvenil sistemik lupus eritematozus (jSLE), birçok organ ve sistemi tutabilen, önemli morbidite ve hatta mortaliteye yol açabilen, kronik otoimmün bir hastalıktır. Klinik bulgular oldukça değişkenken, hematolojik bulgular hem tanı anında hem de hastalığın seyri sırasında, hafif bulgulardan hayatı tehdit edebilecek düzeylere kadar görülebilir. Hematolojik bulgular; en sık anemi, lökopeni, trombositopeni, lenfadenopati ve splenomegali, daha nadir olarak hemostaz bozuklukları ve çeşitli otoantikorların varlığı ile karakterizedir. Hematolojik bulgular hastalığa bağlı ya da tedavi ile ilişkili olabileceği gibi, eşlik eden herhangi başka bir hastalığa bağlı da olabilir. Bu derlemenin amacı, SLE'nin hematolojik bulgularını ayrıntılı olarak incelemek ve jSLE hastalarında hematolojik tutuluma ...
Different Presentations of Patients with Transcobalamin II Deficiency: A Single-Center Experience from Turkey
Ünal,Selma | Karahan,Feryal | Arıkoğlu,Tuğba | Akar,Asuman | Kuyucu,Semanur
Objective: Transcobalamin II deficiency is a rare autosomal recessive disease characterized by decreased cobalamin availability, which in turn causes accumulation of homocysteine and methylmalonic acid. The presenting clinical features are failure to thrive, diarrhea, megaloblastic anemia, pancytopenia, neurologic abnormalities, and also recurrent infections due to immune abnormalities in early infancy. Materials and methods: Here, we report the clinical and laboratory features of six children with transcobalamin II deficiency who were all molecularly confirmed. Results: The patients were admitted between 1 and 7 months of age with anemia or pancytopenia. Unexpectedly, one patient had a serum vitamin B12 level lower than the normal range and another one had nonsignificantly elevated ...
Evaluation of the relationship between intravascular hemolysis and clinical manifestations in sickle cell disease: decreased hemopexin during vaso-occlusive crises and increased inflammation in acute chest syndrome
Yildirim,Nazim | Unal,Selma | Karahan,Feryal
The aims of this study were to determine the possible relationships between the levels of hemin, hemopexin, acid sphingomyelinase, nitrite/nitrate (NOx), and other parameters in patients with SCD and to assess whether they were associated with vaso-occlusive crises (VOCs) or acute chest syndrome (ACS). Patients with SCD (homozygous or sickle beta-thalassemia) who were confirmed to have VOC or ACS were included. Blood samples were obtained at admission, on the third day of hospitalization, and at steady state. Demographic characteristics, pain (visual analog scale), complication history, complete blood count, lactate dehydrogenase, and C-reactive protein levels were recorded. Hemin, hemopexin, acid sphingomyelinase, and NOx were measured via ELISA. A total of 31 patients (22 VOC, 9 ACS) wer...
Association between serum cytokine levels with pulp necrosis and apical periodontitis in sickle cell disease
Yilmaz,Melis | Aksu,Seçkin | Karahan,Feryal | Ertaş,Elif | Ünal,Selma
This study’s objective was to assess the relationship between serum cytokine levels and the occurrence of pulp necrosis (PN) and apical periodontitis (AP) in adolescents with Sickle Cell Disease (SCD). A total of 52 adolescents, including 29 individuals diagnosed with SCD, participated in the study. Serum cytokine levels including IL-1, IL-2, IL-4, IL-6, IL-1β, IL-8, IL-10, IL-17, and TNF-α were analyzed. Radiological and intraoral dental examinations were conducted on the same day. Electric pulp testing and cold tests were conducted on all intact crowned teeth to assess the presence of PN. Periapical index scores were derived from panoramic and periapical radiographs to identify teeth exhibiting AP. Statistical analyses were carried out using Student’s t-test, Chi-square test, Spearman co...