Activated protein C resistance in preeclampsia

PubMed ID: 14998192Objectives: Recently, hereditary and acquired diseases that lead to thromboembolic events by changing the hemostatic balance have attracted interest as a cause of preeclampsia. In this study the incidence of activated protein C resistance (APCR) in preeclamptic women was evaluated. Methods: Activated protein C sensitivity ratio (APC-SR) was measured by the modified activated partial thromboplastin time (APTT) method in 19 preeclamptic and 12 healthy pregnant women and 26 normal women as the controls. Results below the levels of 2 were accepted as the presence of APCR. Results: Median APC-SR values of 2.12 and 2.01 in preeclamptic and healthy pregnant women, respectively, were found significantly lower than the normal control values of 2.31 (p = 0.0005, p = 0.001). APCR was detected in 31% of preeclamptic patients, 16.6% of healthy pregnant women and 7.6% of normal controls. Conclusion: APCR was found significantly higher in preeclamptic women and it may play an important role in the pathogenesis of preeclampsia

Local experience with thrombotic thrombocytopenic purpura from the western part of Turkey

WOS: 000237404500006PubMed ID: 16504585Thrombotic thrombocytopenic purpura (TTP) is a fatal disorder if left untreated. Therapeutic plasma exchange (PE) has resulted in excellent remission and survival rates ill these patients but there is a need for alternative immuno-modulatory treatments in unresponsive patients. We present a descriptive, retrospective study of 25 (14 female, 11 male) adult patients admitted to our hematology unit with TTP. The patients' median age was 32 years. The patients were treated with immediate PE and a standard dose of corticosteroid therapy. Twenty percent of the patients obtained a complete response after the addition of Intravenous immuno-globulin (IVIg). Improvement of clinical status, platelet counts and serum LDH levels were seen after a median 13, 14 and 3.5 PE sessions, respectively. The mortality rate was 12%. One patient has a chronic relapsing form of TTP and two patients have relapsed. All the other patients are still in complete remission after a median of 7 years of follow-up. Although PE therapy is life-saving and the application of early corticosteroid treatment could obtain early and durable responses, addition of other immuno-modulatory treatments are needed in unresponsive patients. The use of IVIg could result in a dramatic response. (c) 2006 Elsevier Ltd. All rights reserved

Thrombotic thrombocytopenic purpura: Report of 10 cases

Thrombotic thrombocytopenic purpura (TTP) is a rare and serious disease. Although a number of treatment methods have been used plasma infusion and plasmapheresis has become standard therapy in the treatment of TTP. We investigated clinical and laboratory findings and results of plasmapheresis treatment in 10 patients with acute TTP. Microangiopathic hemolytic anemia and thrombocytopenia were present in all patients, neurologic symptoms were noted in 80%, renal abnormalities in 70% and fever in 60% of patients. Clinical status and laboratory parameters improved strikingly in nine out of ten patients after plasmapheresis therapy was commenced. However, one patient did not respond to this treatment and died on the 6th day of therapy. Unless it is treated effectively, TTP carries a mortality of about 100%. Plasmapheresis should be considered to be the first choice of treatment because it has been shown to be quite effective and safe

Local experience with thrombotic thrombocytopenic purpura from the western part of Turkey

WOS: 000237404500006PubMed ID: 16504585Thrombotic thrombocytopenic purpura (TTP) is a fatal disorder if left untreated. Therapeutic plasma exchange (PE) has resulted in excellent remission and survival rates ill these patients but there is a need for alternative immuno-modulatory treatments in unresponsive patients. We present a descriptive, retrospective study of 25 (14 female, 11 male) adult patients admitted to our hematology unit with TTP. The patients' median age was 32 years. The patients were treated with immediate PE and a standard dose of corticosteroid therapy. Twenty percent of the patients obtained a complete response after the addition of Intravenous immuno-globulin (IVIg). Improvement of clinical status, platelet counts and serum LDH levels were seen after a median 13, 14 and 3.5 PE sessions, respectively. The mortality rate was 12%. One patient has a chronic relapsing form of TTP and two patients have relapsed. All the other patients are still in complete remission after a median of 7 years of follow-up. Although PE therapy is life-saving and the application of early corticosteroid treatment could obtain early and durable responses, addition of other immuno-modulatory treatments are needed in unresponsive patients. The use of IVIg could result in a dramatic response. (c) 2006 Elsevier Ltd. All rights reserved

Immunohistochemical detection of CD 95 (Fas) & Fas ligand (Fas-L) in plasma cells of multiple myeloma and its correlation with survival

WOS: 000233641400010PubMed ID: 16321857Multiple myeloma (MM) is a malignant disease resulting from an uncontrolled proliferation of a neoplastic plasma cell clone in the bone marrow, which might also be induced by the loss of control on apoptosis. Fas ligand (Fas-L), a member of the tumor necrosis factor family, induces apoptosis mediated via its transmembrane death receptor Fas (Apo-1/CD95) antigen. In the present study, immunostaining was performed on the initial diagnostic bone marrow biopsies of 36 MM patients (1 stage I, 5 stage II, 30 stage III), to evaluate the distribution of Fas receptor and Fas-L on malignant plasma cells. Both Fas and Fas-L were positive in 13 cases and negative in 3, whereas 10 cases were Fas-negative, Fas-L-positive and 10 were Fas-positive, Fas-L-negative. Although no association was found between the expression of Fas receptor or Fas-L and overall survival, Fas-L positivity was significantly associated with a shorter event-free survival ( p = 0.0335). In this study, it has been shown that the expression of Fas-L, in malignant plasma cells of myeloma patients significantly shortens the event-free survival, indicating that the defect in apoptosis might be associated with disease progression in MM