Predictors for eltrombopag response in patients with hepatitis C virus-associated thrombocytopenia

Tamer A Elbedewy,1 Mohamed A Elsebaey,1 Samah A Elshweikh,1 Heba Elashry,2 Sherief Abd-Elsalam2 1Internal Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt; 2Tropical Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt Background and aims: Thrombocytopenia is a common hematological abnormality observed in patients infected with hepatitis C virus (HCV). The use of eltrombopag has been approved for HCV-associated thrombocytopenia. This is the first study aiming to determine the predictive factors of response to eltrombopag therapy in patients with HCV-associated thrombocytopenia. Patients and methods: This prospective study was carried out on 130 patients with chronic HCV-associated thrombocytopenia (<50,000×109/L) that precludes the initiation of HCV therapy. Eltrombopag was initiated at a dose of 25 mg once daily; the dose was adjusted with 25 mg increments every 2 weeks to achieve the target platelet count. The primary end point was to achieve stable target platelet count (50,000–100,000×109/L) required to initiate antiviral therapy. Results: Treatment response was achieved in 111 (85.38%) patients. This prospective study showed that megakaryocyte hypoplasia or aplasia and splenectomy were independent risk factors for eltrombopag nonresponse in chronic HCV-associated thrombocytopenic patients. Conclusion: Eltrombopag is safe and effective for patients with HCV-associated thrombocytopenia. Bone marrow examination should be considered before initiating treatment with eltrombopag in chronic HCV-associated thrombocytopenic patients, especially in patients with splenectomy. Keywords: HCV, therapy, thrombocytopenia, predictors, splenectomy, direct-acting antivirals, DAA

Galectin-3 as a prognostic biomarker for diabetic nephropathy

Hossam Hodeib,1 Maha M Hagras,1 Dina Abdelhai,1 Mona M Watany,1 Amal Selim,2 Mohamed A Tawfik,2 Mohamed A Elsebaey,2 Samah A Elshweikh2 1Clinical Pathology, Faculty of Medicine, Tanta University, Tanta, Egypt; 2Internal Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt Introduction: Diabetic nephropathy (DN) represents one of the main causes of end-stage renal disease in type 2 diabetes mellitus (DM) patients. Galectin-3 has been implicated in pathogenesis of many pathological conditions. To date, there are limited data regarding the relationship between galectin-3 and DN.  Aim of the study: Evaluation of serum galectin-3 as a novel prognostic biomarker in patients with DN.  Patients and methods: This prospective study was carried out in the Internal Medicine and Clinical Pathology Departments, Tanta University Hospital, Egypt, from March 2015 to March 2018 on 300 patients with type 2 DM. Patients were divided into three groups: group I included 100 patients with albumin/creatinine ratio (ACR) 300 mg/g (macroalbuminuria). All patients were subjected to the following: full history taking, clinical examination, and laboratory evaluation (HbA1c, creatinine, estimated glomerular filtration rate, ACR, and serum galectin-3). Results: The mean levels of galectin-3 were significantly higher in patients with macroalbuminuria than in those with microalbuminuria and normoalbuminuria. Galectin-3 was a significant predictor for progression to microalbuminuria, macroalbuminuria, dialysis, and death among patients with type 2 DM. Conclusion: Based on this single center prospective study, serum galectin-3 is considered a significant predictor for DN progression among patients with type 2 DM. Keywords: diabetic nephropathy, galectin-3, albumin/creatinine ratio, microalbuminuria, macroalbuminuria, dialysis, diabetes mellitu