Effects of Immune Complexes on Holotranscobalamine Assay of Vitamin B-12 Deficiency in Myeloproliferative Disorders

In myeloproliferative disorders (MPDs), vitamin B-12 levels are measured falsely elevated with conventional methods due to increased carrier protein synthesis. HoloTranscobalamine (HoloTC) assay is a first-choice method for detecting true vitamin B-12 deficiency in MPDs. Our aim was to determine effects of immune complexes on HoloTC assay. This is a cross-section study. Vitamin B-12 levels in 61 patients with myeloproliferative disorders were measured by both electrochemical immunoassay and HoloTC assay. The HoIoTC cutoff was greater than 35 pmol/L. HoloTC assay for each sample were repeated after polyethylene glycol (PEG) treatment to exclude IgG, IgA and IgM type immune complexes. Also, methylmalonic acid, folate, homocystein, liver, and kidney function tests were obtained. Methylmalonic acid test showed that 42 patients (68.9%) had vitamin B-12 deficiency. Vitamin B-12 levels by HoIoTC assay decreased by 19.2 +/- 11.28% in essential thrombocytosis, 40.0 +/- 9.39% in chronic myeloid leukemia, 30.9 +/- 14.62% in myelofibrosis and 21.2 +/- 11.55% in polycythemia vera patients after PEG treatment. There was significant difference between the averages of groups (p< 0.01). Methylmalonic Acid Test was used as the B-12 status variable. The comparison of ROC curves of HoIoTC before and after PEG showed no statistically significance between area under curves. The optimum cut-off points for both HoloTC before and after PEG were 40.6 pmol/L and 32.1 pmol/L, respectively. Immune complexes may have some effect on HoIoTC assay which has been recently reported to have a superior diagnostic accuracy for vitamin Biz deficiency in patients with MPDs. Although exclusion of immune complexes did not improve its diagnostic performances, effects of exclusion were significantly different between subgroups of MPDs

Kimura Disease’s: A Case Report

Kimura is a chronic inflamatuary disease at oral mucosa which presents as large subcutaneous nodules or masses on the head or neck of adulthood males. The lesions characteristics are eosinophilia in lymphocytic infiltration, fibrosis and diffuse vascularity. Eosinophilia and elevated blood IgE can be peresent. A 62 years old female with inguinal mass and itching was presented

Preeklampsinin Patogenezinde Maternal Oksidatif Stres, Demir/Çinko, Bakır/Çinko Oranları ve Eser Element Düzeylerinin Rolü

Purpose:Preeclampsia (PE) is a complex disease and the underlying mechanisms are not known, yet. It is well known that oxidative stress and trace elements play a role in the pathogenesis of various diseases. Several studies have shown that the levels and proportions of trace elements are closely related to the severity of the disease. The aim of the study was to investigate the changes in some characteristics parameters, serum zinc, iron, copper levels, and copper/zinc and iron/zinc ratios and plasma lipid peroxidation levels in patients with mild and severe preeclampsiaAma&ccedil;: Preeklampsi (PE) kompleks bir hastalıktır ve hastalığın patogenezinde yer alan mekanizmalar hen&uuml;z aydınlatılamamıştır. Oksidatif stres ve eser elementlerin &ccedil;eşitli hastalıkların patogenezinde rol oynadığı iyi bilinmektedir. Yapılan &ccedil;eşitli &ccedil;alışmalarda, eser elementlerin d&uuml;zeylerinin ve oranlarının, hastalığın şiddeti ile yakından ilişkili olduğunu g&ouml;stermiştir. Bu &ccedil;alışmanın amacı, hafif ve şiddetli preeklamptik hastalarda bazı karakteristik &ouml;zelliklerin, serum &ccedil;inko, demir, bakır d&uuml;zeyleri, bakır/&ccedil;inko ve demir/&ccedil;inko oranları ile plazma lipid peroksidasyon d&uuml;zeylerini değişikliklerini araştırmaktı

Diabetic ketoacidosis as the presenting manifestation of pancreatic adenocarcinoma with cystic features

AbstractThe common presenting symptoms of pancreatic cancer are abdominal pain, weight loss, and jaundice. Pancreatic adenocarcinoma presenting with diabetic ketoacidosis is a very rare emergent clinical condition. However, pancreatic ductal cystadenocarcinoma presenting with diabetic ketoacidosis was not reported. We describe a 60-year-old man with pancreatic cystadenocarcinoma presenting with diabetic ketoacidosis as the initial manifestation. It must be kept in mind that in diabetic ketoacidosis cases, the precipitating factor may be pancreatic ductal cystadenocarcinoma

Association between neutrophil-to-lymphocyte ratio and nutritional status in geriatric patients

Background Neutrophil-to-lymphocyte ratio (NLR) and presence of malnutrition have been found to be associated with mortality and morbidity in various clinical conditions. We investigated the association between NLR and nutritional status in geriatric patients. Methods This cross-sectional study included 95 geriatric (age >= 65 years) patients from general internal medicine outpatient clinic of a university hospital. Nutritional status of the patients was evaluated using Mini Nutritional Assessment (MNA), Geriatric Nutritional Risk Index, albumin, total cholesterol, body mass index, mid-arm circumference, and calf circumference. NLR was calculated from the complete blood count results. Results A total of 59 patients were female, and the mean age was 73 +/- 9.8 years. According to the MNA, 51.6% of patients had a normal nutritional status, and 48.4% were malnourished or at risk of malnutrition. The mean NLR of patients with malnourished or at risk of malnutrition was significantly higher than that of patients with normal nutritional status (P = 0.004). There was a negative correlation between NLRs and the MNA scores (r = -0.276, P = 0.007). Optimal NLR cutoff point for patients with malnourished or at risk of malnutrition was 1.81 with 71.7% sensitivity and 63.3% specificity [95% confidence interval (CI): 0.562-0.780, P = 0.004]. Logistic regression analysis revealed that elevated NLR was an independent factor in prediction of malnutrition or risk of malnutrition in geriatric patients. Conclusion These results demonstrated that NLR was associated with the nutritional status of geriatric patients. NLR may be a useful nutritional marker for evaluating the nutritional status of geriatric outpatients

Relationships Among Some Biochemical Parameters, Trace Elements and Lipid Peroxidation Levels in Women With Gestational Diabetes Mellitus

Aim:The aim of the present study was to determine levels of copper (Cu), zinc (Zn), iron (Fe), malondialdehyde and some biochemical parameters in women with gestational diabetes mellitus (GDM) compared with healthy pregnant women, and to evaluate the relationships among these parameters.Materials and Methods:The patients consisted of 56 pregnant with GDM. The control group consisted of 60 healthy pregnant women. Plasma malondialdehyde, blood glucose, insulin, glycosylated hemoglobin (HbA1c), total cholesterol, triacylglycerol and LDL-cholesterol were measured by biochemical methods. The concentrations of serum Fe, Cu and Zn were determined by flame atomic absorption spectrophotometer.Results:The levels of blood glucose, insulin, HOMA-IR, glycosylated hemoglobin (HbA1c), total cholesterol, triacylglycerol and LDL-cholesterol, levels of plasma malondialdehyde, levels of serum Fe and Cu in women with GDM group were found higher than those in healthy pregnant women. However, levels of serum Zn were significantly lower in GDM pregnants than those in the healthy pregnant women. There were significant negative correlations between LDL-cholesterol and Cu levels of GDM subjects. Additionally, there were significant negative correlation between LDL-cholesterol and plasma malondialdehyde levels. However, there were significant positive correlations between serum Fe and plasma malondialdehyde levels.Conclusion:Our findings emphasize the significant deficiencies of Zn levels and the significant elevation of malondialdehyde, hyperglycemia and hyperlipidemia in women with GDM. Therefore, supplementation with Zn element involved in the antioxidative system may increase antioxidative enzyme activities, and consequently, an improvement in fetal and maternal complications may be expected