The diagnostic value of basophil activation tests in hypersensitivity reactions due to contrast media

Aims: Current tests used for the diagnosis of hypersensitivity reactions (HRs) due to radiocontrast media (RCM) are associated with important shortcomings. The present study investigated the diagnostic value of basophil activation test (BAT) in immediate HRs to RCM. Methods: This was a cross-sectional study with prospective enrollment. The skin test (ST) with RCM was performed in cases with suspicious immediate RCM allergy. The patients were categorized into four groups (G); G1: positive ST to RCM; G2: negative ST to RCM; G3: no RCM reaction; and G4: controls with no history of RCM use. BAT was performed using flow cytometry to analyze CD63 and CD203c expression in basophils. Activated basophil percentage (ABP), stimulation index (SI), mean fluorescence intensity (MFI), and the SI of the MFI (MFI SI) were compared across 4 groups. Results: A total of 42 patients (female: 73.8%, age 26 to 78 years) were evaluated. SI was greater in G1 (n=7) than in G3 (n=9) (p=0.05); MFI was greater in G1 than in G4 (n=17) (p=0.03); and MFI SI was greater in G1 than in G4 (p=0.03). Four subjects (57.1%) in G1 had an ABP of >5%, 3 subjects (42.8%) had a SI ?2, and 5 patients (71.4%) had elevated MFI; the corresponding figures in G2 (n=9) were 2 (22.2%), 1 (11.1%) and 1 (11.1%), respectively. All three criteria were positive only in 2 patients in G1. Conclusions: This study suggests that, based on ABP, SI, and MFI assessments, BAT may represent a partially useful test in patients with a history of immediate RCM reactions

Herediter anjioödemli hastalarda karın ağrısının tek nedeni herediter anjioödem olmayabilir

WOS:000378063300022Herediter anjioödemin temel klinik presentasyonlarından birisi karın ağrısıdır. Danazol herediter anjioödem hastalarında uzun yıllar yaygın olarak kullanılmış olan bir ilaçtır. Burada nihai tanıları kolon karsinomu olan danazol tedavisi altında karın ağrısı olan iki herediter anjioödem hastası sunulmuştur. Bu makalede 2 konu vurgulanmıştır. Birincisi; herediter anjioödem hastalarında ''karın ağrısı'' ayırıcı tanısının, herediter anjioödem tanısı mevcut olsa bile yapılması gereken bir semptom olma özelliğini koruduğunu vurgulamak; ikincisi ise uzun süreli uygulanan danazol tedavisinin maligniteler gibi olası bir advers etkisini ortaya koymaktırAbdominal pain is one of the basic clinical presentations of the hereditary angioedema and danazol is a common medicine which has been used for long years in patients with hereditary angioedema. We present two hereditary angioedema patients with abdominal pain albeit under danazol treatment, whose final diagnoses was colon carcinoma. There are two consequences in this article which shall be insisted on: First; in patients with hereditary angioedema, the differential diagnosis of "abdominal pain" is always important even though hereditary angioedema diagnosis exists. And the second; It can be hardy speculated that long term danazol treatment may cause different malignancie

VASKÜLO - BEHÇET HASTALARINDA BAZI LİPİD METABOLİZMASI PARAMETRELERİ VE ANTİKARDİYOLİPİN ANTİKOR DÜZEYLERİ

TEDAVİ ALMAYAN VE VASKÜLER TUTULUMU OLAN 12 BEHÇET HASTASI İLE 20 SAĞLIKLI KONTROL GRUBUNDA LİPİD PROFİLİ VE ANTİKARDİYOLİPİN ANTİKOR DÜZEYLERİ KARŞILAŞTIRILMIŞTIR

Generation of Platelet Microparticles after Cryopreservation of Apheresis Platelet Concentrates Contributes to Hemostatic Activity

Objective: In the last decade, substantial evidence has accumulated about the use of cryopreserved platelet concentrates, especially in trauma. However, little reference has been made in these studies to the morphological and functional changes of platelets. Recently platelets have been shown to be activated by cryopreservation processes and to undergo procoagulant membrane changes resulting in the generation of platelet-derived microparticles (PMPs), platelet degranulation, and release of platelet-derived growth factors (PDGFs). We assessed the viabilities and the PMP and PDGF levels of cryopreserved platelets, and their relation with thrombin generation. Materials and Methods: Apheresis platelet concentrates (APCs) from 20 donors were stored for 1 day and cryopreserved with 6% dimethyl sulfoxide. Cryopreserved APCs were kept at -80 °C for 1 day. Thawed APCs (100 mL) were diluted with 20 mL of autologous plasma and specimens were analyzed for viabilities and PMPs by flow cytometry, for thrombin generation by calibrated automated thrombogram, and for PDGFs by enzyme-linked immunosorbent assay testing. Results: The mean PMP and PDGF levels in freeze-thawed APCs were significantly higher (2763±399.4/μL vs. 319.9±80.5/μL, p<0.001 and 550.9±73.6 pg/mL vs. 96.5±49 pg/mL, p<0.001, respectively), but the viability rates were significantly lower (68.2±13.7% vs. 94±7.5%, p<0.001) than those of fresh APCs. The mean endogenous thrombin potential (ETP) of freeze-thawed APCs was significantly higher than that of the fresh APCs (3406.1±430.4 nM.min vs. 2757.6±485.7 nM.min, p<0.001). Moreover, there was a significant positive poor correlation between ETP levels and PMP levels (r=0.192, p=0.014). Conclusion: Our results showed that, after cryopreservation, while levels of PMPs were increasing, significantly higher and earlier thrombin formation was occurring in the samples analyzed despite the significant decrease in viability. Considering the damage caused by the freezing process and the scarcity of evidence for their in vivo superiority, frozen platelets should be considered for use in austere environments, reserving fresh platelets for prophylactic use in blood banks