Hipertrigliseridemiye Bağlı Akut Pankreatit Hasta Deneyimleri: Araştırma Makalesi

Introduction: Hypertriglyceridemia is also involved in the etiology of acute pancreatitis. Hypertriglyceridemia in addition, plasmapheresis in acute pancreatitis triggered by and/or different treatments such as heparin therapy can be applied. Objective: The aim of our study was to share our experience with the treatment, clinical course, and demographic features of patients with acute pancreatitis related to hypertriglyceridemia and the effectiveness of plasmapheresis. Method: Patients admitted to the service with the diagnosis of acute pancreatitis in Ankara Atatürk Sanatorium Training and Research Hospital Gastroenterology Clinic between 01 January 2018 and 31 December 2022 were retrospectively screened. Triglyceride level of 800 mg/dl and above at the time of first admission to our hospital. Results: A total of 12 patients were included in the study. The mean age of the patients was 52.8, 5 patients were male and 7 patients were female. 9 of the patients had acute pancreatitis due to hypertriglyceridemia for the first time ; 3 of them, 2 acute pancreatitis attacks had passed. Half of the patients had a body mass index above 30. Diabetes was observed in 7 patients in their history. 5 patients had previously diagnosed hyperlipidemi. Conclusion: Acute pancreatitis due to hypertriglyceridemia early recognition is important to reduce the morbidity and mortality associated with this disease. Plasmapheresis can be used safely in these patients with a low side-effect profile.  Since plasmapheresis may reduce the severity of pancreatitis in progressive pancreatitis, it should be used in the early period.Giriş: Akut pankreatit etiyolojisinde hipertrigliseridemi de yer almaktadır. Akut pankreatitin tetiklediği hipertrigliseridemi yanında plazmaferez ve/veya heparin tedavisi gibi farklı tedaviler uygulanabilir. Amaç: Biz bu çalışmamızda hipertrigliseridemiye bağlı oluşan akut pankreatitli hastalarımızın demografik özelliklerini, pankreatitlerinin seyrini, uygulanan tedavi yöntemlerini ve plazmaferezin etkinliğini araştırdık. Yöntem:  Ankara Atatürk Sanatoryum Eğitim ve Araştırma Hastanesi Gastroenteroloji Kliniği'nde 01 Ocak 2018-31 Aralık 2022 tarihleri arasında akut pankreatit tanısı ile servise başvuran hastalar retrospektif olarak tarandı. Bulgular: Çalışmaya toplam 12 hasta dahil edildi. Hastaların yaş ortalaması 52,8 olup, 5 hasta erkek, 7 hasta kadındı. 9 hastada ilk kez hipertrigliseridemiye bağlı akut pankreatit gelişti; 3'ü, 2'si akut pankreatit atağı geçmişti. Hastaların yarısının vücut kitle indeksi 30'un üzerindeydi. Özgeçmişinde 7 hastada diyabet gözlendi.5 hastada daha önce hiperlipidemi tanısı konmuştu. Sonuç: Hipertrigliseridemiye bağlı akut pankreatit te  erken teşhis, bu hastalıkla ilişkili morbidite ve mortaliteyi azaltmak için önemlidir. Yan etki profili düşük olan bu hastalarda plazmaferez güvenle kullanılabilir. Progresif pankreatitte plazmaferez pankreatit şiddetini azaltabileceğinden erken dönemde kullanılmalıdır

Demir Eksikliği Anemisi Nedeniyle Gastroskopi Ve Kolonoskopi Yapılan Hastalarda Malignite Sıklığının Değerlendirilmesi: Araştırma Makalesi

Aim: In this study, we aim to present the results of patients in our clinic who underwent colonoscopy and gastroscopy because of iron deficiency. Method: Patients who underwent gastroscopy and colonoscopy for the etiology screening of iron deficiency anemia in Ankara Ataturk Sanatorium Training and Research Hospital Gastroenterology Department between July 2021 and December 2022 were included in the study. Age, gender, anamnesis and endoscopic results of the patients were acquired retrospectively via investigation of patients files. SPSS 21.0 for statistical analysis Windows program used.Descriptive statistical methods(mean,standard) were used. Results: The mean age of men was 63.6±7.4 years, and the mean age of women was 58.4±8.6 years. During this period, colonoscopy was requested in 576 (20%) of 2880 patients due to the etiology of iron deficiency anemia. Of the patients, 280 (48.6%) were male and 296 (51.4%) were female. Gastroscopy was performed in 496 of the cases. Although colonoscopy was normal, there were 40 (6.9%) patients who did not undergo gastroscopy. 205 (35.6%) patients had no endoscopic finding to explain anemia and 296 (51.4%) had no colonoscopic polyps or carcinomas and no colonoscopic findings to explain anemia. Colonoscopy was normal in 98 (17%) of the patients and there was no significant feature in esophagogastroscopy. Conclusion: In the patients included in the study, polyps were detected in 52.4% of the patients and adenocarcinoma in 6.5% of the patients during colonoscopy.When investigating the cause of IDA, it should be kept in mind that there might be several underlying causes, especially if a pathology originating from the gastrointestinal tract is considered.Amaç: Bu çalışmada kliniğimizde demir eksikliği nedeniyle kolonoskopi ve gastroskopi yapılan hastaların sonuçlarını sunmayı amaçladık. Yöntem: Temmuz 2021-Aralık 2022 tarihleri ​​arasında Ankara Atatürk Sanatoryum Eğitim ve Araştırma Hastanesi Gastroenteroloji bölümünde demir eksikliği anemisi etiyoloji taraması için gastroskopi ve kolonoskopi yapılan hastalar çalışmaya dahil edildi. . Hastaların yaş, cinsiyet, anamnez ve endoskopik sonuçları retrospektif olarak hasta dosyaları incelenerek elde edildi. İstatistiksel analiz için SPSS 21.0 Windows programı kullanılmıştır. Tanımlayıcı istatistiksel yöntemler (ortalama, standart) kullanılmıştır. Bulgular: Erkeklerin yaş ortalaması 63,6±7,4, kadınların yaş ortalaması 58,4±8,6 idi. Bu dönemde 2880 hastanın 576'sına (%20) demir eksikliği anemisi etiyolojisi nedeniyle kolonoskopi istendi. Hastaların 280'i (%48,6) erkek, 296'sı (%51,4) kadındı. Olguların 496'sına gastroskopi yapıldı. Kolonoskopi normal olmasına rağmen gastroskopi yapılmayan 40 (%6,9) hasta vardı. 205 (%35,6) hastada anemiyi açıklayacak endoskopik bulgu, 296 (%51,4) hastada kolonoskopik polip veya karsinom ve anemiyi açıklayacak kolonoskopik bulgu yoktu. Hastaların 98'inde (%17) kolonoskopi normaldi ve özofagogastroskopide anlamlı bir özellik yoktu. Sonuç: Çalışmaya dahil edilen hastalarda kolonoskopi sırasında hastaların %52,4'ünde polip, %6,5'inde adenokarsinom saptanmıştır. DEA nedeni araştırılırken altta yatan birkaç neden olabileceği akılda tutulmalıdır

Presentation and management of paroxysmal nocturnal hemoglobinuria: a single-center experience

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired disorder characterized by intravascular hemolysis. Real-world experience of PNH management is largely unreported. A retrospective analysis was undertaken based on medical records from six patients with PNH [two with aplastic anemia (AA)] treated at our center, Dicle University, Turkey. Diagnosis was based on granulocyte PNH clones, ranging from 93% to 66%. All patients had symptoms consistent with PNH. One patient was managed adequately with supportive measures only. Five were treated with the complement inhibitor eculizumab. Follow-up data (<1 year) were available in four cases (the fifth had received only three infusions by final follow-up). Hemoglobin level in these four patients increased from 4.1-7.2 g/dL to 8.3-13.0 g/dL. Lactate dehydrogenase, a marker for hemolysis, decreased profoundly in the two non-AA patients, with more minor improvements in the two AA patients. Weakness and fatigue improved in all eculizumab-treated patients. Four of the five treated patients became transfusion independent, including the patient given only three infusions. In the remaining case, a patient with AA, transfusion requirement decreased, and abdominal pain and dysphagia resolved. No adverse events occurred. PNH can be successfully managed in routine practice