Koyunlarda Yemlemeden Sonra Kan Oksidan-antioksidan Denge ile Bazı Biyokimyasal Parametrelerdeki Değişimlerin Belirlenmesi

Daily variations in the concentration of urea, glutamine, glucose, cortisone, malondialdehyde (MDA) and antioxidant potential (AOP) were evaluated in the blood of sheep fed once a day. The study was carried out on 10 Anatolian Merinos sheep, average 1.5 years old and healthy. Animals were fed once per day with 61.3 % forage and 38.7 % concentrate mixture throughout the experimental period for 15 days. The blood samples were taken from the animals at first hour before and at 1, 3, 5, 7, 9, 12, 18 and 24th hours after feeding. Urea concentration decreased at first hour after feeding compared to before feeding and started augmentation after that and reached to levels before feeding at 12th hour after feeding. Glucose concentration increased at first hour after feeding compared to before feeding and started decline after that and reached to levels before feeding at 5th hour after feeding. Glutamine and cortisone concentrations decreased from at first hour to at 7th hour after feeding compared to before feeding and reached to levels before feeding at 7th hour after feeding. MDA levels decreased at first and 5th hours after feeding compared to before feeding and started increasing after 7th hour and reached significantly higher levels than before feeding in samples taken from at 12th hour to at 24th hour after feeding. While AOP increased at 3th and 9th hours after feeding, it decreased at 5, 7 and 12th hours after feeding. We concluded that the blood metabolic profiles and oxidant and antioxidant balance in sheep vary depending on time after feeding. In order to maximize the diagnostic value of these the blood metabolic profiles, the most suitable time for blood collection seems to be just before the feeding in sheep fed once a day.Bu proje çalışması, koyunlarda beslemeden sonra geçen zamana bağlı olarak kan metabolik profili ile oksidan-antioksidan dengede meydana gelen değişiklikleri tespit etmek amacıyla yapıldı. Araştırma; ortalama 1,5 yaşlı, sağlıklı 10 Anadolu Merinosu koyunda gerçekleştirildi. Hayvanlar 15 gün süren deneme boyunca % 61.3 kaba yem ve % 38.7 karma yemden oluşan rasyonla günde bir kez beslendiler. Hayvanlardan besleme öncesi ve beslemeden sonraki 1, 3, 5, 7, 9, 12, 18 ve 24. saatlerde kan örnekleri alındı. Kan örneklerinde, üre, glikoz, glutamin ve kortizol düzeyleri ile malondialdehid (MDA) ve antioksidan potansiyel (AOP) belirlendi. Üre düzeyleri besleme öncesine göre besleme sonrası ilk saatte düştü, bu saatten sonra artmaya başladı ve besleme önceki düzeylerine beslemeden sonraki 12. saatte ulaştı. Glikoz düzeyleri besleme öncesine göre beslemeden sonraki ilk saatte önemli oranda arttı, bu saatten sonra düşerek beslemeden sonraki 5. saatte besleme öncesi düzeylerine ulaştı. Glutamin ve kortizol düzeyleri besleme öncesine göre beslemeden sonraki ilk saatten 7.saate kadar önemli düzeyde düşüş gösterdi ve beslemeden sonraki 7.saatte besleme öncesi düzeylere ulaştığı bulundu. MDA düzeyleri beslemeden sonraki ilk ve 5. saat örneklerinde önemli düzeyde düşüş gösterdi ve 7. saatten sonra artmaya başlayarak 12 saatten 24. saate kadar alınan örneklerde önemli düzeyde arttığı tespit edildi. AOP beslemeden sonraki 3. ve 9. saatlerde önemli oranda artarken, 5, 7 ve 12. saatlerde önemli oranda azaldığı bulundu. Sonuç olarak, koyunlarda kan metabolik profil ile oksidan-antioksidan dengenin beslemeden sonra geçen zamana bağlı olarak değişmektedir

Effects of age on the concentrations of plasma cytokinesand lipidperoxidation in sheep

Bu çalışmanın amacı, değişik yaşlardaki koyunlarda kan sitokin düzeyleri ve lipid peroksidasyon ürünü malondialdehid (MDA) seviyesi ile tiroid hormonları düzeylerine yaşın etkilerinin belirlenmesidir. Çalışmada, aynı bakım ve besleme şartlarındaki bir sürüden kuzu (4-6 aylık, kuzu), genç (12-18 aylık) ve ergin (36-40 aylık) dişi koyun kullanıldı. Her bir yaş grubundan 10 baş olmak üzere toplam 30 koyundan sabah yemlemesinden önce kan örnekleri alındı. Kan örneklerinde MDA, glutatyon (GSH), interlökin-1 beta (IL-1β), tümör nekrozis faktör alfa (TNF-α) ve interlökin-6 (IL-6) ile T3 ve T4 düzeyleri belirlendi. Genç koyunların kuzularınkinden önemli oranda daha yüksek plazma MDA ve daha düşük IL-6 düzeylerine sahip oldukları bulundu. GSH, IL-1β, TNF-α, T3 ve T4 düzeyleri bakımından yaş grupları arasında farkın olmadığı saptandı. Sonuç olarak, koyunlarda kan lipid peroksidasyonu ve IL-6 düzeylerine yaşın etkisi olduğu söylenebilir.The aim of this study is to determine the effectsof age on blood cytokine levels and lipid peroxidationproduct malondialdehyde (MDA) levels and thyroid hormones levels in sheep of different ages. Female sheep oflamb (4-6 months), young (12-18 months) and adult (36-40 months) from a herd in same care and feeding conditions were used in the study. Blood samples were taken before morning feding from 30 sheep in total, 10 heads from each age group. MDA, glutathione (GSH), interleukin-1 (IL-1), tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6) and T3 and T4 levels were determined in blood samples. Young animals have significantly higher MDA and lower IL-6 levels than lambs. There was no difference between age groups in terms of GSH, IL-1β, TNF-α, T3 and T4 levels. As a result, age has an effect on blood lipid peroxidation and IL-6 levels in sheep

TURKISH JOURNAL of ONCOLOGY Gastrointestinal Stromal Tumors: A Single Center Experience

OBJECTIVE Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumor of the gastrointestinal (GI) tract. The aim of this retrospective study was to explore the characteristics, prognostic factors, and treatment results of GIST cases. METHODS Clinical and pathological data of 35 GIST patients at our center between 2002 and 2015 were reviewed. RESULTS Total of 18 (51.4%) were women and 17 (48.6%) were men, with median age of 54 years. Common site of tumor was stomach (48.6%). Abdominal pain (37.1%) was common clinical symptom. Risk group distribution was 8.6% low, 31.4% intermediate, and 60% high-risk cases. Mean follow-up period of the patients was 34 months. Low-risk GIST can be treated with surgery alone. Recurrence was observed in only 1 of 10 patients who received adjuvant treatment. All 6 patients in whom metastasis was determined were in high-risk group, and 4 of them had liver metastasis. Metastasis was not detected in any of the patients who had <5 mitoses per 50 high-power field (HPF), but in 5 of 12 patients who had >10 mitoses per 50 HPF, metastasis was determined. Metastasis did not correlate with site or size of tumor, but was related to high mitotic rate (p=0.015). Median overall survival of the patients was 79 months. CONCLUSION Low-risk GIST can be treated with surgery alone. Imatinib therapy significantly improves survival of high-risk or advanced-stage GIST patients. Metastasis did not correlate with site or size of tumor, but correlation with high mitotic rate was observed

Effects of boron administration on hematological parameters in rats given gentamicin

Çalışma, gentamisinin yan etkilerinden korunmak için bor (B) kullanımının hematolojik parametrelere etkilerini belirlemek amacıyla yapıldı. Toplamda 56 adet Wistar Albino erkek sıçan her grupta 7 hayvan olacak şekilde 8 gruba rastgele ayrıldı. İlk grup kontrol grubu olarak ayrılırken (borsuz yemle beslendiler), deneme grupları ise, gentamisin (100 mg/kg i.p.), B-5 (5 mg/kg B, i.p.), B-10 (10 mg/kg B, i.p.), B-20 (20 mg/kg B, i.p.), B-5 + gentamisin (5 mg/kg B ve 100 mg/kg gentamisin, i.p.), B-10 + gentamisin (10 mg/kg B ve 100 mg/kg gentamisin, i.p.), B-20 + gentamisin (20 mg/kg B ve 100 mg/kg gentamisin, i.p.) şeklinde oluşturuldu. Toplam 14 gün süren deneme döneminde, sıçanlara gentamisin enjeksiyonundan 4 gün önce B verilmeye başlandı ve denemenin 14.gününde tamamlandı.Gentamisin uygulamasına 4. gün başlandı ve deneme döneminin 12. gününde bu uygulama sonlandırıldı. Denemenin sonunda, hayvanlardan kan örnekleri anestezi altında kalpten alındı. Alınan kan örneklerinde; eritrosit, lökosit ve trombosit sayıları ile hematokrit değer, hemoglobin miktarı, ortalama eritrosit hacmi (MCV), ortalama eritrosit hemoglobini (MCH) ve ortalama eritrosit hemoglobin düzeyi (MCHC) belirlendi. Gentamisin lökosit sayısını ve hematokrit değeri düşürdü. Yüksek B uygulaması (20 mgB/kg) lökosit sayısını önemli düzeyde azalttı. Sonuç olarak, bor uygulamasının gentamisinin yol açtığı lökosit sayısındaki azalmayı önlemede etkiye sahip olmadığı kanaatine varıldı.The purpse of this study is to determine the effects of boron (B) utilisation on hematological parameters in order to protect from gentamicin side effects.Totally 56 Wistar Albinomale rats were randomly divided into eight groups containing 7 animal per group. While first group served as a control(fed a diet without boron), experimental groups were as follows; gentamicin group (100 mg/kg, i.p.), B-5 group (5 mg/kg B, i.p.), B-10 group (10 mg/kg B, i.p.), B-20 group (20 mg/kg B, i.p.), B-5 + gentamicin group (5 mg/kg B and 100 mg/kg gentamicin, i.p.), B-10 + gentamicin group (10 mg/kg B and 100 mg/kg gentamicin, i.p.), and B-20 + gentamicin group (20 mg/kg B and 100 mg/kg gentamicin, i.p.). In experimental period lasted totally 14 days,B application started to be given 4 days before injection of gentamicinto rats and was completed the fourteenth dayof the experiment. Gentamicin started to be given to rats on the fourth day and finished on the twelfth dayof the experiment. In the end of the experiment, the blood samples were taken from the animals by cardiac punctureunder anaesthesia. In the blood smaples, erythrocyte, leukocyte and platelet counts, haematocrite value, hemoglobin concentration, mean cell volume (MCV), mean cell hemoglobin (MCH), mean cell hemoglobine concentration (MCHC) were determined. Gentamicin decreased leucocyte counts and haematocrite value. High boron utilization (20 mg/kg B, i.p.) decreased significantly leucocyte counts. In conclusion, the boron supplementation has no a preventive effect on leucocyte counts reduced by gentamicin

Seasonal Association of Immune Thrombocytopenia in Adults

Saydam, Guray/0000-0001-8646-1673; GURKAN, EMEL/0000-0002-3060-4054WOS: 000362846400002PubMed: 26740892Background: Immune thrombocytopenia (ITP) is an autoimmune disorder. It is characterized by thrombocytopenia due to thrombocyte destruction mediated by auto-antibodies; however, cytotoxic and defective regulatory T-lymphocytes play an important role in its pathogenesis. While childhood ITP is usually acute, self-limiting and generally seasonal in nature, ITP in adults is usually chronic; its relation with seasons has not been studied. Aims: We investigated whether months and/or seasons have triggering roles in adults with ITP. Study Design: Descriptive study. Methods: A retrospective case review of adult patients with primary ITP diagnosed at various University Hospitals in cities where Mediterranean climate is seen was performed. Demographic data, date of referral and treatments were recorded. Corticosteroid-resistant, chronic and refractory cases were determined. Relation between sex, corticosteroid-resistant, chronic and refractory ITP with the seasons was also investigated. Results: The study included 165 patients (124 female, mean age=42.8 +/- 16.6). Most cases of primary ITP were diagnosed in the spring (p=0.015). Rates of patients diagnosed according to the seasons were as follows: 35.8% in spring, 23% in summer, 20.6% in fall, and 20.6% in winter. With respect to months, the majority of cases occurred in May (18.2%). Time of diagnosis according to the seasons did not differ between genders (p=0.699). First-line treatment was corticosteroids in 97.3%, but 35% of the cases were corticosteroid-resistant. Steroid-resistant patients were mostly diagnosed in the spring (52.1%) (p=0.001). ITP was chronic in 52.7% of the patients and they were also diagnosed mostly in the spring (62.7%) (p=0.149). Conclusion: This is the first study showing seasonal association of ITP in adults and we have observed that ITP in adults is mostly diagnosed in the spring. The reason why more patients are diagnosed in the spring may be due to the existence of atmospheric pollens reaching maximum levels in the spring in places where a Mediterranean climate is seen

Effect of peppermint supplementation to diet on rumen protozoal numbers and some ruminal parameters in sheep

Bu çalışma, koyunlarda yeme nane ilavesinin rumen protozoon sayısı ile bazı rumen ve kan parametrelerine etkisini belirlemek amacıyla yapıldı. Çalışmada 18 adet koyun kullanılmış olup, bunlar her grupta 6 adet olacak şekilde 3 gruba ayrıldı. Toplam 30 gün süren deneme periyodu boyunca, Kontrol, %2.5 Nane ve %5 Nane gruplarındaki koyunlar sırasıyla nane içermeyen, %2.5 nane ve %5 nane ilave edilmiş yemlerle beslendi. Denemenin sonunda koyunlardan rumen ve kan örnekleri alındı. Rumen örneklerinde; protozoon sayısı, pH ve amonyak düzeyleri belirlendi. Kan örneklerinde ise kan sayımı, plazma üre, glikoz, malondialdehid (MDA) ve glutasyon (GSH) düzeyleri, eritrositlerde süperoksit dismutaz (SOD) ve katalaz (CAT) enzim aktiviteleri belirlendi. Çalışmada; gruplar arasında rumen protozoon sayısı, pH ve amonyak düzeyleri bakımından istatistiksel farklar olduğu tespit edildi. Yeme nane ilavesinin hematolojik parametreler ile plazma üre, glikoz, MDA ve GSH düzeyleri, SOD ve CAT enzim aktivitelerine etkisinin olmadığı bulundu. Bu çalışmada elde edilen bulgular, koyunların yemine %5 düzeyinde nane ilavesinin hematolojik parametreler ile kan oksidan-antioksidan dengeyi etkilemeksizin rumen protozoon sayısını azalttığını gösterdi.This study was carried out to investigate the effects of dietary supplementation of peppermint on rumen protozoal numbers and some ruminal and hematological parameters in sheep. Eighteen sheep in a completely randomized desing were allocated to three treatments contained 6 sheep per group. During the experimental period (30 days), the sheep were fed to diets containing no peppermint, 2.5 % peppermint and 5% peppermint for groups of Control, 2.5%Peppermint and 5%Peppermint respectively. The rumen protozoal numbers, ruminal pH, rumen ammonia concentration, hematological parameters, plasma urea and glucose, malondialdehyde (MDA) and glutathione (GSH) concentrations, enzyme activities of superoxide dysmutase (SOD) and catalase (CAT) in ruminal and blood samples taken from sheep at the end of experiment were determined. Statistical significant differences were found in protozoal numbers, ruminal pH and rumen ammonia concentrations between three groups. Hematological parameters, concentrations of plasma urea, glucose, MDA and GSH, erythrocyte enzyme activities of SOD and CAT were not influenced by addition of peppermint to the diet. The results showed that addition of peppermint at a concentration of 5% to diet of sheep decreases ruminal protozoal numbers without affected hematological parameters and oxident-antioxident balance in the blood

Dynamic Thiol/Disulfide Balance and Ischemia Modified Albumin Levels in Patients with Polycythemia Vera

Aim: Polycythemia vera is a chronic myeloproliferative disease characterized by increased red cell mass and JAK2 mutation positivity. Transformation to myelofibrosis and acute leukemia is possible in patients with polycythemia vera. Oxidative stress causes DNA damage and might be a reason for malignant transformation. Thiol molecules can prevent the harmful effects of oxidative stress. Therefore, in this study, we aimed to analyze the state of thiol homeostasis in patients with polycythemia vera. Material and Methods: Thirty-one patients with polycythemia vera and 80 healthy volunteers were included in this study. Serum samples of the cases were stored until the end of the study. Native thiol, total thiol, disulfide, and ischemia modified albumin levels were determined. Results: The mean ischemia modified albumin (1.09±0.21 vs 0.67±0.08; p<0.001, mean disulfide (23.5±6.1 vs 10.7±2.6; p<0.001), the mean disulfide/native thiol ratio (5.6±1.1 vs 3.1±1.2; p<0.001), the mean disulfide/total thiol ratio (5.0±0.9 vs 2.9±1.0; p<0.001), the mean native thiol (418.9±80.6 vs 371.4±103.7; p=0.024), the mean total thiol (466.0±89.8 vs 393.0±105.5; p=0.001) and the mean disulfide/total thiol ratio (89.8±1.8 vs 94.1±2.0; p<0.001) were found higher in polycythemia vera patients. Ischemia modified albumin levels were also higher in high-risk polycythemia vera patients. Patients on ruxolitinib therapy had higher native thiol, total thiol and disulfide levels, and higher disulfide/native thiol and disulfide/total thiol ratios. Conclusion: Oxidative stress markers are still high in patients with polycythemia vera who were under treatment. Besides, ruxolitinib may be helpful to decrease oxidative stress in these patients

Seasonal Association of Immune Thrombocytopenia in Adults

Background: Immune thrombocytopenia (ITP) is an au-toimmune disorder. It is characterized by thrombocyto-penia due to thrombocyte destruction mediated by auto-antibodies; however, cytotoxic and defective regulatory T-lymphocytes play an important role in its pathogen-esis. While childhood ITP is usually acute, self-limiting and generally seasonal in nature, ITP in adults is usually chronic; its relation with seasons has not been studied.Aims: We investigated whether months and/or seasons have triggering roles in adults with ITP.Study Design: Descriptive study.Methods: A retrospective case review of adult patients with primary ITP diagnosed at various University Hos-pitals in cities where Mediterranean climate is seen was performed. Demographic data, date of referral and treatments were recorded. Corticosteroid-resistant, chronic and refractory cases were determined. Rela-tion between sex, corticosteroid-resistant, chronic and refractory ITP with the seasons was also investigated.Results: The study included 165 patients (124 female, mean age=42.8±16.6). Most cases of primary ITP were diagnosed in the spring (p=0.015). Rates of patients diagnosed according to the seasons were as follows: 35.8% in spring, 23% in summer, 20.6% in fall, and 20.6% in winter. With respect to months, the majority of cases occurred in May (18.2%). Time of diagnosis according to the seasons did not differ between genders (p=0.699). First-line treatment was corticosteroids in 97.3%, but 35% of the cases were corticosteroid-resis-tant. Steroid-resistant patients were mostly diagnosed in the spring (52.1%) (p=0.001). ITP was chronic in 52.7% of the patients and they were also diagnosed mostly in the spring (62.7%) (p=0.149).Conclusion: This is the first study showing seasonal as-sociation of ITP in adults and we have observed that ITP in adults is mostly diagnosed in the spring. The reason why more patients are diagnosed in the spring may be due to the existence of atmospheric pollens reaching maximum levels in the spring in places where a Medi-terranean climate is seenBackground: Immune thrombocytopenia (ITP) is an au-toimmune disorder. It is characterized by thrombocyto-penia due to thrombocyte destruction mediated by auto-antibodies; however, cytotoxic and defective regulatory T-lymphocytes play an important role in its pathogen-esis. While childhood ITP is usually acute, self-limiting and generally seasonal in nature, ITP in adults is usually chronic; its relation with seasons has not been studied.Aims: We investigated whether months and/or seasons have triggering roles in adults with ITP.Study Design: Descriptive study.Methods: A retrospective case review of adult patients with primary ITP diagnosed at various University Hos-pitals in cities where Mediterranean climate is seen was performed. Demographic data, date of referral and treatments were recorded. Corticosteroid-resistant, chronic and refractory cases were determined. Rela-tion between sex, corticosteroid-resistant, chronic and refractory ITP with the seasons was also investigated.Results: The study included 165 patients (124 female, mean age=42.8±16.6). Most cases of primary ITP were diagnosed in the spring (p=0.015). Rates of patients diagnosed according to the seasons were as follows: 35.8% in spring, 23% in summer, 20.6% in fall, and 20.6% in winter. With respect to months, the majority of cases occurred in May (18.2%). Time of diagnosis according to the seasons did not differ between genders (p=0.699). First-line treatment was corticosteroids in 97.3%, but 35% of the cases were corticosteroid-resis-tant. Steroid-resistant patients were mostly diagnosed in the spring (52.1%) (p=0.001). ITP was chronic in 52.7% of the patients and they were also diagnosed mostly in the spring (62.7%) (p=0.149).Conclusion: This is the first study showing seasonal as-sociation of ITP in adults and we have observed that ITP in adults is mostly diagnosed in the spring. The reason why more patients are diagnosed in the spring may be due to the existence of atmospheric pollens reaching maximum levels in the spring in places where a Medi-terranean climate is see

Seasonal Association of Immune Thrombocytopenia in Adults

Background: Immune thrombocytopenia (ITP) is an au-toimmune disorder. It is characterized by thrombocyto-penia due to thrombocyte destruction mediated by auto-antibodies; however, cytotoxic and defective regulatory T-lymphocytes play an important role in its pathogen-esis. While childhood ITP is usually acute, self-limiting and generally seasonal in nature, ITP in adults is usually chronic; its relation with seasons has not been studied.Aims: We investigated whether months and/or seasons have triggering roles in adults with ITP.Study Design: Descriptive study.Methods: A retrospective case review of adult patients with primary ITP diagnosed at various University Hos-pitals in cities where Mediterranean climate is seen was performed. Demographic data, date of referral and treatments were recorded. Corticosteroid-resistant, chronic and refractory cases were determined. Rela-tion between sex, corticosteroid-resistant, chronic and refractory ITP with the seasons was also investigated.Results: The study included 165 patients (124 female, mean age=42.8±16.6). Most cases of primary ITP were diagnosed in the spring (p=0.015). Rates of patients diagnosed according to the seasons were as follows: 35.8% in spring, 23% in summer, 20.6% in fall, and 20.6% in winter. With respect to months, the majority of cases occurred in May (18.2%). Time of diagnosis according to the seasons did not differ between genders (p=0.699). First-line treatment was corticosteroids in 97.3%, but 35% of the cases were corticosteroid-resis-tant. Steroid-resistant patients were mostly diagnosed in the spring (52.1%) (p=0.001). ITP was chronic in 52.7% of the patients and they were also diagnosed mostly in the spring (62.7%) (p=0.149).Conclusion: This is the first study showing seasonal as-sociation of ITP in adults and we have observed that ITP in adults is mostly diagnosed in the spring. The reason why more patients are diagnosed in the spring may be due to the existence of atmospheric pollens reaching maximum levels in the spring in places where a Medi-terranean climate is seenBackground: Immune thrombocytopenia (ITP) is an au-toimmune disorder. It is characterized by thrombocyto-penia due to thrombocyte destruction mediated by auto-antibodies; however, cytotoxic and defective regulatory T-lymphocytes play an important role in its pathogen-esis. While childhood ITP is usually acute, self-limiting and generally seasonal in nature, ITP in adults is usually chronic; its relation with seasons has not been studied.Aims: We investigated whether months and/or seasons have triggering roles in adults with ITP.Study Design: Descriptive study.Methods: A retrospective case review of adult patients with primary ITP diagnosed at various University Hos-pitals in cities where Mediterranean climate is seen was performed. Demographic data, date of referral and treatments were recorded. Corticosteroid-resistant, chronic and refractory cases were determined. Rela-tion between sex, corticosteroid-resistant, chronic and refractory ITP with the seasons was also investigated.Results: The study included 165 patients (124 female, mean age=42.8±16.6). Most cases of primary ITP were diagnosed in the spring (p=0.015). Rates of patients diagnosed according to the seasons were as follows: 35.8% in spring, 23% in summer, 20.6% in fall, and 20.6% in winter. With respect to months, the majority of cases occurred in May (18.2%). Time of diagnosis according to the seasons did not differ between genders (p=0.699). First-line treatment was corticosteroids in 97.3%, but 35% of the cases were corticosteroid-resis-tant. Steroid-resistant patients were mostly diagnosed in the spring (52.1%) (p=0.001). ITP was chronic in 52.7% of the patients and they were also diagnosed mostly in the spring (62.7%) (p=0.149).Conclusion: This is the first study showing seasonal as-sociation of ITP in adults and we have observed that ITP in adults is mostly diagnosed in the spring. The reason why more patients are diagnosed in the spring may be due to the existence of atmospheric pollens reaching maximum levels in the spring in places where a Medi-terranean climate is see

Seasonal Association of Immune Thrombocytopenia in Adults

Background: Immune thrombocytopenia (ITP) is an autoimmune disorder. It is characterized by thrombocytopenia due to thrombocyte destruction mediated by autoantibodies; however, cytotoxic and defective regulatory T-lymphocytes play an important role in its pathogenesis. While childhood ITP is usually acute, self-limiting and generally seasonal in nature, ITP in adults is usually chronic; its relation with seasons has not been studied. Aims: We investigated whether months and/or seasons have triggering roles in adults with ITP. Study Design: Descriptive study. Methods: A retrospective case review of adult patients with primary ITP diagnosed at various University Hospitals in cities where Mediterranean climate is seen was performed. Demographic data, date of referral and treatments were recorded. Corticosteroid-resistant, chronic and refractory cases were determined. Relation between sex, corticosteroid-resistant, chronic and refractory ITP with the seasons was also investigated. Results: The study included 165 patients (124 female, mean age=42.8±16.6). Most cases of primary ITP were diagnosed in the spring (p=0.015). Rates of patients diagnosed according to the seasons were as follows: 35.8% in spring, 23% in summer, 20.6% in fall, and 20.6% in winter. With respect to months, the majority of cases occurred in May (18.2%). Time of diagnosis according to the seasons did not differ between genders (p=0.699). First-line treatment was corticosteroids in 97.3%, but 35% of the cases were corticosteroid-resistant. Steroid-resistant patients were mostly diagnosed in the spring (52.1%) (p=0.001). ITP was chronic in 52.7% of the patients and they were also diagnosed mostly in the spring (62.7%) (p=0.149). Conclusion: This is the first study showing seasonal association of ITP in adults and we have observed that ITP in adults is mostly diagnosed in the spring. The reason why more patients are diagnosed in the spring may be due to the existence of atmospheric pollens reaching maximum levels in the spring in places where a Mediterranean climate is seen