Papers by Meryem Albayrak
Türkiye çocuk hastalıkları dergisi, 2012
Baylor University Medical Center Proceedings
Upper gastrointestinal (UGI) bleeding due to gastric ulcer and gastritis can be seen in severely ... more Upper gastrointestinal (UGI) bleeding due to gastric ulcer and gastritis can be seen in severely ill or premature infants but is rarely reported in healthy term newborns. UGI endoscopy is crucial for the etiological evaluation and appropriate treatment of UGI hemorrhages. This report discusses the differential diagnosis and treatment approach in a previously healthy infant who was admitted to the neonatal intensive care unit due to life-threatening severe UGI bleeding causing hemodynamic instability.
Gazi Medical Journal, 2009
Myelosuppression is a serious complication during treatment of acute lymphoblastic leukemia and t... more Myelosuppression is a serious complication during treatment of acute lymphoblastic leukemia and the duration of myelosuppression is affected by underlying bone marrow failure syndromes and drug pharmacogenetics caused by genetic polymorphisms. Mutations in the thiopurine S-methyltransferase (TPMT) gene causing excessive myelosuppression during 6-mercaptopurine (MP) therapy may cause excessive bone marrow toxicity. We report the case of a 15-year-old girl with TALL who developed severe pancytopenia during consolidation and maintenance therapy despite reduction of the dose of MP to 5% of the standard dose. Prednisolone therapy produced a remarkable but transient bone marrow recovery. Analysis of common TPMT polymorphisms revealed TPMT *3A/*3C.
Pediatric Hematology and Oncology, Mar 31, 2014
Menorrhagia is an important health problem in women of reproductive age. The aims of this study w... more Menorrhagia is an important health problem in women of reproductive age. The aims of this study were to assess the prevalence of menorrhagia and hemostatic abnormalities associated with menorrhagia in university students. The pictorial blood assessment chart (PBAC) was used to identify students with menorrhagia. Those with a PBAC score > 100 were examined by pelvic ultrasound and laboratory tests including complete blood count, levels of clotting factors, von Willebrand factor antigen, and ristocetin cofactor activity and Platelet Function Analyser-100 (PFA-100). Platelet aggregation was studied in students with prolonged PFA-100 closure time. Menorrhagia was identified in 82 (21.8%) of 376 students. Six of 82 students who had pelvic pathologies were excluded. Eleven (14.5%) of the remaining 76 students were found to have bleeding disorders, including von Willebrand disease in five (6.5%), platelet function disorder in four (5.2%), and clotting factor deficiencies in two (2.6%). Menorrhagia is a common but mostly unrecognized and untreated problem among university students. Underlying bleeding disorders are not rare and require comprehensive hemostatic evaluation for identification.
Biological Trace Element Research, May 23, 2008
Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, Aug 31, 2018
British journal of medicine and medical research, Jan 10, 2015
A 19 year-old boy admitted with pain and discoloration on his chest wall 18 months after a Nuss p... more A 19 year-old boy admitted with pain and discoloration on his chest wall 18 months after a Nuss procedure performed for pectus excavatum deformity. His physical examination revealed that this skin lesion was an ecchymosis. We diagnosed a very rare bleeding disorder due to Factor VII deficiency which is a recessively inherited coagulation disorder where even spontaneous bleedings may be seen. We aimed to discuss the management of the patient, if it had been diagnosed preoperatively and the preoperative preparation before the bar removal.
Indian Journal of Pediatrics, Mar 2, 2023
Journal of medicine and palliative care, Jun 28, 2022
Munchausen syndrome (MS) is a condition in which a patient deliberately mimics signs and symptoms... more Munchausen syndrome (MS) is a condition in which a patient deliberately mimics signs and symptoms of health problems to gain attention from their close circle and healthcare professionals. Symptoms can be self-induced or fabricated. The paper aimed to discuss MS detected in an adolescent girl who presented with hematological findings and shift the interest to factitious disorders that may be confronted in pediatric practice. A thirteen-year-old girl was admitted to the pediatric hematology outpatient clinic with bruises spread throughout the body, predominantly localized on the arms, persisting for three months and disappearing every two weeks. She had complaints of fatigue and loss of appetite, emerging simultaneously with the occurrence of bruises. Following elaborative examinations, we discovered that the patient was painting bruises on her skin using an eye shadow. MS needs to be considered in differential diagnoses among patients with long-term, inconsistent, and irrational complaints, no underlying causes, and normal laboratory findings. Overall, we presented the case to underline that MS is likely to be confronted in pediatric practice.
Journal of health sciences and medicine, Jan 17, 2022
Aim: Epistaxis may be a symptom of an inherited bleeding disease.. We aimed to analyze an approve... more Aim: Epistaxis may be a symptom of an inherited bleeding disease.. We aimed to analyze an approved pediatric bleeding score (PBS) as a screening test for von Willebrand Disease (VWD) in children with epistaxis Material and Method: We retrospectively reviewed the medical records of pediatric patients, who applied to the Pediatric Hematology Department with the complaint of epistaxis between January 2018 and December 2019. Results: One hundred and sixty eight patients enrolled in this study There were 65(38.7%) girls and 103(61.3%) boys, with a mean age of 114±49 months (range 8 months to 18 years).The PBS of 34 patients was greater than/ or equal to 2. Factor 8, von Willebrand factor antigen, and von Willebrand Ristocetin cofactor levels were significantly lower in patients with PBS≥2 compared to those in patients with PBS<2 (%73±43 vs % 91±29, p=0.03; 87±44 vs 106±29 IU/dl, p=0.03; 72±39 vs 98±30 IU/ dl, p=0.001, respectively). While 15 (44%) of 34 patients with PBS ≥ 2 diagnosed VWD, but in the group with PBS<2, VWD was diagnosed for only 4 children (0.02%) (4/134). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PBS for diagnosis of VWD was 79.0%, 87.2%, 44%, and 97% respectively. Conclusion: PBS could be integrated into the evaluation of children suspected of having a bleeding disorder such as VWD in pediatrician's offices. Our cut off value 2 appears to be significant in exclusion of VWD, since its high negative predictive value.
Anatolian Current Medical Journal, Sep 24, 2021
Aim: The present study aimed to investigate the iron store status in patients with hypothyroidism... more Aim: The present study aimed to investigate the iron store status in patients with hypothyroidism due Hashimoto thyroiditis and subclinical hypothyroidism. Material and Method: We retrospectively reviewed the medical records of patients who were followed up at our university hospital with the diagnosis of hypothyroidism due to Hashimoto thyroiditis and subclinical hypothyroidism between 2010-2021. Results: Nineteen patients with Hashimoto thyroiditis, 17 with subclinical hypothyroidism, and 20 controls were enrolled in this study. There was no significant difference in mean age among three groups (138.3±46.8 months, 116.0±68.1 months, 151.8±50.3 months in groups of Hashimoto thyroiditis, subclinical hypothyroidism and controls respectively p=0.169). There was a significant female preponderance in HT group (68.5%, p=0.001). There was no significant difference for mean ferritin levels among groups (p=0.440). There was no correlation between TSH and ferritin level (r=-0.132, p=0.410) but we found a positive correlation between ferritin and free T4 level (r=0.340, p=0.030). Conclusion: We found a positive relationship between ferritin and thyroxine hormone that made us think that iron supplementation may be effective in the treatment of hypothyroidism. But this hypothesis warrants further prospective and experimental studies.
Leukemia Research, Oct 1, 2019
Fanconi Anemia and other inherited bone marrow failure syndromes Background: Neutropenia in infan... more Fanconi Anemia and other inherited bone marrow failure syndromes Background: Neutropenia in infancy and childhood poses a diagnostic challenge as the etiology ranges from acute life-threatening conditions to chronic benign diseases. Primary autoimmune neutropenia (PAN) in children is presented by severe neutropenia, but mild bacterial infections and spontaneous resolution. Anti-granulocyte antibody (AGA) testing is necessary or helpful in establishing the diagnosis. But detection of these antibodies frequently remains difficult. Here we report 2 cases with PAN who were diagnosed in AGA. Case report: Case 1: A 10-month-old female patient presented with fever, nasal discharge. Complete blood count results are as follows, Hb 12.7 g/dl, white blood cells 4.9×10 3 /μL, absolute neutrophil count (ANC) 0.8×10 3 /μL, platelets (PLT) 248×10 3 /μL. During the follow-up the patient was understood to have severe neutropenia when there was no infection, but has increase in ANC during infections. Serum IgG, IgM and IgA levels were normal. Additional samples were taken and sent to an off-site laboratory for congenital neutropenia mutations. Results were negative for all the known mutations. AGA were found to be positive. Patient is under follow up without treatment. Case 2: Neutropenia was detected at 9 months during a regular visit (ANC 0.9×10 3 /μL). The baby had bronchiolitis for 3 times and otitis for two times and one hospitalization. The patient's growth and development were appropriate for his age. There was consanguinity between parents. During the follow-up, he had ANC levels mostly between 0.1-0.2×10 3 /μL. For twice ANC >1×10 3 /μL was detected in the samples taken during the infection period. Bone marrow aspiration was performed at the age of one and was unrevealing. Cytogenetic analysis from the bone marrow was normal. Congenital neutropenia mutations were negative. The patient's AGA was found to be positive. PAN has a benign, self-limited course and early diagnoses in AGA prevents unnecessary work-up and interventions. Both the cases tested positive for anti-neutrophil antibodies. Conclusion: PAN is a rare disease in children. In most cases the diagnosis is suspected in a neutropenic patient after exclusion of other causes. In both our cases, absolute neutrophil count in the blood stream during acute infections were over 1×10 3 /μL. Patients remained neutropenic outside these periods. AGA is helpful in diagnoses of PAN patients. PAN has a benign, selflimited course and early diagnoses in AGA prevents unnecessary work-up and interventions.
Turkiye Klinikleri Journal of Pediatrics, 2006
PubMed, May 23, 2013
Bezoar is the accumulation of indigestible foreign substances in the digestive tract and a rare c... more Bezoar is the accumulation of indigestible foreign substances in the digestive tract and a rare cause of intestinal obstruction in children. The accumulation of stones within the digestive system is called lithobezoar, and the colon is the rarest site for accumulation. A 13-year-old female patient was admitted to our hospital with colicky abdominal pain and constipation. She had been unable to pass her stool for the last six days and had passed stones-containing stools previously. She had a history of pica and iron-deficient anemia. The case is presented to discuss the diagnostic and therapeutic features of partial colonic obstruction secondary to colonic lithobezoar accumulation.
Turkish Journal of Hematology, 2014
Ultrasound in Obstetrics & Gynecology, 2021
Turkish Journal of Hematology, 2020
Objective: Immune thrombocytopenia (ITP) is a rare autoimmune disease and hematologic disorder ch... more Objective: Immune thrombocytopenia (ITP) is a rare autoimmune disease and hematologic disorder characterized by reduced platelet counts that can result in significant symptoms, such as bleeding, bruising, epistaxis or petechiae. The thrombopoietin receptor agonist, eltrombopag is second-line agents used to treat chronic immune thrombocytopenia purpura in adults and children. Methods: The aim of the present study was to evaluate the efficacy, safety and side effects, especially iron deficiency of eltrombopag treatment in pediatric patients with acute refractory and chronic immune thrombocytopenia. Results: The diagnosis was chronic ITP in 89 patients and acute refractory ITP in 16 patients. The mean age of patients was 9.5 ± 4.5 years (1.2-18 years) at the beginning of EPAG treatment. Overall response rate was 74.3 %(n:78). The mean time for Plt count ≥50×10 9 /L was 11.6 ±8 weeks (range 1-34 weeks). The treatment was stopped in 27 patients (25.7%) on an average of 6.8±9 months (range 1-38 months). The reason for discontinuation was lack of response in 18 patients, nonadherence in 4 patients, and hepatotoxicity in 2 patients. Response to treatment continued for average of 4 months after cessation of EPAG in 3 patients. Conclusion: Results of the current study imply that eltrombopag is an effective therapeutic option in pediatric patients with acute refractory and chronic ITP. However, patients must be closely monitored for response and side effects especially iron deficiency during treatment.
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Papers by Meryem Albayrak