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Biomedical subjects

Hakan Ozdogu

Publications and source records attributed to Hakan Ozdogu.

12 recordsLinked to original sources
PubMed2007

Lemierre syndrome variant: Staphylococcus aureus associated with thrombosis of both the right internal jugular vein and the splenic vein after the exploration of a river cave.

BACKGROUND: Lemierre syndrome is a rare and potentially fatal entity characterized by septic emboli from thrombosis of the internal jugular vein after oropharyngeal infection. The etiologic agent is not always an anaerobic bacterium. We report a patient with a Lemierre syndrome variant who presented with thrombosis of both the right internal jugular vein and the splenic vein as well as septic pulmonary emboli caused by Staphylococcus aureus, which proved resistant to methicillin, amoxicillin, and ciprofloxacin. The patient was thought to have acquired the infection during the exploration of a river cave in Turkey 10 days before his admission to the hospital. Such caves are natural reservoirs of infectious microorganisms. METHODS: The patient had a physical examination, coagulation screening tests, tests of thrombin generation and fibrinolysis, coagulation inhibitors, activated protein C resistance, early and late serological tests (including autoantibodies), computed tomographic studies of the chest and abdomen, and bacterial examination of peripheral blood. Bacterial investigations were made on samples collected from the river cave. RESULTS: After having undergone a 6 week course of antimicrobial treatment and anticoagulant therapy, the patient recovered from the infection with no residual complications, and the signs and symptoms of Lemierre syndrome resolved. CONCLUSION: The results probably indicate an exposure of the patient to soil-based Staphylococcus aureus. This observation suggests the action of environmental factors that may contribute to the development of this rare syndrome.

Adult↗
PubMed2007

A dramatic response to rituximab in a patient with resistant thrombotic thrombocytopenic purpura (TTP) who developed acute stroke.

BACKGROUND: Refractory condition can occur in 10-30% of all cases of thrombotic thrombocytopenic purpura despite increased frequency of total plasma exchange. Rituximab can affect the clinical outcome of the refractory cases. However, little is known about usefulness of rituximab on central nervous system involvement mimicking acute ischemic stroke. METHODS: We report the case of a woman with refractory thrombotic thrombocytopenic purpura who developed an acute onset right sided paralysis, dysarthria, and central facial paralysis, suggestive of cerebrovascular accident while under plasma exchange, corticosteroid, and vincristine therapy. RESULTS: After initiation of rituximab (375 mg/m(2) weekly for 4 weeks), a dramatic response occurred and the patient's neurologic function recovered fully within days. Sustained remission was achieved, and the patient was well 1 year after her admission, while she was on azathioprine treatment. CONCLUSION: This report suggests that rituximab can provide a good outcome of the dramatic central nervous system involvement in patients with thrombotic thrombocytopenic purpura.

Adult↗
PubMed2007

The apoptosis of blood polymorphonuclear leukocytes in sickle cell disease.

BACKGROUND: The apoptosis of human polymorphonuclear leukocytes (PMNs) in patients with sickle cell disease (SCD) is not well understood. The goal of this study was to examine the apoptosis of PMNs in patients with SCD and in controls. METHODS: Flow cytometric quantitation of PMN apoptosis was performed in 17 patients during and after sickle cell vasoocclusive crisis and in 17 healthy volunteers. Plasma nitric oxide concentrations were also measured in patients with SCD. RESULTS: The mean of annexin-V and annexin-V/PI staining (early and late apoptotic cells) increased to a greater degree in patients with SCD than in healthy controls for patients with SCD during and after vasoocclusive crisis. The mean of PI staining showing dead cells was higher only in patients after SCD crisis than in healthy controls. In the SCD groups during and after vasoocclusive crisis, there was no difference between PMN apoptosis levels. Furthermore, plasma nitric oxide concentrations were not correlated with PMN apoptosis. CONCLUSIONS: There was an evidence that the alteration of blood PMN apoptosis could contribute to the pathogenetic mechanisms of vasoocclusion in patients with SCD. This can be attributed to the effects of numerous inflammatory mediators rather than simply the effects of nitric oxide.

Adolescent↗
PubMed2006

Long-term colchicine therapy in a patient with Behçet's disease and acute promyelocytic leukemia.

Behçet's disease causes a continuous T-lymphocytic mediated inflammatory reaction in the small arterioles, which results in gradual destruction of any human organ or system. The benefit of treatment with colchicine in patients with Behçet's disease has been reported in literature. Acute leukemia has seldom been associated with Behçet's disease, although acute promyelocytic leukemia is a particular subtype of leukemia that is often characterized by special cytogenetic abnormalities. We report a male patient with acute promyelocytic leukemia and Behçet's disease who had received long-term treatment with colchicine. To our knowledge, this is the first report of the concomitant occurrence of acute promyelocytic leukemia and Behçet's disease, which suggests that long-term colchicine therapy has a role in the pathogenesis of acute promyelocytic leukemia. The patient described has been treated with retinoic acid and idarubicin (the ATRA-IDA protocol). At the time of this writing, his disease is in clinical remission.

Adult↗
PubMed2006

Wegener's granulomatosis with a possible thyroidal involvement.

Wegener's granulomatosis (WG) is an autoimmune disorder characterized by the involvement of many organ systems. In patients with refractory disease, the efficacy of cyclophosphamide, corticosteroids and infliximab has been reported recently. Even in cases with serological response, disease progression has still been observed. Herein, we report a case of WG, most likely accompanied with subacute granulomatous thyroiditis while the patient was on cyclophosphamide, corticosteroid and infliximab therapy. As far as we know, this is the first time that such a copresentation has been observed, suggesting that mechanisms other than T-cell-mediated cytotoxicity may be important in the pathogenesis of granulomatous thyroiditis.

Adrenal Cortex Hormones↗
PubMed2005

Aplastic anemia in a professional musician exposed to instrument polish.

Chemicals are known to cause toxin-induced aplastic anemia. However, some chemicals documented in only a few cases to possess only a possibility of toxic potential may also be responsible for the development of aplastic anemia. This report presents a case of a string musician with bone marrow failure. The patient used a certain type of polish (komalak) to shine his musical instrument and did this frequently. He presented with nasal bleeding, and a workup on admission revealed pancytopenia. Aplastic anemia was diagnosed on the basis of bone marrow histology results. An analysis for gene polymorphism related to the metabolic detoxification enzymes glutathione S-transferase and N-acetyltransferase 2 indicated that the patient was genetically susceptible to developing toxicity. This case suggests that frequent use of this polish may cause a toxic effect that leads to bone marrow failure. Musicians should be made aware of the risks associated with these types of chemicals.

Adult↗
PubMed2005

Bone marrow necrosis: a rare complication of herbal treatment with Hypericum perforatum (St. John's wort).

A 22-year-old man presented with fever and ulceration of the oral mucosa. The patient had pharyngeal and esophageal candidiasis. For the 3 weeks prior to presentation, he had been taking approximately 1000 mg/day of flowering herbs (Hypericum perforatum L, known as St. John's wort) for treatment of depression. A complete blood count on the first day of hospitalization showed agranulocytosis and normocytic anemia. His condition worsened, and he developed progressive dysphagia. A bone marrow biopsy on day 3 revealed bone marrow necrosis. After the diagnosis was established (day 3 of hospitalization), treatment with granulocyte colony-stimulating factor 48 U/day, intravenous immunoglobulin 400 mg/kg, and amphotericin B 100 mg/day was initiated. The patient did not respond, and died within one week of the diagnosis. This cases suggests that Hypericum species may lead to severe hematologic toxicity, with conditions involving bone marrow necrosis.

Adult↗
PubMed2004

Partial splenic embolization in myelodysplastic syndrome associated with immune thrombocytopenia.

BACKGROUND: Currently, all treatments for patients with myelodysplastic syndrome (MDS) are still experimental. Supportive care, including treatment of infection and transfusion of blood and blood-related products, remains the most important aspect of therapy in these cases. This article discusses the results of partial splenic embolization in a patient who had MDS with refractory anemia. METHODS: The patient was placed under observation and was given supportive treatment. In addition to MDS with refractory anemia, there were management difficulties related to severe thrombocytopenia after alloimmunization from multiple blood transfusions. Therefore it is thought that partial splenic embolization might be an alternative treatment for the management thrombocytopenia. RESULTS: Although the patient did not live long because of the sepsis and ileus, hematologic response was obtained. CONCLUSION: The observation during the treatment in this case suggests that partial splenic embolization may be a valid new alternative for treating thrombocytopenia due to alloimmunization.

Aged↗
PubMedDate not supplied

Fatal cardiac tamponade in a patient with Kawasaki disease.

Kawasaki disease (KD) is usually a self-limiting condition, but cardiac complications are not uncommon and can lead to significant morbidity and mortality. This article describes the case of an 18-year-old man with rapidly progressive and ultimately fatal KD. Polyserositis syndrome and cardiac tamponade developed during a convalescent phase of the illness. Treatment with high-dose corticosteroid and intravenous immunoglobulin-G therapy was unsuccessful. The patient continued to deteriorate despite supportive care. Severe cardiac tamponade developed, and percutaneous pericardiocentesis was performed, but the patient died hours later. This is the second reported case of KD featuring a polyserositis syndrome and impending cardiac tamponade, and the first with fatal outcome.

Adolescent↗