Browsing by Author "Akgun, Cihangir"

Now showing 1 - 20 of 33

A 3-Day Boy With a Right Preauricular Swelling
(Springer, 2010) Akgun, Cihangir; Peker, Erdal; Akbayram, Sinan; Dogan, Murat; Tuncer, Oguz; Kirimi, Ercan
A 3-day-old boy was admitted for right preauricular swelling. Examination showed a toxic looking neonate with poor neonatal reflexes. There was erythema and swelling of 4 x 3 cm at the level of the right cheek. Laboratory investigation pointed to a bacterial infection. With parenteral antibiotics, the lesion resolved completely.
Acquired Methemoglobinemia Due To Application of Prilocaine During Circumcision
(Elsevier Science inc, 2012) Akbayram, Sinan; Akgun, Cihangir; Dogan, Murat; Gundogdu, Mustafa; Caksen, Huseyin; Oner, Ahmet Faik
Acute Appendicitis in Two Children With Henoch-Schonlein Purpura
(Maney Publishing, 2012) Bilici, Salim; Akgun, Cihangir; Melek, Mehmet; Peker, Erdal; Akbayram, Sinan; Bulut, Gulay; Dogan, Murat
In Henoch-Schonlein purpura (HSP), involvement of the ileum and ascending colon with vasculitis can mimic appendicitis and cause unnecessary appendicectomy. A 13-year-old boy presented with signs of HSP and abdominal pain. He was treated with prednisolone (2 mg/kg/day) for 10 days, but there was no improvement. At laparotomy he had acute suppurative appendicitis. A 12-year-old girl presented with HSP associated with abdominal pain and bloody diarrhoea and at laparotomy was also found to have suppurative appendicitis. Both patients had vasculitic areas in the ileum. In HSP, although suppurative appendicitis is rare, it should always be considered and appropriate investigations, including ultrasonography, undertaken.
Acute Hepatotoxicity Due To Clonazepam in a Girl Using Oxcarbazepine
(Elsevier Science Bv, 2013) Akbayram, Sinan; Aktar, Fesih; Akgun, Cihangir; Caksen, Huseyin
Acute Itp Due To Insect Bite: Report of 2 Cases
(Sage Publications inc, 2011) Akbayram, Sinan; Akgun, Cihangir; Dogan, Murat; Caksen, Huseyin; Oner, Ahmet Faik
Immune thrombocytopenic purpura (ITP) of childhood is a common hematologic disorder. Immune thrombocytopenic purpura is characterized by increased destruction of antibody-coated platelets in the reticuloendothelial system. In the majority of children with acute ITP, thrombocytopenia occurs within 1 to 3 weeks after an infectious disease. Immune thrombocytopenic purpura may also occur after rubella, rubeola, chickenpox, or live virus vaccination. Here we report 2 cases with acute ITP that were developed after honeybee and insect bite.
An Analysis of Children With Brucellosis Associated With Isolated Thrombocytopenia
(Sage Publications inc, 2011) Akbayram, Sinan; Dogan, Murat; Akgun, Cihangir; Peker, Erdal; Parlak, Mehmet; Oner, Ahmet Faik
Hematologic abnormalities of mild anemia and leucopenia have been frequently associated with acute brucellosis, but thrombocytopenia are less frequently seen. In the present study, we documented 5 (2.6%) isolated thrombocytopenic patients with the manifestations of brucellosis observed during the course of active infection. Five (2.6%) patients, 4 boys and 1 girl, with ages ranging from 2 to 14 years, had isolated thrombocytopenic at diagnosis. In 5 (2.6%) patients, platelet counts ranged from 39 000 to 120 000/mm(3). Tube agglutination tests for brucellosis were positive for all patients (1/160-1/1280). All patients recovered completely, and their thrombocytopenia returned to normal by 2 to 4 weeks after antibiotic treatment of brucellosis. In our study, we present 5 patients with Brucella-induced thrombocytopenia mimicking idiopathic thrombocytopenic purpura to emphasize the isolated thrombocytopenia and the resolution of thrombocyte counts following treatment of brucellosis.
An Analysis of Children With Brucellosis Associated With Pancytopenia
(informa Healthcare, 2011) Akbayram, Sinan; Dogan, Murat; Akgun, Cihangir; Peker, Erdal; Parlak, Mehmet; Caksen, Huseyin; Oner, Ahmet Faik
Brucellosis produces a variety of nonspecific hematologic abnormalities. Hematologic complications of mild anemia and leukopenia have been frequently associated with acute brucellosis, but pancytopenia is less frequently seen. In this study, records of children with brucellosis aged under or equal to 16 years, admitted to Yuzuncu Yil University Hospital between 2004 and 2010, were analyzed retrospectively. Over this time period, 187 patients with brucellosis were diagnosed. Twenty-five (13.3%%) of 187 patients had pancytopenia during admission to hospital. The diagnosis of brucellosis was confirmed by standard tube agglutination test in all patients; titers were 1:320 in 1 patient and 1:1280 in 24 patients. Blood culture was positive for Brucella melitensis in 3 patients (12%%). Fever was the most common manifestation, followed by malaise, anorexia, sweating, and weight loss. Fever and splenomegaly were the common signs in most patients. In addition, arthritis was observed in 5 patients, and epistaxis, headache, and abdominal pain were observed in 3 patients. The common bone marrow aspiration findings consisted of increased megakaryocytes and hyperplasia of erythroid series, with a shift to the left of the granulocytic series. Histiocytic hyperplasia was observed in the bone marrow smear of 2 patients. Mild hemophagocytosis was observed in the bone marrow of 3 patients. All patients recovered completely, and their peripheral blood counts returned to normal by 2 to 6 weeks after antibiotic treatment of brucellosis. In conclusion, the authors would like to emphasize that brucellosis should be considered in the differential diagnosis of children with pancytopenia.
The Association of Oxidant Status and Antioxidant Capacity in Children With Acute and Chronic Itp
(Lippincott Williams & Wilkins, 2010) Akbayram, Sinan; Dogan, Murat; Akgun, Cihangir; Mukul, Yurdaguel; Peker, Erdal; Bay, Ali; Oner, Ahmet Faik
Purpose: This study was undertaken to investigate oxidant and antioxidant systems in patients with immune thrombocytopenic purpura (ITP). With this purpose, we measured the levels of serum malondialdehyde (MDA), total antioxidant capacity (TAC), total oxidant status (TOS), and other oxidative stress parameters. Patients and Methods: Fifty-two pediatric patients with ITP (25 acute, 27 chronic) and 21 healthy children were included in the study. Patients with acute ITP were studied, before and after, methylprednisolone treatment. Results: Hemoglobin, hematocrit, platelet count, and TAC were statistically significantly lower in patients with acute ITP before treatment than those in the control group (P<0.05). In addition, in this group, MDA, TOS levels, and OSI (oxidative stress index) were found to be higher than those in the control group. In chronic ITP group, although hemoglobin hematocrit, platelet counts, and TAC levels were statistically significantly lower than those in the control groups, the mean platelet volume, MDA, TOS, and OSI were found to be statistically significantly higher (P<0.05). Platelet count and mean platelet volume values were statistically significantly lower in patients with acute ITP before treatment than after treatment (P<0.05). We also found a positive correlation between thrombocyte count and TAC, in patients with acute ITP before treatment (r: 0.601, P<0.001) and acute ITP after treatment (r: 0.601, P<0.001) and chronic ITP (r: 0.601, P<0.001). A negative correlation was found between thrombocyte count and serum MDA levels, in patients with acute ITP before treatment (r: -0.356, P<0.001) and acute ITP after treatment (r: -0.356, P<0.001) and chronic ITP (r: -0.356, P<0.001). We also found a negative correlation between thrombocyte count and serum OSI, in patients with acute ITP before treatment (r: -0.494, P<0.001) and acute ITP after treatment (r: -0.494, P<0.001) and chronic ITP (r: -0.494, P<0.001). A negative correlation was found between thrombocyte count and TOS, in patients with acute ITP before treatment (r: -0.470, P<0.001) and acute ITP after treatment (r: -0.470, P<0.001) and chronic ITP (r: -0.470, P<0.001). In conclusion, increased MDA, TOS and OSI, and decreased TAC levels were found in patients with acute and chronic ITP. Conclusions: On the basis of these findings, we suggest that free oxygen radicals may have an effect on the structural and functional damage of platelets, and on the mechanism of thrombocytopenia in both, acute and chronic ITP.
Atypical Presentation of Herpes Zoster in a Case With Acute Myeloblastic Leukemia
(Elsevier Science Bv, 2013) Aktar, Fesih; Akbayram, Sinan; Akdeniz, Necmettin; Aktar, Sirac; Akgun, Cihangir; Dogan, Murat; Oner, Ahmet Faik
Herpes zoster (HZ) is often associated with painful erythematous vesicular eruptions of the skin or mucous membranes. Approximately 10% to 30% of the population will suffer from HZ during their lifetime. HZ is infrequent in healthy children. However, diminished cellular immunity seems to increase risk of reactivation because incidence increases with age and in immunocompromised states. We report a 7 year old girl with acute myeloblastic leukemia HZ infection on the right palmar, elbow and forearm region (C7, C8 and T1 dermatomes). We want to indicate unusual localization of HZ on the acute myeloblastic leukemia child patient.
Benidipine Hydrochloride Intoxication in a Child
(Elsevier Science inc, 2012) Akbayram, Sinan; Akgun, Cihangir; Dogan, Murat; Geylani, Hadi; Sari, Nesim; Taskin, Alparslan Gokmen; Caksen, Huseyin
A Case of Chediak-Higashi Syndrome Presented With Hemophagocytic Lymphohistiocytosis
(Akad Doktorlar Yayinevi, 2011) Akbayram, Sinan; Akgun, Cihangir; Basaranoglu, Murat; Kaya, Avni; Balta, Gunay; Ustyol, Lokman; Oner, Ahmet F.
Chediak Higashi syndrome, is a rare autosomal recessive disorder characterised by oculocutaneus albinism, recurrent respiratory system infections and other pyogenic infections. Hemophagocytic lymphohistiocytosis can develop in any time of the life in patients with Chediak Higashi syndrome. A 14-month-old girl patient was diagnosed as hemophagocytic lymphohistiocytosis with the laboratory findings of pancytopenia, high levels of triglyceride and ferritin, hypofibrinogenemia, low ratio of natural killers in lymphocyte subtypes, and with determined macrophages that made hemophagocytosis in recurrent bone marrow aspirates. The treatment protocol of hemophagocytic lymphohistiocytosis 2004 was administered. During the maintenance treatment, recurrence was developed. In the second bone marrow examination, the diagnosis of Chediak Higashi syndrome was made with determined intracytoplasmic giant granules. Hair analysis result was meaningful for Chediak Higashi syndrome. In this report, we would like to emphasize the condition that especially in early infants, Chediak Higashi syndrome presenting with hemophagocytic lymphohistiocytosis may be misdiagnosed because of the uncertain clinical findings and this can be the result of resistance to treatment.
A Case of Immune Thrombocytopenic Purpura Presenting With Intracranial Hemorrhage
(Elsevier Science Bv, 2013) Akbayrami, Sinan; Aktar, Fesih; Akgun, Cihangir; Bektas, Mehmet Selcuk; Caksen, Huseyin; Onert, Ahmet Faik
Immune thrombocytopenic purpura is an acute, generally considered a self-limiting benign disorder with a 60%-80% change of spontaneous recovery occurring usually within a few months after onset. Intracranial hemorrhage is a rare but life-threatening complication of childhood immune thrombocytopenic purpura. We report a 4-year-old girl who admitted with headache, vomiting, bleeding from noise and bruises on the extremities. Her neurological examination was normal. Based on laboratory finding she was diagnosed immune thrombocytopenic purpura and intracranial hemorrhage. We suggest that cranial imaging should be perform in patients with immune thrombocytopenic purpura admitted with bleeding symptoms, vomiting and headache even if they had no abnormal neurological signs.
A Case of Leptospirosis With Multiple Organ Dysfunction
(Aves Yayincilik, Ibrahim Kara, 2010) Okur, Mesut; Akgun, Cihangir; Bektas, Mehmet Selcuk; Kaya, Avni; Temel, Hayrettin; Acikgoz, Mehmet; Dogan, Sekibe Zehra
Leptospirosis is a zoonotic infection caused by a spirochete of the genus Leptospira, which may affect both humans and animals and is common worldwide. The disease may lead to distinct clinical pictures in humans varying from subclinical infection to multiple organ dysfunction and even death. In this paper, we presented a 8-year-old male patient admitted with the complaints of fever, malaise, fatigue and night sweating, who had been feeding a pet rabbit in the house, and who had jaundice of the sclera and skin, a rash, gastrointestinal bleeding and hepatosplenomegaly found on examination. He developed encephalopathy, bleeding diathesis, hepatic and renal failure; and was diagnosed with leptospirosis based on the clinical symptoms and laboratory tests. After 14-days of therapy with crystallized penicillin and intensive supportive treatment, the neurological and hematological anomalies improved as well as the renal and hepatic dysfunction. In conclusion, we would like to emphasize that the probability of leptospirosis should be considered in children presenting with jaundice, encephalopathy, multiple organ dysfunction and bleeding diathesis if there are any environmental risk factors.
A Case of Leukocytoclastic Vasculitis With Membranoproliferative Glomerulonephritis
(Duzce Univ, 2013) Akgun, Cihangir; Kaya, Avni; Akbayram, Sinan; Tuncer, Oguz; Okur, Mesut; ArsIan, Sukru; Ozen, Suleyman
Henoch-Schonlein purpura is the most common vasculitis in childhood with the pathogenesis of immunoglobulin A deposition in small-vessel wall. As the end-organ vasculature involved, this disease is characterized by palpable purpura, abdominal pain, arthritis, and renal disease. Renal involvement may present with isolated haematuria and/or proteinuria from mild to severe as nephrotic levels. Membranoproliferative glomerulonephritis is the most common cause of chronic glomerulonephritis in older children and young adults and also one of the major causes of nephrotic syndrome. In this case, we reported the concurrent of leukocytoclastic vasculitis with membranoproliferative glomerulonephritis.
The Clinical Analysis of Childhood Henoch-Schonlein Purpura Patients
(deri Zuhrevi Hastaliklar dernegi, 2012) Akgun, Cihangir; Akbayram, Sinan; Kaya, Avni; Temel, Hayrettin; Bilici, Salim; Aktar, Fesih; Arslan, Sukru
Background and Design: Henoch-Schonlein purpura is affected often the skin, joints, gastrointestinal tract and kidneys and common systemic vasculitis of childhood. Henoch-Schonlein purpura are many and varied symptoms, also it was followed in children policlinics and hospitalized diseases for an important role. We aimed to determination of the patients with Henoch-Schonlein purpura by examination of their clinical analyses. Material and Method: The medical records of 212 patients with Henoch-Schonlein purpura in our polyclinics have been retrospectively studied. These patients were analyzed age groups, diagnosed seasons, held systems, laboratory findings, the treatments, complications and prognosis. SPSS 13 statistical software package was used for data analysis. Results: The mean age of the patients was 9.33 +/- 3.20 years. The disease was more frequently demonstrated in fall and winter seasons. There was no statistically assosiation between age groups with season, joint involvement, central neryeous system involvement, gastrointestinal system involvement and scrotal involvement but there was a positive correlation between age groups and renal involvement Conclusion: The treatment duration increases with the age of the patient and the necessity to use a combined treatment (antihistaminic, non-steroid anti-inflammatory treatment and steroids) increases. (Turkderm 2012; 46: 73-7)
Clinical Features and Prognosis With Guillain-Barre Syndrome
(Wolters Kluwer Medknow Publications, 2011) Akbayram, Sinan; Dogan, Murat; Akgun, Cihangir; Peker, Erdal; Sayin, Refah; Aktar, Fesih; Caksen, Huseyin
Background: Guillain-Barre syndrome (GBS) is an acute inflammatory polyneuropathy commonly characterized by rapidly progressive, symmetric weakness and areflexia. Materials and Methods: We retrospectively assessed the clinical manifestations, results of electrodiagnostic tests, functional status and prognosis of 36 children diagnosed with GBS. Results: Based on clinical and electrophysiological findings, the patients were classified as having acute inflammatory demyelinating polyradiculoneuropathy (AIDP) (n = 25), acute motor axonal neuropathy (AMAN) (n = 10) and acute motor-sensory axonal neuropathy (AMSAN) (n = 1). Twenty (55.5%) patients were males and 16 (44.5%) patients were females. The mean age of the 36 patients was 68.1 +/- 45.01 months (range, 6-180 months). Five (13.8%) patients were younger than 2 years. The most common initial symptoms were limb weakness, which was documented in 34 (94.4%) patients. In our study, 18 patients (51.4%) showed albuminocytological dissociation (raised protein concentration without pleocytosis) on cerebrospinal fluid (CSF) examination. Three patients (8.3%) required mechanical ventilation therapy during hospitalization. Unfortunately, three (8.3%) patients died; one patient had AIDP and two patients had axonal involvement (one case was AMAN and another case was AMSAN). When we compared the cases of residual sequel/dead and cases of complete recovery for neural involvement type including AIDP, AMAN and AMSAN, we did not find a statistically significant difference between the groups (P > 0.05). Conclusion: Our findings showed that cases of GBS was not uncommon in children younger than 2 years of age, and CSF protein level might be found high in the first week of the disease in about one half of the patients, with a higher rate of morbidity and mortality in patients with axonal involvement than in those with AIDP.
Clinical Findings in Children With Cutaneous Anthrax in Eastern Turkey
(Wiley, 2010) Akbayram, Sinan; Dogan, Murat; Akgun, Cihangir; Peker, Erdal; Bektas, M. Selcuk; Kaya, Avni; Oner, Ahmet Faiko
Anthrax is a zoonosis produced by Bacillus anthracis. The aim of this study was to evaluate the clinical findings, therapy, and outcome in children with cutaneous anthrax (CA). Data on age, gender, occupation, clinical symptoms and findings, location and type of lesions, clinical history, laboratory findings, treatment, and outcome were recorded from patients' medical records, retrospectively. The study included 65 patients between 1 month and 18 years old (9.0 +/- 4.0 years), 37 patients (56.9%) were male and 28 (43.1%) were female. Most of the patients (89.1%) were admitted in summer and autumn (p < 0.001). Of the 65 patients, 20 patients (30.8%) had received antibiotherapy before admission to our hospital. All patients except one had a contact history with infected animals. A 1-month-old patient had a contact history with his mother who had CA. On clinical examination, anthrax edema was noted in 36 (55.3%) patients, anthrax pustule in 27 (41.5%), and anthrax edema and anthrax pustule in two (3%) patients. Gram staining and culture was positive for B. anthracis in 35 (53.8%) patients, and only Gram staining was positive in 10 (15.4%) patients. In the remaining 20 (30.8%) patients, the diagnosis was made by clinical findings. Because the anthrax outbreak in Turkey was associated with slaughtering or milking of ill cows, sheep, or goats, and handling raw meat without taking any protective measures, persons in the community must be educated about using personal protective equipment during slaughtering of animals and handling of meat and skins.
The Clinical Outcome of 260 Pediatric Itp Patients in One Center
(Sage Publications inc, 2011) Akbayram, Sinan; Dogan, Murat; Ustyol, Lokman; Akgun, Cihangir; Peker, Erdal; Bilici, Salim; Oner, Ahmet Faik
In the current study, clinical and laboratory findings and treatment modalities of children with acute and chronic immune thrombocytopenic purpura (ITP) were evaluated retrospectively. Our purpose was to determine clinical outcome of children with ITP and their responses to different treatment regimes. Total of 260 children with ITP were enrolled in the study. The mean age of patients was 76.8 +/- 48.1 months. The therapy responses of high-dose methylprednisolone (HDMP; n = 134), standard dose methylprednisolone (n = 32), and intravenous immunoglobulin (IVIG; n = 15) treatments were similar. Two (0.8%) of the 260 ITP patients had intracranial bleeding. None of the patients died due to hemorrhage. Of all the patients with ITP, 191 (73.5%) completely resolved within 6 months after initiation of the disease and therefore they were diagnosed as acute ITP; 69 patients (26.5%) had progressed into chronic ITP. The therapy responses of HDMP, standard dose methylprednisolone, and IVIG treatments are similar.
The Correlation of Clinic and Pathogenesis of Idiopathic Nephrotic Syndrome With Urine Interleukin-13, Granzyme-B, Cd80, Cd28 and Matrix Metalloproteinase-2 Levels
(Springer, 2013) CengizZeybek; Hacihamdioglu, Duygu Ovunc; Akgun, Cihangir; Yalcinkaya, Fatos; EsraBaskin
A Desensitization Protocol in Children With L-Asparaginase Hypersensitivity
(Lippincott Williams & Wilkins, 2010) Akbayram, Sinan; Dogan, Murat; Akgun, Cihangir; Caksen, Hueseyin; Oner, Ahmet Faik
Background: L-asparaginase is effective in the treatment of malignant diseases, but it has been associated with hypersensitivity reactions in 5% to 45% of the patients. Purpose: To determine whether a desensitization protocol in children with native Escherichia coli L-asparaginase hypersensitivity allows subsequent safe administration of native E. coli L-asparaginase. Patients and Methods: A desensitization protocol was used in 9 children with leukemia (n = 8) or Langerhans cell histiocytosis (n = 1) and previous severe (n = 4) or mild/moderate (n = 5) L-asparaginase hypersensitivity. Dexamethasone (2 mg/kg intravenously) and pheniramine hydrogen maleate (1 mg/kg intravenously) were administered 1 hour before each of the following L-asparaginase administrations. Subsequently, 0.1%, 1%, 5%, 10%, and the remaining 84% of the total dose of L-asparaginase (10,000 IU/m(2)) were each prepared in 240 mL 0.9% saline and infused over 4 hours (20 h in total). Results: After desensitization, none of the patients had recurrence of hypersensitivity reactions during the subsequent 2 to 15 doses (median: 6 doses/patient; 68 doses in total) of native E. coli L-asparaginase. Conclusion: This desensitization protocol was safe and allows continued administration of native E. coli L-asparaginase administration.