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    A Rare Nephrotic Syndrome Related to Chronic Lymphocytic Leukemia: Focal Segmental Glomerulosclerosis
    (Springernature, 2022) Karakus, Volkan; Atas, Unal; Uzuntas, Sahnura; Dere, Yelda; Meteoglu, Ibrahim
    Chronic lymphocytic leukemia (CLL) is a hematological disease characterized by the proliferation of monoclonal B-lymphocytes. Although autoimmune complications such as autoimmune hemolytic anemia and immune thrombocytopenia are common in CLL patients, nonhematological autoimmune complications are rather rare. The most common renal involvements are membranoproliferative glomerulonephritis and minimal change disease. Focal segmental glomerulosclerosis (FSGS) is predominantly associated with Hodgkin's lymphoma among hematological malignancies. FSGS associated with CLL is rarely reported in the literature, with a poor understanding of the common pathophysiology and a very limited experience with this co-occurrence. Although Rai Stage 1/Binet Stage B CLL, our 61-year-old case, who was diagnosed with secondary FSGS, which is a very rare complication, was treated with fludarabine, cyclophosphamide, and rituximab (FCR) combination. Following the treatment, a complete response was achieved about CLL, and the patient, whose renal findings recovered, is in remission and under follow-up for six years. Although the mechanisms between CLL and autoimmune complications are not fully elucidated, it is usually related to immune disorders like an abnormal T-cell response and polyclonal antibody production. While FSGS is very rare in lymphoma, its co-existence with CLL is reported only in a limited number of case reports. Steroids may be used in these patients; however, in cases not responding to steroids, treatment of the underlying CLL is required.
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    Are Platelet-related Parameters Predictive of the Prognosis of Hodgkin's Lymphoma?
    (Galenos Yayincilik, 2021) Akdeniz, Aydan; Mehtap, Ozgur; Karakus, Volkan; Unal, Serkan; Aygun, Kemal; Temel, Gulhan Orekici; Tombak, Anil
    Objective: Hodgkin's lymphoma has a good prognosis unless it has relapsed or become refractory. The predictive value of platelet (Plt)-related parameters, namely, mean Plt volume (MPV), plateletcrit (PCT), Plt distribution width, and Plt, is shown in some solid tumors and hematological malignancies, but it remains unknown in Hodgkin's lymphoma. This study aimed to define their values and effects on staging and relapsing status in patients with Hodgkin's lymphoma by comparing them with those in healthy subjects. Methods: Values of Plt-related parameters of 217 patients with Hodgkin's lymphoma and 205 healthy individuals were documented and compared according to the disease stage and relapsing status. We defined the cutoff values for diagnosis, staging, and relapsing status of these parameters using the receiving operating characteristic curve analysis. Results: For diagnosis, the cutoff values of MPV, Plt, and PCT were 8.49 fL, 32,1000/mm(3), and 0.31, respectively. For staging, the cutoff values of MPV and Plt were 9.5 fL and 12 fL, respectively. None of the parameters were associated with relapsing status. Conclusion: This is the first study evaluating Plt-related parameters in Hodgkin's lymphoma. Further studies including survival analyses will clarify the effect of these parameters on Hodgkin's lymphoma.
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    Can SARS-CoV-2 infection cause prolonged pseudothrombocytopenia? A case presentation and literature summary
    (Pergamon-Elsevier Science Ltd, 2024) Atas, Unal; Sinanoglu, Mustafa; Karakus, Volkan
    [Abstract Not Available]
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    The effects of tacrolimus and mycophenolate mofetil on regression of encapsulating peritoneal sclerosis in a rat model
    (Asoc Regional Dialisis Trasplantes Renales, 2021) Huddam, Bulent; Sasmaz, Simge; Haberal, Nihan; Azak, Alper; Genek, Dilek Gibyeli; Kocak, Gulay; Karakus, Volkan
    Objective: Encapsulating peritoneal sclerosis (EPS) is a rare, but potentially fatal complication of peritoneal dialysis. Currently, treatment of peritoneal fibrosis is not fully possible yet. In this study, we aimed to demonstrate the effects of tacrolimus therapy on peritoneal fibrosis and inflammation when administered alone or with mycophenolate mofetil (MMF) in the EPS model induced in rats. Methods: Thirty six Wistar albino rats were separated into six equal groups. Group I was the control group. Group II-VI were administered intraperitoneal chlorhexidine (CH) for induced EPS model in rats. Group II, IV, V, VI were administered isotonic liquid, tacrolimus, tacrolimus and concurrently with CH, tacrolimus and MMF together, respectively. Group III was not administered any drug. All peritoneal samples were stained immunohistochemically with matrix metalloproteinase-2 (MMP-2) antibody. Thickness of peritoneal fibrosis, subserosal large collagen fibers, subserosal fibroblast proliferation and subserosal fibrotic matrix deposition were evaluated. Results: Comparing the experimentally induced EPS groups, the best histopathological results and the largest staining with MMP-2 were achieved in Group VI. Furthermore, in all treatment groups (IV, V, VI) more staining with MMP-2 was detected compared to non-treatment groups (I, II, III) but no statistically significant differences were found among all groups. A statistically significant remission was observed in all histopathological parameters, primarily peritoneal thickness in rats that were administered MMF with tacrolimus, compared to rats which were administered tacrolimus only. Conclusion: Concurrent use of tacrolimus and MMF in the treatment of EPS may be a promising approach.