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    Idiopathic thrombocytopenic purpura associated with splenic tuberculosis: Case report
    (2013) Dal M.S.; Dal T.; Tekin R.; Bodakçi E.; Düzköprü Y.; Ayyildiz M.O.
    Tuberculosis is still one of the most prevalent and fatal infectious diseases in spite of considerable improvements in medical science. Splenic tuberculosis is a rare form of extrapulmonary tuberculosis. There are limited numbers of cases in which immune thrombocytopenia is associated with splenic tuberculosis. We report a case of immune thrombocytopenic purpura due to splenic tuberculosis. Our case was a 58-year-old female with headache, gum bleeding, redness in legs, and ecchymoses on the arms for 10 days. On admission to hospital, laboratory tests were as follows: platelet count 6.000/mm3 (150 000-450 000), haemoglobin: 12 g/dl, WBC: 8000/mm3, erythrocyte sedimentation rate: 58 mm/h and C-reactive protein was in normal ranges. After standard laboratory tests, the pa tient was diagnosed with idiopathic thrombocytopenic purpura. The patient presented abdominal lymphadenopathies and spleen in normal size in radiological examinations. Diagnostic laparotomy and splenectomy and lymph node excision was performed and splenic tuberculosis was detected in pathologic and microbiologic examination. The patient was successfully treated with apheresis platelets suspension, intravenous immunoglobulin and antituberculous therapy. In conclusion, splenic tuberculosis should be suspected in patients who have fever, abdominal lymphadenopathies and immune thrombocytopenic purpura. Histopathological examination is still an ideal method to confirm the diagnosis, suitably aided by microbiological examination.
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    Öğe
    Large granular lymphocytic leukemia
    (2000) Işikakdo?an A.; Ayyildiz M.O.; Tiftik N.; Müftüo?lu E.
    LGL-L is a rare disorder characterized by clonal proliferation of cells with large granular lymphocytes. LGL-L can be divided into two major lineage: T(CD3 +) and NK (CD3 -) which have distinct clinical and prognostic features. T-LGL-L represents 80-85% of the all LGL-L. The disease may occur both in men and women, and mostly affects elderly people. Clinical features of T-LGL-L is characterized by recurrent infection related to neutropenia, hepatosplenomegaly and rheumatoid arthritis. Laboratory findings include positive rheumatoid factor and antinuclear antibody. The clinical presentation of NK-LGL leukemia is more acute than T-LGL leukemia, with B symptoms, massive hepatosplenomegaly, involvement of the gastrointestinal tract, and coagulopathy in most cases. Patients are younger and usually have an aggressive course with multiorgan failure and death within a few months of diagnosis despite multiagent chemotherapy. Occasional patients have a chronic NK-LGL leukemia with a more indolent course similar to T-LGL leukemia.