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    Effects of Different Doses of Oral Iron on Hepcidin and Treatment Response in Iron Deficiency Anemia
    (Springer India, 2024) Beyler, Ozlem; Demir, Cengiz; Demircan, Vehbi; Kacmaz, Murat
    IntroductionIron deficiency anemia (IDA) is a common health problem. The hepcidin hormone is the main regulator of systemic iron balance. The body responds to IDA by decreasing hepcidin. This study investigated how different iron supplementation regimens affect hepcidin levels in women with IDA. 87 female participants aged 18-45 years with hemoglobin < 10 g/dL and serum ferritin < 20 ng/ml were assigned to receive iron therapy every other day, once daily, or twice daily. Hemogram, serum iron, serum iron binding capacity, ferritin, hepcidin, and C-reactive protein values were measured at baseline and on the 15th and 90th days of treatment in all groups. On the seventh day, no significant difference was found between the once-daily and twice-daily groups (p = 0.42) in reticulocyte counts. By the 15th day, hemoglobin and MCV levels showed significant improvement in the twice-daily group compared to the other groups (p < 0.01). At the third month, ferritin levels were significantly higher in the twice-daily group compared to the every-other-day and once-daily groups (p = 0.03). No significant differences were observed in hepcidin levels at three months across all groups. The study concludes that twice-daily iron supplementation results in the most significant hematological improvements but with increased gastrointestinal side effects. These findings underscore the importance of tailoring iron dosing schedules to individual patient needs. In cases where rapid haemoglobin response is required, twice-daily dosing may provide superior results. Conversely, once-daily dosing may be preferred if tolerable anemia can be maintained. Every other day dosing, although associated with fewer side effects and better tolerability, may not provide adequate support for erythropoiesis.
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    Pulse Methylprednisolone-Induced Sinus Bradycardia: A Case Report
    (Baskent Univ, 2023) Beyler, Ozlem; Demir, Cengiz
    Corticosteroids have a wide range of uses. The most common adverse side effects of high-dose pulse steroids are hyperglycemia, gastrointestinal intolerance, and psychiatric symptoms. Cardiac arrhythmias have been reported in patients who receive high- dose steroid therapy. Bradycardia is a rare adverse side effect of pulse steroid therapy. We present the case of a 57-year-old male patient who developed symptomatic sinus bradycardia after he received pulse methylprednisolone therapy as treatment for graft-versus-host disease. The patient's pulse steroid therapy was discontinued, and the dose of methylprednisolone was reduced to 100 mg/ day. He was treated conservatively and with close observation; the patient's heart rate increased to 68 beats/min after 1 day, and then to 78 beats/min. The diagnosis of methylprednisolone-induced bradycardia was made after exclusion of other common etiologies of sinus bradycardia. This case report demonstrates the importance of careful cardiovascular monitoring in patients who receive high-dose methylprednisolone because of dose-related cardiovascular risks.