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    RELATIONSHIP BETWEEN VON WILLEBRAND FACTOR ACTIVITY AND THERAPEUTIC SUCCESS OF THROMBOLYTIC THERAPY IN PATIENTS WITH MYOCARDIAL INFARCTION
    (Modestum Ltd, 2007) Kiki, Ilhami; Kose, Nuri; Gundogdu, Mehmet; Kaya, Hasan; Cetinkaya, Ramazan
    Aim: Von Willebrand Factor is a glycoprotein, which plays role in primary hemostasis, mainly acts getting platelets to adhere onto the subendothelial tissue and carrying Factor VIII. Although vWF deficient animals had been shown to be resistant to atherosclerosis and thrombotic events, it had not been proven in humans. In this study, we aimed to investigate whether a relationship exists between VWF activity and therapeutic success of thrombolysis. Methods: The study was carried out on 40 patients who were administered thrombolytic therapy due to myocardial infarction and 30 healthy controls. Von Willebrand Factor activity was measured in plasma samples which were taken before the procedure. The results were compared between therapy effective and ineffective patients and controls. Results: Average vWF activity was 131.0 +/- 64.0% in patients whereas 113.9 +/- 47.7% in controls (p> 0.05). On the other hand, mean VWF activities of 24 patients who achieved therapeutic success and 16 therapy failed patients were 103.9 +/- 58.9% and 171.7 +/- 49.0% respectively (p< 0.01). Conclusion: In this study; we found that plasma vWF activity is among the factors affecting the outcome of thrombolytic therapy in patients with myocardial infarction so, it may be used to predict the therapeutic success of thrombolysis.
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    Relationship between von Willebrand factor activity and therapeutic success of thrombolytic therapy in patients with myocardial infarction
    (TIP ARASTIRMALARI DERNEGI, 2007) Kiki, Ilhami; Köse, Nuri; Gündo?du, Mehmet; Kaya, Hasan; Çetinkaya, Ramazan
    Aim: Von Willebrand Factor is a glycoprotein, which plays role in primary hemostasis, mainly acts getting platelets to adhere onto the subendothelial tissue and carrying Factor VIII. Although vWF deficient animals had been shown to be resistant to atherosclerosis and thrombotic events, it had not been proven in humans. In this study, we aimed to investigate whether a relationship exists between VWF activity and therapeutic success of thrombolysis. Methods: The study was carried out on 40 patients who were administered thrombolytic therapy due to myocardial infarction and 30 healthy controls. Von Willebrand Factor activity was measured in plasma samples which were taken before the procedure. The results were compared between therapy effective and ineffective patients and controls. Results: Average vWF activity was 131.0±64.0% in patients whereas 113.9±47.7% in controls (p>0.05). On the other hand, mean VWF activities of 24 patients who achieved therapeutic success and 16 therapy failed patients were 103.9±58.9% and 171.7±49.0% respectively (p<0.01). Conclusion: In this study; we found that plasma vWF activity is among the factors affecting the outcome of thrombolytic therapy in patients with myocardial infarction so, it may be used to predict the therapeutic success of thrombolysis.
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    Spuriously high phosphate level which is promptly resolved after plasmapheresis in a patient with multiple myeloma
    (Pergamon-Elsevier Science Ltd, 2007) Kiki, Ilhami; Gundogdu, Mehmet; Kaya, Hasan
    We present a 57 year old female patient with IgG multiple myeloma and marked hyperphosphatemia. The patient had no clinical symptoms related to hyperphosphatemia. Serum inorganic phosphate measurements were repeated on sulfosalicylic acid deproteinized serum samples, yielding normal phosphate levels. We realized that this hyperphosphatemia was spurious because of high paraprotein levels. Afterwards, therapeutic plasma exchange (TPE) was administered due to hyperviscosity and bleeding tendency. After the administration of TPE, serum phosphate was reduced to normal level. Therapeutic plasma exchange resulted in steady-state serum phosphate levels during the three months follow up period. We concluded that high phosphate levels must be confirmed by measuring in deproteinized serum samples in multiple myeloma patients in order to distinguish pseudohyperphosphatemia from the true ones. In addition, TPE effectively reduces the spuriously elevated phosphate levels possibly by removing paraproteins. (C) 2007 Elsevier Ltd. All rights reserved.
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    Thrombotic thrombocytopenic purpura in a patient with brucella infection is highly responsive to combined plasma infusion and antimicrobial therapy
    (Karger, 2007) Erdem, Fuat; Kiki, Ilhami; Guendogdu, Mehmet; Kaya, Hasan
    Objective: To report a case of brucella infection presenting with thrombotic thrombocytopenic purpura (TTP) that responded well to plasma and antimicrobial treatment infusion. Case Presentation and Intervention: A 51-year-old man with moderate confusion, depressed mood and dysarthria was admitted. He was chronically ill, with fever (38.5 degrees C), anemia, jaundice and petechial-purpuric skin lesions. Neurological examination revealed diminished consciousness with a Glasgow coma scale score of 7 and +1 neck rigidity. The hemoglobin and platelet counts were decreased and reticulocyte index, erythrocyte sedimentation rate, as well as serum lactate dehydrogenase and renal dysfunction were elevated. TTP was a possible diagnosis and the patient responded well to plasma infusion and antimicrobial treatment. Conclusion: This report shows that therapy of underlying infection together with plasma infusion may be a successful treatment option for brucellosis-induced TTP. Copyright (C) 2007 S. Karger AG, Basel.