Hepatitis: Yilmaz R

Ozaslan E, Yilmaz R, Simsek H, Tatar G. · Division of Gastroenterology, Hacettepe University Hospital, Ankara, Turkey. · Ann Pharmacother. · Pubmed #12398565 No free full text.

Abstract: OBJECTIVE: Due to their antiproliferative activity, the probable effects of interferons on a fetus are a concern. We report on a pregnant patient who developed acute hepatitis C during pregnancy and was treated with a short course of interferon alfa therapy with a successful outcome. CASE SUMMARY: A 26-year-old woman was diagnosed with acute hepatitis C at the 16th week of pregnancy. She received a total dose of 72 million units of interferon alfa-2b during a 2 1/2 month period. Although the therapy was discontinued due to adverse effects, a complete biochemical and virologic response was obtained. Premature labor occurred and healthy, but growth-restricted, twin infants were born transvaginally. At 18 months of age, they had normal development, with a negative hepatitis C serology. DISCUSSION: The rate of transmission of hepatitis C virus from mother to infant is within the range of 1-5%. Although acute hepatitis C during pregnancy is a very rare occurrence, the mother is at a great risk for chronic infection. There is scarce literature about the probable effects of interferon use during pregnancy due to a lack of controlled studies in this special population. A total of 8 infants, including ours, exposed to interferon alfa and/or ribavirin during pregnancy showed no congenital anomalies or malformations. CONCLUSIONS: Patients with chronic hepatitis whose therapy can be delayed should not be treated with interferon due to a lack of controlled studies. However, women exposed to interferon inadvertently during pregnancy may be encouraged to continue pregnancy. In patients with acute hepatitis C during pregnancy, the use of interferon therapy should be considered with close monitoring.

Yazici P, Yeniay L, Aydin U, Taşbakan M, Ozütemiz O, Yilmaz R. · Ege University, Medical School Department of General Surgery, Izmir, Turkey. · Turkiye Parazitol Derg. · Pubmed #18351544 links to  free full text

Abstract: Visceral leishmaniasis (VL) is one of the parasitic infections causing different pathogeneses of various systems including intraabdominal solid organs. L. donovani and L.infantum, particularly in Turkey, have been diagnosed in systemic infections. In the present case study, a 43-year-old woman with left upper abdominal pain, persistent fever and splenic pathology according to the radiological findings was investigated. Laboratory findings showed elevated liver function tests and anemia while radiological studies revealed splenomegaly, and nodular infiltration and laceration of the spleen. Because of enlarged intraabdominal lymph nodes observed during surgery, a lymph node biopsy and a liver biopsy were also performed along with the splenectomy. Results from the pathological examination of the spleen were nonspecific and the liver biopsy confirmed a diagnosis of granulomatosis hepatitis. Further examination of the hepatic granulomatosis including parasitic evaluation and serological evaluation with the rK39 dipstick test revealed VL. In conclusion, in cases of visceral organ pathology accompanied by persistent fever, and hematological disorders, parasitic infections, particularly VL, should be considered in the differential diagnosis.

Kahraman S, Yilmaz R, Genctoy G, Arici M, Altun B, Erdem Y, Yasavul U, Turgan C. · Department of Nephrology, Faculty of Medicine, Hacettepe University, Ankara, Turkey. · Nephron Clin Pract. · Pubmed #15824511 No free full text.

Abstract: BACKGROUND: Iron supplementation is the cornerstone of anaemia management in haemodialysis (HD) patients. However, efficacy and safety of intravenous (IV) iron therapy in hepatitis C virus (HCV)-positive HD patients is yet to be elucidated. METHODS: Sixty-six maintenance HD patients with suboptimal response to recombinant human erythropoietin (rh-EPO) were administered IV iron. Each patient received 100 mg/session IV iron sucrose for ten consecutive HD sessions and then the dose was decreased to 50-100 mg weekly or biweekly. Patients were followed for haemoglobin (Hb), ferritin, rh-EPO dose requirements, transaminase levels, and adverse drug reactions. RESULTS: Baseline demographic and clinical characteristics, as well as Hb, ferritin, transaminase levels, rh-EPO and iron doses were similar between HCV-positive (n = 32) and HCV-negative patients (n = 29). After 5 months of follow-up, a significant increase in ferritin and Hb levels and decrease in rh-EPO doses were observed in both groups. The incidence of adverse drug reactions was not associated with HCV serology. Significant elevation in both alanine and aspartate aminotransferase levels were detected in HCV-positive patients. CONCLUSION: This study has shown that IV iron administration reverses suboptimal response to rh-EPO administration in HD patients regardless of HCV serology. There is however subtle increase of transaminase levels in HCV-positive patients. Further studies are warranted to reveal the impact of variation in serum transaminase levels during IV iron administration in HCV-positive HD patients.