Retrospective Analysis of Patients Hospitalized with the Diagnosis of Microangiopathic Hemolytic Anemia in our Internal Medicine Clinic

Öz

Introduction: Microangiopathic hemolytic anemia (MAHA) is a group of diseases rarely seen and having severe mortality rate if it doesn’t treated. Aim: Our aim is to emphasize the need to recall the MAHA in differential diagnosis of patients with thrombocytopenia, especially those without end-organ involvement, which are presented in this study. At the same time to show the rate of mortality decreases in early diagnosis and treatment. Materials and methods: We retrospectively reviewed the cases that were diagnosed and examined and treated in the Internal Medicine Service between september 2017 and may 2019. A total of 15 patients were included in the study. From patients, first application; complete blood count, sedimentation, peripheral smear, direct coombs, CRP, coagulation tests and biochemical tests were performed. In addition, before and after each plasmapheresis procedure; complete blood count, urea, creatinine, LDH, indirect bilirubin levels were measured.Findings: Gender ratio of the patients was 8 / 7 (53.3 / 46.6) and the mean age was 46.8 (25-79). As a result of etiological classification of patients; 8 patients (53.3%) had TTP (Thrombotic thrombocytopenic purpura), 4 patients (%26.6 ) had vitamin B12 deficiency, 1 patient had systemic lupus erythematosus ( %6.6), 1 patient (%6.6) was associated with complement, 1 patient (%6.6) had drug-releated MAHA. Conclusion : Of the 15 patients included in the study, 11 patients (73.3%) were recovered, 1 patient (6.6%) died after discharge, and 4 patients (20%) died during follow, totally 5 (%33.3) patients died.

Anahtar Kelimeler

• Anemia
• hemolytic
• retrospective

İç Hastalıkları Servisimizde Mikroanjiopatik Hemolitik Anemi (MAHA) Tanısı İle Yatırılarak Takip Ettiğimiz Hastaların Retrospektif Analizi

Öz

Giriş: Mikroanjiopatik hemolitik anemiler (MAHA) oldukça nadir görülen ve tedavi edilmediğinde mortal seyreden bir grup hastalığa verilen isimdir.
Amaç: Bu çalışmadaki amacımız; trombositopeni saptanan ve özellikle de end-organ tutulumu olmayan hastalarda ayırıcı tanıda MAHA’nın hatırlanması gerekliliğini vurgulamaktır. Aynı zamanda erken tanı ve tedavide mortalite oranının düştüğünü gösterebilmektir. Gereç ve yöntem: Eylül 2017- mayıs 2019 tarihlerinde arasında iç hastalıkları servisinde tanısı koyularak takip ve tedavi edilen vakaları retrospektif olarak inceledik. Tanı kriterlerine uyan toplam 15 hasta çalışmaya alındı. Hastalardan, ilk başvuruda; tam kan sayımı, sedimentasyon, periferik yayma, direkt coombs, CRP, koagülasyon testleri ve biyokimyasal tetkikler çalışıldı. Ayrıca her plazmaferez işleminden önce ve sonra; tam kan sayımı, üre, kreatin, LDH, indirek bilirubin düzeyleri bakıldı. Bulgular: Hastaların E/K oranı 8 /7 (% 53.3/ 46.6) ve yaş ortalaması 46.8 (25-79) bulundu. Hastaların etyolojik sınıflandırılması sonucu; 8 hasta (%53.3) TTP(Trombotik trombositopenik purpura) olarak, 4 hasta (%26.6) vitamin B 12 eksikliğine bağlı, 1 hasta sistemik lupus eritamatozus (%6.6), 1 hasta (%6.6) atipik hemolitik üremik sendrom ve 1 hasta (%6.6) da ilaç ilişkili MAHA olarak değerlendirildi. Sonuç: Çalışmaya alınan 15 hastadan 11 hastanın (%73.3) iyileşme, 4 hastanın (%20) izlemi esnasında exitus, 1 hastanın (%6.6) taburculuktan sonra, toplamda 5 (%33.3) hastanın exitus olduğu tespit edildi.

Anahtar Kelimeler

• Anemi
• hemolitik
• retrospektif

Kaynakça

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