Effects of Immune Complexes on Holotranscobalamine Assay of Vitamin B12 Deficiency in Myeloproliferative Disorders

In myeloproliferative disorders (MPDs), vitamin B12 levels are measured falsely elevated with conventional methods due to increasedcarrier protein synthesis. HoloTranscobalamine (HoloTC) assay is a first-choice method for detecting true vitamin B12 deficiency inMPDs. Our aim was to determine effects of immune complexes on HoloTC assay. This is a cross-section study. Vitamin B12 levels in61 patients with myeloproliferative disorders were measured by both electrochemical immunoassay and HoloTC assay. The HoloTCcutoff was greater than 35 pmol/L. HoloTC assay for each sample were repeated after polyethylene glycol (PEG) treatment to exclude IgG, IgA and IgM type immune complexes. Also, methylmalonic acid, folate, homocystein, liver, and kidney function tests wereobtained. Methylmalonic acid test showed that 42 patients (68.9%) had vitamin B12 deficiency. Vitamin B12 levels by HoloTC assaydecreased by 19.2±11.28% in essential thrombocytosis, 40.0±9.39% in chronic myeloid leukemia, 30.9±14.62% in myelofibrosisand 21.2±11.55% in polycythemia vera patients after PEG treatment. There was significant difference between the averages of groups(p< 0.01). Methylmalonic Acid Test was used as the B12 status variable. The comparison of ROC curves of HoloTC before and afterPEG showed no statistically significance between area under curves. The optimum cut-off points for both HoloTC before and afterPEG were 40.6 pmol/L and 32.1 pmol/L, respectively. Immune complexes may have some effect on HoloTC assay which has been recently reported to have a superior diagnostic accuracy for vitamin B12 deficiency in patients with MPDs. Although exclusion of immunecomplexes did not improve its diagnostic performances, effects of exclusion were significantly different between subgroups of MPDs.

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A comparison between the efficacy and safety of microscopic inguinal and subinguinal varicocelectomy

Öz:

Objective: To compare microscopic inguinal (MIV) and subinguinal varicocelectomy (MSV) surgeries with respect to efficacy and safety.Material and methods: Patients who underwent varicocelectomy between January 2002 and January2018 were evaluated retrospectively and prospectively. The patients who underwent varicocelectomyuntil December 2015 were analyzed retrospectively and the cases after January 2016 were analyzedprospectively. In our study, the married infertile male cases were compared on the basis of operationduration, number of ligated veins, number of preserved veins, postoperative pain score (visual analogue scale: VAS), patient satisfaction, surgeon satisfaction, changes in sperm parameters, testicularconsistency, pregnancy rates, and complications, such as hydrocele, testicular atrophy, and recurrenceof varicocele. Surgical success rates were compared by semen analysis between unmarried infertilemale cases because pregnancy rates cannot be tested. The patients were recalled for control examinations every 3 months for 1 year and tested the above-mentioned parameters. Statistical Package for theSocial Sciences Version 20 Windows Software was used for data analysis and comparison between thetwo groups.Results: The study included a total of 136 adult patients. Mean age of the patients was 28.14 (20–41)years. MSV and MIV were performed in 62 (45.6%) and 74 (54.4%) patients, respectively. No statistically significant difference was detected between the two groups in terms of admission duration, semenparameters within the 1-year follow-up process, hormonal changes, and complication rates. Operationduration was significantly longer in the MSV group. It was determined that a fewer number of veinswere ligated, and a fewer number of veins needed to be ligated in the MIV group. The analysis of allthe patients revealed that pain scores at 4 and 24 hours postoperatively were significantly statisticallylower in the MSV group.Conclusion: MIV and MSV are distinct, efficient, and safe surgical techniques with specific advantages and disadvantages. Their efficacy and safety rates are similar.

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İmmün Kompleksler Myeloproliferatif Hastalıklarda B12 Vitamin Eksikliğinin Holotranskobalamin Testini Etkileyebilir

Öz:

Miyeloproliferatif hastalıklarda (MPH), artan taşıyıcı protein sentezi nedeniyle, vitamin B12 düzeylerinin, geleneksel yöntemlerle ölçümünde bazı zorluklar yaşanmaktadır HoloTranskobalamin (HoloTC) testi MPH’da gerçek B12 eksikliklerini tespit etmek için ilk seçilecek testlerden birisidir. Bu çalışmadaki amacımız immunkomplekslerin HoloTC testi üzerindeki etkilerini tespit etmektir. Bu araştırma, Kesitsel bir çalışmadır. Hastanemizin Hematoloji Kliniğine başvuran ve MPH tanısı ile takip edilen 61 hastanın Vitamin B12 düzeyleri hem elektro-kimyasal immünassay hem de HoloTC testi ile çalışıldı. Aynı örnekler immün kompleksleri çöktürmek için polyetilen glikol (PEG) ile muamele edildikten sonra HoloTC testi tekrar edildi. Aynı zamanda, metilmalonik asit, folat, homosistein düzeyleri ile birlikte karaciğer ve böbrek testleri yapıldı. Metilmalonik asit testi ile 42 hastanın (%68.9), vitamin B12 eksikliği tespit edildi. PEG muamelesinden sonra HoloTC testi ile Vitamin B12 düzeyleri essansiyel trombositosis hastalarında %19.2±11.28, kronik myeloid lösemi hastalarında %40.0±9.39, myelofibrosis’te %30.9±14.62% ve polistemiya vera (PV) hastalarında ise 21.2±11.55% oranlarında azaldı. Grupların ortalamaları arasında istatistiksel anlamlı fark bulundu (p< 0.01). B12 durum değişkeni olarak Metilmalonik Asit Testi alındı. PEG uygulaması öncesi ve sonrası HoloTC testlerinin ROC eğrileri karşılaştırıldı. Her iki durumun eğri altında kalan alanları istatistiksel olarak anlamlı bir farklılık göstermedi. Optimum “cut-off” noktaları PEG öncesi HoloTC için 40.6 pmol/L; PEG sonrası için ise 32.1 pmol/L olarak tespit edildi. Son zamanlarda myeloproliferatif hastalıklarda tanısal doğruluğu gösterilmiş olan HoloTC testi, bu hastalıklarda oluşan immun komplekslerden etkilenebilir. İmmun komplekslerin ekarte edilmesi bu testin diagnostik performansını etkilememekle birlikte etkileri hastalık gruplarına göre anlamlı olarak farklık göstermektedir.

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Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	ÇEKDEMIR D, DEMİRDÖĞEN Ş, cinemre f, ÖZKAYA F, AYDEMİR B, CİNİSLİOĞLU A, Dilaveroglu N, ALTAY M, Cekdemir Y, ADANUR Ş, Gunduz M, Polat Ö, Cinemre H, ÖZBEY İ (2019). Effects of Immune Complexes on Holotranscobalamine Assay of Vitamin B12 Deficiency in Myeloproliferative Disorders. , 31 - 37. 10.4999/uhod.193047
Chicago	ÇEKDEMIR DEMET,DEMİRDÖĞEN Şaban Oğuz,cinemre fatma behice,ÖZKAYA FATİH,AYDEMİR Birsen,CİNİSLİOĞLU AHMET EMRE,Dilaveroglu Nilgun,ALTAY MEHMET SEFA,Cekdemir Yasin ertug,ADANUR ŞENOL,Gunduz Mehmet,Polat Özkan,Cinemre Hakan,ÖZBEY İsa Effects of Immune Complexes on Holotranscobalamine Assay of Vitamin B12 Deficiency in Myeloproliferative Disorders. (2019): 31 - 37. 10.4999/uhod.193047
MLA	ÇEKDEMIR DEMET,DEMİRDÖĞEN Şaban Oğuz,cinemre fatma behice,ÖZKAYA FATİH,AYDEMİR Birsen,CİNİSLİOĞLU AHMET EMRE,Dilaveroglu Nilgun,ALTAY MEHMET SEFA,Cekdemir Yasin ertug,ADANUR ŞENOL,Gunduz Mehmet,Polat Özkan,Cinemre Hakan,ÖZBEY İsa Effects of Immune Complexes on Holotranscobalamine Assay of Vitamin B12 Deficiency in Myeloproliferative Disorders. , 2019, ss.31 - 37. 10.4999/uhod.193047
AMA	ÇEKDEMIR D,DEMİRDÖĞEN Ş,cinemre f,ÖZKAYA F,AYDEMİR B,CİNİSLİOĞLU A,Dilaveroglu N,ALTAY M,Cekdemir Y,ADANUR Ş,Gunduz M,Polat Ö,Cinemre H,ÖZBEY İ Effects of Immune Complexes on Holotranscobalamine Assay of Vitamin B12 Deficiency in Myeloproliferative Disorders. . 2019; 31 - 37. 10.4999/uhod.193047
Vancouver	ÇEKDEMIR D,DEMİRDÖĞEN Ş,cinemre f,ÖZKAYA F,AYDEMİR B,CİNİSLİOĞLU A,Dilaveroglu N,ALTAY M,Cekdemir Y,ADANUR Ş,Gunduz M,Polat Ö,Cinemre H,ÖZBEY İ Effects of Immune Complexes on Holotranscobalamine Assay of Vitamin B12 Deficiency in Myeloproliferative Disorders. . 2019; 31 - 37. 10.4999/uhod.193047
IEEE	ÇEKDEMIR D,DEMİRDÖĞEN Ş,cinemre f,ÖZKAYA F,AYDEMİR B,CİNİSLİOĞLU A,Dilaveroglu N,ALTAY M,Cekdemir Y,ADANUR Ş,Gunduz M,Polat Ö,Cinemre H,ÖZBEY İ "Effects of Immune Complexes on Holotranscobalamine Assay of Vitamin B12 Deficiency in Myeloproliferative Disorders." , ss.31 - 37, 2019. 10.4999/uhod.193047
ISNAD	ÇEKDEMIR, DEMET vd. "Effects of Immune Complexes on Holotranscobalamine Assay of Vitamin B12 Deficiency in Myeloproliferative Disorders". (2019), 31-37. https://doi.org/10.4999/uhod.193047

APA	ÇEKDEMIR D, DEMİRDÖĞEN Ş, cinemre f, ÖZKAYA F, AYDEMİR B, CİNİSLİOĞLU A, Dilaveroglu N, ALTAY M, Cekdemir Y, ADANUR Ş, Gunduz M, Polat Ö, Cinemre H, ÖZBEY İ (2019). Effects of Immune Complexes on Holotranscobalamine Assay of Vitamin B12 Deficiency in Myeloproliferative Disorders. Uluslararası Hematoloji-Onkoloji Dergisi, 45(4), 31 - 37. 10.4999/uhod.193047
Chicago	ÇEKDEMIR DEMET,DEMİRDÖĞEN Şaban Oğuz,cinemre fatma behice,ÖZKAYA FATİH,AYDEMİR Birsen,CİNİSLİOĞLU AHMET EMRE,Dilaveroglu Nilgun,ALTAY MEHMET SEFA,Cekdemir Yasin ertug,ADANUR ŞENOL,Gunduz Mehmet,Polat Özkan,Cinemre Hakan,ÖZBEY İsa Effects of Immune Complexes on Holotranscobalamine Assay of Vitamin B12 Deficiency in Myeloproliferative Disorders. Uluslararası Hematoloji-Onkoloji Dergisi 45, no.4 (2019): 31 - 37. 10.4999/uhod.193047
MLA	ÇEKDEMIR DEMET,DEMİRDÖĞEN Şaban Oğuz,cinemre fatma behice,ÖZKAYA FATİH,AYDEMİR Birsen,CİNİSLİOĞLU AHMET EMRE,Dilaveroglu Nilgun,ALTAY MEHMET SEFA,Cekdemir Yasin ertug,ADANUR ŞENOL,Gunduz Mehmet,Polat Özkan,Cinemre Hakan,ÖZBEY İsa Effects of Immune Complexes on Holotranscobalamine Assay of Vitamin B12 Deficiency in Myeloproliferative Disorders. Uluslararası Hematoloji-Onkoloji Dergisi, vol.45, no.4, 2019, ss.31 - 37. 10.4999/uhod.193047
AMA	ÇEKDEMIR D,DEMİRDÖĞEN Ş,cinemre f,ÖZKAYA F,AYDEMİR B,CİNİSLİOĞLU A,Dilaveroglu N,ALTAY M,Cekdemir Y,ADANUR Ş,Gunduz M,Polat Ö,Cinemre H,ÖZBEY İ Effects of Immune Complexes on Holotranscobalamine Assay of Vitamin B12 Deficiency in Myeloproliferative Disorders. Uluslararası Hematoloji-Onkoloji Dergisi. 2019; 45(4): 31 - 37. 10.4999/uhod.193047
Vancouver	ÇEKDEMIR D,DEMİRDÖĞEN Ş,cinemre f,ÖZKAYA F,AYDEMİR B,CİNİSLİOĞLU A,Dilaveroglu N,ALTAY M,Cekdemir Y,ADANUR Ş,Gunduz M,Polat Ö,Cinemre H,ÖZBEY İ Effects of Immune Complexes on Holotranscobalamine Assay of Vitamin B12 Deficiency in Myeloproliferative Disorders. Uluslararası Hematoloji-Onkoloji Dergisi. 2019; 45(4): 31 - 37. 10.4999/uhod.193047
IEEE	ÇEKDEMIR D,DEMİRDÖĞEN Ş,cinemre f,ÖZKAYA F,AYDEMİR B,CİNİSLİOĞLU A,Dilaveroglu N,ALTAY M,Cekdemir Y,ADANUR Ş,Gunduz M,Polat Ö,Cinemre H,ÖZBEY İ "Effects of Immune Complexes on Holotranscobalamine Assay of Vitamin B12 Deficiency in Myeloproliferative Disorders." Uluslararası Hematoloji-Onkoloji Dergisi, 45, ss.31 - 37, 2019. 10.4999/uhod.193047
ISNAD	ÇEKDEMIR, DEMET vd. "Effects of Immune Complexes on Holotranscobalamine Assay of Vitamin B12 Deficiency in Myeloproliferative Disorders". Uluslararası Hematoloji-Onkoloji Dergisi 45/4 (2019), 31-37. https://doi.org/10.4999/uhod.193047