Barbaros Şahin Karagün

Endonasal treatment of acute invasive fungal rhinosinusitis in immunocompromised pediatric hematology–oncology patients

OBJECTIVES Acute invasive fungal rhinosinusitis (AIFR) is an aggressive fungal infection in immunocompromised patients with high mortality rates. The aim of this study is to present our experiences on endonasal treatment in immunocompromised pediatric hematology-oncology patients with AIFR. METHODS Thirteen pediatric hematology-oncology patients treated for AIFR between March 2006 and December 2011 were analyzed retrospectively. We reviewed the following data for all patients: age, gender, predisposing disease, initial symptoms, pathological diagnosis, microbiological results, laboratory findings, surgical procedure, number of operations and treatment outcomes. RESULTS Nine of 13 patients with lesions confined to sinonasal cavity were operated with endoscopic approach. Open surgery was performed in four patients, three of them had palatal and buccal lesions and one had facial skin involvement. Endoscopic approach was also used for sinonasal lesions of these four patients. A total of 7 patients died: 4 patients with progression of the underlying disease, 2 patients with sepsis and 1 patient due to renal failure. Survival rate in surgically treated patients was found 46% (6/13 patients). CONCLUSIONS Endonasal endoscopic approach is both feasible and efficient technique, also enables excellent local control with less morbidity compared to open surgery. This approach is suitable for patients who are diagnosed in the early stages of AIFR and also presents a less traumatic option for patients with poor health status. Open surgical procedure should be preferred in patients with disease extending out of the sinonasal cavity.

Juvenile Myelomonocytic Leukemia (JMML)

Ya z›fl ma Ad re si/Ad dress for Cor res pon den ce Dr. Barbaros Şahin Karagün, Çukurova Üniversitesi Tıp Fakültesi, Pediatrik Hematoloji-Onkoloji Anabilim Dalı, Adana, Türkiye Tel.: +90 322 338 60 60 E-posta: drbkaragun@yahoo.com.tr Ge liş ta ri hi/Re cei ved: 24.09.2013 Ka bul ta ri hi/ Ac cep ted: 21.01.2014 Çukurova Üniversitesi Tıp Fakültesi, Pediatrik Hematoloji-Onkoloji Anabilim Dalı, Adana, Türkiye Barbaros Şahin Karagün, İlgen Şaşmaz, Bülent Antmen, Yurdanur Kılınç The Journal of Pediatric Research 2014;1(3):118-26 DO I: 10.4274/jpr.09797

Membranous nephropathy presenting with nephrotic syndrome in a child with thalassemia major

Few data on the renal effects of thalassemia syndrome are available in the literature. Recent clinical studies identified proximal tubular damage and glomerular filtration abnormalities in thalassemia. Iron‐chelating agents might be nephrotoxic as well, but proven glomerular injury, either due to anemia or chelating therapy, has not previously been demonstrated in thalassemia patients. Here, we report the first thalassemia patient presenting with nephrotic syndrome to be diagnosed with membranous nephropathy in the literature.