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• W2324703119 abstract "Sixty years old male patient was admitted to hospital for squamuos cell lung carsinom with brain metastasis. After two cure taxol and cisplatin chemotherapy and cranial radiotherapy was applied diarrhea and diminished oral intake were developed. After admission chest radiogram revealed pneumothorax and a chest tube was performed. Because of purulent chest drainage, microbiological examination was performed and Escherichia coli and Enterecoccus faecalis were identified. According to the antibiogram result imipenem, teicoplanin and ciprofloxacin was begun. During hospitalization first laboratory examinations were as follows; hemoglobin level 10,9 gr/dl white blood cell counts (WBC) 5,5x109/L, platelet counts 210x109/L, absolute neutrophil counts (ANC) 3,6x109/L, erythrocyte sedimentation rate 85 mm/h, C-reactive protein 17,8 mg/dl. But on the second day ANC was 0,2 x109/L. Peripheral blood smear revealed neutrophil agglutination (figure 1A, 1B) and blood count was performed with a citrate buffer tube examination for the doubt of ethylenediaminetetraacetic acid (EDTA) secondary pseudo-neutropenia. And the ANC count was 4,6 x109/L and the patient was considered as pseudo-neutropenia secondary to EDTA. Patient was died 7th day of admittion due to sepsis. Major causes of neutropenia during hospitalization were infections and drugs. Bone marrow metastasis secondary to solid malignancy should also be considered in patients with malignancy and neutropenia. But without exclusion of pseudo-neutropenia with a simple peripheral blood smear may cause to unnecessary processes such as bone marrow biopsy or treatment with G-CSF [1]. In conclusion; in patient with neutropenia for the exclusion of pseudo-neutropenia first procedure must be the evaluation of peripheral blood smear. NOTROPENININ NADIR BIR NEDENI: ILLUZYON (EDTA’YA BAĞLI PSEUDONOTROPENI) Altmis yasinda erkek hasta. beyin metastazli squamoz hucreli akciger Ca tanilari ile Medikal Onkoloji bolumu tarafindan takip edilen hastaya 20.11.2014’de 1.kur Taxol+Cisplatin kemoterapisi ve 01.12.2014 tarihinde de kraniyal RT tedavisi uygulaniyor. 24.12.2014 tarihinde 2.kur KT’sini alan hasta 12.01.2015’de ishal ve oral alim bozuklugu nedeni ile yatiriliyor. Takibi sirasinda ani gelisen solunum sikintisi olmasi uzerine cekilen PA akciger grafisinde sol akcigerde pnomotorkas saptanmasi uzerine gogus tupu takilmak uzere yogun bakima aliniyor. Gogus tupunden puylu mayi gelmesi uzerine kulturlerinde de Escherichia coli ve Enterecoccus faecalis nedeni ile imipenem ve teikoplanin antibiyotik tedavileri baslaniyor. Cekilen toraks CT’de nekrotizan pnomoni saptanarak tedaviye ciprofloksasin ekleniyor. Yatis hemoglobini 10,9 gr/dl, lokosit 5,5x109/L, absolu notrofil sayisi 3,6x109/L platelet 221x109/L ESH 85/mmh, CRP 17,8 mg/dl, biyokimyasinda patolojik degerleri AST 76IU/L, ALT 47IU/L, LDH 1114U/L, albumin 2,9 g/dl olan hastanin yatisinin 2.gunu tam kan sayiminda lokosit 5,3 x109/L, absolu notrofil sayisi 0,2 x109/L, kontrol tam kan sayiminda lokosit 6,8x109/L mm3, absolu notrofil sayisi 0,3x109/L gelmesi uzerine Hematoloji konsultasyonu isteniyor. Hastanin bakilan periferik yaymasinda aglutinasyonlar olusturan notrofil kumeleri izlenmesi uzerine (figure 1) EDTA’ya bagli pseudo-neutropeni olabilecegi dusunelerek sitratli tupte tekrar tam kan sayimi yapilarak lokosit sayisi 5,3 x109/L, absolu notrofil sayisi 4,6 x109/L saptandi ve olguya ‘EDTA’ya bagli pseudo-notropeni’tanisi konularak takip tam kan sayimlari sitratli tupte yapildi. Hasta yatisinin 7.gunu sepsis nedeni ile ex oldu Hastanede yatisi sirasinda notropeni gelisen olgularda ilk akla gelen sebepler ilac veya enfeksiyonlar olmaktadir. Ozellikle hastamizda oldugu gibi mevcut bir malignite ile birlikte notropeni varsa kemik iligi metastazi da akla gelebilmektedir. Fakat gercek bir notropeni yokken, pseudo-notropeni aydinlatilmadan etyolojiyi aydinlatmak adina yapilacak kemik iligi veya G-CSF gibi tedaviler gereksiz olmaktadir (1). Sonuc olarak, notropeni gelisen olgularda pseudo-notropeniyi ekarte etmek icin, tipki trombositopenili olgulardaki pseudo-trombositopeniyi ekarte etmek icin yaptigimiz gibi yapilmasi gereken ilk tetkik periferik yayma olmalidir." @default.
• W2324703119 created "2016-06-24" @default.
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• W2324703119 date "2016-01-22" @default.
• W2324703119 modified "2023-10-16" @default.
• W2324703119 title "A RARE CAUSE OF NEUTROPENIA: AN ILLUSION (EDTA-INDUCED PSEUDO-NEUTROPENIA)" @default.
• W2324703119 doi "https://doi.org/10.20515/otd.30448" @default.
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