Does hand mirror morphology a useful diagnostic tool for the treatment decision of acute undifferentiated leukemia at admission?

It is difficult how to manage acute undifferentiated leukemia in daily practice, but generally, hand mirror morphology provides ease to treat these patients. Thirty-nine years old male patient was admitted to with the complaints of echymosis, and pain at his left buttock due to an intramuscular injection for the treatment of previously diagnosed of the lower respiratory infection. Peripheral blood smear revealed >%50 blasts cells with a moderate nuclear: cytoplasmic ratio and one or more nucleoli. The blast cells showed a hand-mirror morphology and not harboring auer rods. According to the flow cytometric analysis the blastic cells do not represent to be originated from myeloid or lymphoid origin, because the cells harboring both of two cell lineages. AML-like therapy was commenced based on the positive myeloid markers including CD117 and CD135. Even though hand mirror morphology of the blasts usually demonstrates the lymphoid origin and the patients are treated as ALL like therapy, myeloid blasts rarely represents the same morphology, as was in our patient.

The clinicopathological features and survival of Castleman disease: a multicenter Turkish study

OBJECTIVE

In this study, we aimed to investigate the clinicopathological features and survival of CD, which is quite rare and has many unknowns.

PATIENTS AND METHODS

This study was conducted by retrospectively evaluating patients diagnosed with CD in six different centers in Turkey.

RESULTS

The median age of 33 patients included in the study was 49 and 51.5% (n = 17) of these patients were women. 18 (54.5%) patients were in the hyaline vascular subtype and most of the patients were UCD (n = 20, 60.6%). The most common involvement region was head and neck (n = 19, 57.5%). The UCD group was younger than the MCD group (p=0.027). Visceral lymph node involvement was higher in MCD than in UCD (p=0.001). Similarly, it was observed that there was more hepatomegaly (p=0.035) and splenomegaly (p=0.013) in the MCD group. During the median 19.5 months follow-up period, there were no patients who died.

CONCLUSIONS

It was observed that UCD and MCD are different clinical entities. Promising survival times can be achieved with surgical and systemic treatments in both subtypes of this extremely rare disease. However, this result should be supported by well-designed prospective comprehensive studies.

Using plasma exchange to successfully manage thyrotoxicosis in a patient with possible antithyroid drug-related thrombotic thrombocytopenic purpura

OBJECTIVE

Thrombotic thrombocytopenic purpura (TTP) is a rare disease characterized by microangiopathic hemolytic anemia, thrombocytopenic purpura, neurologic abnormalities, fever, and renal insufficiency. The association or co-existence of thyrotoxicosis or antithyroid drugs with TTP has not been previously reported. Subject and Results. Herein, we present a 54-year-old female patient newly diagnosed with toxic multinodular goiter accompanying with TTP, possibly triggered by either thyrotoxicosis or antithyroid drugs.

CONCLUSIONS

The present report is the first in the literature to demonstrate the co-existence of these two diseases and the use of plasma exchange as a modality to treat both conditions.

A forgotten screening test for iron deficiency anemia: oral iron absorption test

OBJECTIVE

In this study, we aimed to investigate the iron absorption defects using the oral iron absorption test (OIAT) in patients with iron deficiency anemia (IDA).

MATERIALS AND METHODS

Forty-six patients with IDA which nonresponder to oral iron treatment were included in the study. OIAT was started at 8 a.m. after an overnight fast; 52.8 mg of elemental iron were given orally as 160 mg of iron sulfate. Iron levels of all participants were analyzed at baseline and at the 3rd hour of the study.

RESULTS

Compared to baseline; serum iron levels whose serum iron levels exceed 91 mcg/ dl in 40(%87) patients. Further investigations in 6 patients revealed that 4 patients had chronic atrophic gastritis with helicobacter pylori infection; while the remaining 2 patients did not have any prominent.

CONCLUSIONS

This study demonstrated that OIAT is a good index for the evaluation of absorption defects and can be a screening clinical test of IDA.

Evaluation of serum levels of zinc, copper, and Helicobacter pylori IgG and IgA in iron deficiency anemia cases

OBJECTIVE

Iron deficiency anemia (IDA) is the most common form of anemia. Impaired intake absorption and blood loss are the main factors in the etiology. Impaired absorption can be caused by a decrease in trace elements such as copper and zinc, which are found in the structure of enzymes that coordinate iron metabolism or act as a catalyst for them, and the existence of Helicobacter pylori (H. pylori), which inhibits iron absorption in the stomach. Serum levels of zinc, copper, and H. pylori antibodies were measured in IDA cases, and correlations with IDA were evaluated.

PATIENTS AND METHODS

The study group was composed of 115 IDA cases who were followed at hematology outpatient clinics, and the control group was composed of 92 gender- and age-matched healthy individuals. Patients were diagnosed with iron deficiency anemia according to hemoglobin, serum ferritin, and iron levels and total iron-binding capacity. Serum zinc, copper, H. pylori immunoglobulin A (HpIgA) and immunoglobulin G (HpIgG), vitamin B12, and folic acid levels were examined in the blood specimens collected.

RESULTS

No statistically significant difference in zinc and copper serum levels between the study and control groups was observed (p > 0.05 for both groups). Although no difference was observed between the HpIgG levels of the two groups, patients with IDA had a statistically significant increase in HpIgA levels (p < 0.05). Pearson's correlation analysis showed that the zinc levels of the IDA group did not have a correlation with any parameters (p < 0.05 for all). Copper levels had a positive correlation with only the HpIgA level in the IDA group (r = 0.222, p = 0.017).

CONCLUSIONS

Trace elements and H. pylori infection did not have a correlation with IDA. Elevated levels of HpIgA and positive correlation of HpIgA with copper levels were observed. The literature review clearly suggests that several points require further explanation, and extensive research with larger samples is required.

CD11b(+)Ly6C(++)Ly6G(-) Cells with Suppressive Activity Towards T Cells Accumulate in Lungs of Influenza a Virus-Infected Mice

Influenza A virus (IAV) infection causes an acute respiratory disease characterized by a strong inflammatory immune response and severe immunopathology. Proinflammatory mechanisms are well described in the murine IAV infection model, but less is known about the mechanisms leading to the resolution of inflammation. Here, we analyzed the contribution of CD11b⁺Ly6C⁺⁺Ly6G^– cells to this process. An accumulation of CD11b⁺Ly6C⁺⁺Ly6G^– cells within the lungs was observed during the course of IAV infection. Phenotypic characterization of these CD11b⁺Ly6C⁺⁺Ly6G^– cells by flow cytometry and RNA-Seq revealed an activated phenotype showing both pro- and anti-inflammatory features, including the expression of inducible nitric oxide synthase (iNOS) by a fraction of cells in an IFN-γ-dependent manner. Moreover, CD11b⁺Ly6C⁺⁺Ly6G^– cells isolated from lungs of IAV-infected animals displayed suppressive activity when tested in vitro, and iNOS inhibitors could abrogate this suppressive activity. Collectively, our data suggest that during IAV infection, CD11b⁺Ly6C⁺⁺Ly6G^– cells acquire immunoregulatory function, which might contribute to the prevention of pathology during this life-threatening disease.

Serum uric acid and inflammation in patients with immune thrombocytopenic purpura: preliminary results

OBJECTIVE

The purpose of this study was to evaluate the uric acid (UA) and C-reactive protein (CRP) levels in patients with immune thrombocytopenic purpura (ITP).

PATIENTS AND METHODS

Forty patients with newly diagnosed ITP and 40 healthy individuals were enrolled in the study. The patients were divided into two groups; group 1 (n = 40) consisted of patients with ITP, and group 2 (n = 40) consisted of healthy subjects. UA and CRP levels were measured in the blood samples from them.

RESULTS

There were no statistical differences in gender, age and body mass index between two groups (p > 0.05 for all). Compared to group 2, group 1 had significantly higher UA levels (p = 0.002), whereas CRP levels were not significantly different (p > 0.05). In ITP patients, serum UA and CRP levels significantly correlated with low platelet count (r = -0.362, p = 0.022; r = -0.383, p = 0.015, respectively); and UA levels significantly correlated with CRP levels (r = 0.436, p = 0.005).

CONCLUSIONS

The present study showed that UA levels increased in patients with ITP and negatively correlated with platelet counts. UA levels might be a mediator of inflammation via enhanced production of inflammatory cytokines; they might also be a potential mediator of low platelet count, and could play a pathophysiological role in the development of ITP.

Primary tubercular chorioretinitis

The aim of this report is to emphasize that corticosteroids should not be prescribed when the etiological factors remain unidentified. A 34-year-old male visited our ophthalmology clinic suffering from blurred vision. Behçet's disease had been diagnosed 5 years prior, and the patient was taking an oral immunosuppressant and a systemic corticosteroid. Vitreous cell count and foci of chorioretinitis (apparently confined to the ocular fundus) were evident. A vitreous sample was subjected to polymerase chain reaction, which resulted in the identification of and Mycobacterium tuberculosis. Treatment with a combination of four anti-tuberculosis drugs was commenced. During the follow-up, the vitritis disappeared, and the foci of active chorioretinitis improved. Systemic and Sub-Tenon corticosteroid treatment should not be prescribed until vitreous and anterior chamber fluid samples have been evaluated in patients with uveitis. Some microbes are not detected on routine examination.

Serum oxidative stress, visfatin and apelin in healthy women and those with premenstrual syndrome

The aim of this study was to investigate whether there is a relationship between premenstrual syndrome and oxidative stress, visfatin and apelin. The study included 40 women with premenstrual syndrome and 40 healthy women. In all subjects, serum visfatin, apelin and oxidative stress parameters were studied in venous blood samples. The oxidative stress parameters were higher in the premenstrual syndrome group than among the controls, but this difference did not reach statistical significance (p > 0.05). It was found that total antioxidant capacity was similar in both groups. For the insulin-serotonin cycle markers, no significant difference was found between groups in terms of visfatin level (p = 0.893), although apelin was found to be significantly higher in the premenstrual syndrome group when compared with the controls (p < 0.001). According to our results, apelin can be used as an ancillary laboratory test in the diagnosis of premenstrual syndrome.

Prolidase activity and oxidative stress parameters in patients with nasal polyps

BACKGROUND AND AIM

Oxidative stress is believed to have a role in the development of nasal polyps (NPs). It is also known that prolidase activity increases secondary to chronic inflammation. The purpose of this study was to evaluate the association between prolidase activity and oxidative stress parameters in patients with NPs.

MATERIALS AND METHODS

Sixty patients with NPs, septal deviations and the concha hypertrophies were recruited to the study. Patients were divided into two groups; group 1 (n=30) consisted of patients with NPs, and group 2 (n=30) included patients with septal deviations and concha hypertrophies. Polyp specimens were taken from all patients who underwent endoscopic surgery for NPs. Control specimens were acquired from patients who underwent an operation for septoplasty or concha hypertrophy. Blood and tissue samples were obtained to assess lipid hydroperoxide (LOOH), catalase (CAT) and prolidase activity.

RESULTS

Compared to group 2, group 1 had significantly higher LOOH and prolidase levels, and lower CAT levels both in serum and tissue samples (p<0.05 for all). Prolidase activity was correlated with increased LOOH and decreased CAT levels (r = 0.507 p = 0.004; r = - 0.579, p = 0.001, respectively).

CONCLUSIONS

Our study demonstrated that oxidative stress and prolidase activity, both in serum and the tissue in patients with NPs, were higher than in patients without NPs.

Evaluation of preoperative and postoperative S-100B levels in children with chronic adenotonsillar hypertrophy: preliminary results

OBJECTIVES

Upper air obstruction leads hypoxia, it is also known that S-100B levels increase by glial activations indicate cerebral hypoxic injury. This study aimed to evaluate the preoperative and postoperative S-100B levels in children with chronic adenotonsillar hypertrophy.

PATIENTS AND METHODS

The study comprised 40 patients with indications for tonsillectomy and/or adenoidectomy following a diagnosis of chronic adenotonsillar hypertrophy and 40 age-gender matched control patients. Blood samples were taken from the patients preoperatively and at four weeks postoperatively. Preoperative and postoperative serum S-100B levels were analyzed.

RESULTS

The serum S-100B levels in the preoperative period were found to be significantly higher compared to those of the control group (p < 0.05). The S-100B levels were significantly decreased in the postoperative period (p < 0.05).

CONCLUSIONS

The development of chronic adenotonsillar hypertrophy would play a role in increased S-100B levels. This indicates that neuronal damage would exists in patients with chronic adenotonsillar hypertrophy.

Oxidative stress parameters and ceruloplasmin levels in patients with severe preeclampsia

BACKGROUND

Oxidative stress is believed to have a role in the development of preeclampsia (PE). It is known that an increased ceruloplasmin (CP) level is also associated with PE. The aim of this study was to investigate the relationship between oxidative stress parameters and CP levels in patients with severe PE.

PATIENTS AND METHODS

Sixty patients with severe PE and 60 healthy pregnant women were recruited to the study. All study subjects were divided into 2 groups; group 1(n=60) consisted of patients with severe PE, and group 2 (n=60) consisted of healthy pregnant subjects. Blood samples were obtained to measure CP, total antioxidant status and total oxidant status from all subjects. Oxidative stress index was calculated.

RESULTS

Compared to group 2; group 1 had significantly higher CP, total oxidant status, oxidative stress index and lower total antioxidant status levels (p<0.001, p<0.001, p=0.001, p=0.008, respectively). Serum CP levels were significantly correlated with oxidative stress index levels (r=0.385, p=0.002).

CONCLUSION

The present study demonstrated that both oxidative stress and CP levels increased in patients with PE, and increased CP levels seem to be a consequence of oxidative stress.

Evaluation of ceruloplasmin levels in patients with pulmonary cystic echinococcus

AIM

In this study, we aimed to evaluate serum CP levels in the serum samples before and after the surgical interventions in patients with pulmonary cystic echinococcus (CE).

MATERIALS AND METHODS

Forty-eight patients with pulmonary CE who underwent surgery and 48 healthy individuals were enrolled to the study. Patients were divided in two groups; group 1 (n=48) consisted of patients with pulmonary CE, and group 2 (n=48) consisted of healthy subjects. Before and after surgical interventions serum CP levels were measured.

RESULTS

Compared to group 2, group 1 had significantly higher CP levels at baseline (p <0.001). In group 1, CP levels were significantly decreased after the surgical intervention (p <0.001).

CONCLUSIONS

The present study showed that CP levels increased in patients with pulmonary CE; chronic inflammation may cause these rises, and may be an immune response of the host, and these levels decreased after the surgical intervention.

Effects of rosiglitazone treatment on insulin resistance and TNF-alpha levels in patients with chronic kidney disease: a prospective study

AIM

The aim of the study was to investigate the effects of rosiglitazone treatment on insulin resistance (IR) and tumor necrosis factor-alpha (TNF-alpha) levels in non-diabetic chronic kidney disease (CKD) patients with IR.

PATIENTS AND METHODS

Thirty non-diabetic CKD patients with IR were enrolled in the study. Patients were grouped into two: group 1 (n = 15) received rosiglitazone 4 mg tablet for 3 months and patients who did not receive rosiglitazone treatment constituted the group 2 (n = 15). Baseline and after rosiglitazone treatment, homeostatis model assessment-insulin resistance (HOMA-IR) and TNF-alpha levels were measured.

RESULTS

There were no statistical differences in gender, age, HOMA-IR and TNF-alpha levels among group 1 and group 2 (p > 0.05 for all). Compared to baseline in group 1, significant differences were found in HOMA-IR and TNF-alpha levels after 3 months (p = 0.023; p = 0.001, respectively).

CONCLUSIONS

Our study indicates that, rosiglitazone treatment improves the IR and decreases TNF-alpha levels in non-diabetic patients CKD with IR.

Familial Mediterranean fever without cardinal symptoms and role of genetic screening

Familial Mediterranean fever is an autosomal recessive disorder characterized by paroxysmal episodes of fever and serosal inflammation. The classical presentation is fever and severe recurrent abdominal pain due to serositis that lasts for one to three days and the resolves spontaneously. Between the episodes patients are asymptomatic. Ninety-five percent of patients with familial mediterranean fever have painful episodes localized to the abdomen, which is usually the dominant manifestation of the disease. Herein, we present a case of 34-year-old man with incomplete abdominal pain episode of familial mediterranean fever limited to the epigastrum and had no cardinals symptoms of this disease. The diagnosis was made by genetic screening. Successful treatment response was achieved by colchicine.

An adult-onset still's disease with autoimmune thyroiditis

Adult-onset Still's disease is a rare inflammatory disorder of unknown etiology and has same clinical characteristics of the systemic form of juvenile rheumatoid arthritis. A 17 years old white female had arthralgias of multiple joints including small joints of hands. She had fever, rash, hepatosplenomegaly, and CRP-122mg/dl, ESR-91mm in 1st hour. She had also TSH - 6.24μIU/mL, fT3 - 2.1pg/mL, fT4 - 1.36ng/dL and diagnosed as Adult-onset Still's disease with autoimmune thyroiditis. It is an inherited condition and is more common in women than in men.

The effect of day and night shifts on oxidative stress and anxiety symptoms of the nurses

BACKGROUND

Oxidative stress is believed to have a role in the development of chronic diseases. It is also known that long-term night and shift work in nurses might be associated with many health-related problems like fatigue, sleep problems, anxiety and difficulties in maintaining regular lifestyles.

AIM

In this study, we aimed to evaluate the changes of oxidative stress parameters and anxiety indexes of the nurses on day and night shifts.

MATERIALS AND METHODS

One hundred and twenty nurses in ordinary service and intensive care unit (ICU) were enrolled to the study. Subjects were divided into 2 groups; group 1 (n = 60) consisted of nurses working in a day shift and group 2 (n = 60) as working in the night shift. Further, both groups were divided in to 2 groups again; group la and 2a (both n = 30) who working in the ICU, group 1b and 2b (both n = 30) in the ordinary service. Just before and the end of the shifts, blood samples were obtained to measure total antioxidant status (TAS) and total oxidant status (TOS). Oxidative stress index (OSI) was calculated. Anxiety index were determined at the end of the shift using State-Trait Anxiety Inventory index.

RESULTS

Oxidative stress parameters were increased in all nurses at the end of the day and night shifts (p < 0.05). However, both in service and ICU nurses TAS, TOS, and OSI levels were not significantly different at the beginning and the end of the shifts (p > 0.05). Anxiety indexes of each ordinary service and ICU nurses were found to be similar (p > 0.05).

CONCLUSIONS

Ordinary service and ICU nurses' oxidative stress parameters and anxiety indexes were not different and all nurses suffer the similar effects of the shifts both in day and night.

Effects of melatonin on testis histology, oxidative stress and spermatogenesis after experimental testis ischemia-reperfusion in rats

BACKGROUND

Testicular torsion due to oxidative stress results in infertility and testicular damage which can be preventable an important health problem worldwide.

AIM

The purpose of the present study was to investigate the changes of malondialdehyde (MDA), total antioxidant status (TAS), total oxidant status (TOS) levels; histopathological alterations; morphology, concentration and motilities of the sperm in post ischemic reperfused (I/R) testis tissue.

MATERIALS AND METHODS

Forty adult male Wistar rats were carried out and were randomized to five groups; (1) Control group, (2) Ipsilateral left testis ischemia, (3) Melatonin plus ipsilateral left testis ischemia, (4) Contralateral right testis ischemia, 5. Melatonin plus contralateral right testis ischemia. After 1 h ischemia and 24 h perfusion; MDA, TAS and TOS levels were measured, histopathological alterations were determined using by Johnsen's score (JS) and sperm morphology, concentration, motility were examined.

RESULTS

MDA, TAS and TOS levels of the testis tissue did not change in all groups (p > 0.05 for all). JS was decreased in I/R group and melatonin treatment reversed histopathological changes and increased JS both in ipsilateral and contralateral testis. Abnormal sperm rate significantly increased in I/R group and melatonin administration changed abnormal sperm rate to normal.

CONCLUSIONS

As a result, the present study demonstrated that testicular damage occurs following I/R without an increase of MDA, TAS and TOS levels. Our results also suggested that melatonin is a potent antioxidant agent in preventing testicular I/R injury, as shown by increased JS and changed abnormal sperm rate.

Evaluation of pre- and post-surgical oxidative stress parameters in patients with pulmonary cystic echinococcus

BACKGROUND

Hydatid cyst secretes numerous immunomodulatory molecules to the host, and the host reacts these molecules by activating immune response. It is also known that, immune cells generally produce more oxidative products.

AIM

In this study, we aimed to evaluate the antioxidant enzyme using catalase (CAT) and oxidant enzyme using lipid hydroperoxide (LOOH) levels in the serum samples before and after the surgical interventions in patients with pulmonary cystic echinococcus (CE).

PATIENTS AND METHODS

Forty patients with pulmonary CE who underwent surgery and 40 healthy individuals were enrolled to the study. Patients were divided in two groups; group 1 (n=40) consisted of patients with pulmonary CE, and group 2 (n=40) consisted of healthy subjects. Before and after surgical interventions serum CAT and LOOH levels were measured.

RESULTS

Compared to group 2, group 1 had significantly lower CAT and higher LOOH levels before surgery (both p < 0.001). In group 1; CAT levels were significantly increased and LOOH levels significantly increased after the surgical intervention (both p < 0.001).

CONCLUSIONS

The present study showed that oxidative stress increased in patients with pulmonary CE, may be consequence of immune response of the host, and these levels decreased after the surgical intervention.

Effect of melatonin and n-acetylcysteine on hepatic injury in rat induced by methanol intoxication: a comparative study

BACKGROUND

Methanol intoxication leads liver injury; in contrast melatonin and n-acetyl cysteine (NAC) are known to have protective effects on liver.

AIM

We aimed to investigate the ultrastructural effects of melatonin and NAC on livers of methanol intoxicated rats and compare potential protective effects of melatonin and NAC on their liver ultrastructure.

MATERIALS AND METHODS

Fifty-six adult male Wistar rats were carried out and were randomized to eight groups that have seven rats each: Control groups (C 6h, C 24h), treated with intragastric (i.g.) 1.0 ml saline; Methanol groups (M 6h, M 24h), treated with a dose of 3 g/kg i.g. methanol; Melatonin plus methanol groups (MEL+M 6h, MEL+M 24h), treated with dose of 10 mg/kg i.p melatonin immediately, following with a dose of 3 g/kg i.g. methanol; NAC plus methanol groups (NAC+M 6h, NAC+M 24h), treated with dose of 150 mg/kg, following with a dose of 3 g/kg i.g. methanol. 24 h group rats were given the same dose of melatonin and NAC 12 h after intoxication. Electron microscopy was used to evaluate histological changes in liver tissue at both 6th and 24th hour.

RESULTS

Histopathological damage was found to be higher in methanol-induced intoxicated rats compared with the controls. Extensive tubules of smooth endoplasmic reticulum, increased mitochondria, increased primary lysosomes and some marked openings of bile canaliculus were distinguished. Melatonin administration prevents liver injury especially in early hours and although not as effective as melatonin, NAC also prevents liver injury.

CONCLUSIONS

Melatonin is much more efficient than NAC, as well as significantly greater hepatoprotective effect against the liver injury secondary to the methanol intoxication.

Correlation between the resistive index values of renal and orbital arteries

BACKGROUND

Resistive index (RI) is an indirect measurement of blood flow resistance that can be used to evaluate vascular damage.

AIMS

The purpose of this study is to evaluate the association between RI values of orbital and intrarenal arteries by means of Doppler ultrasonography (US).

METHODS

We evaluated 103 diabetic patients. As a control group, 30 subjects were examined. The patients were divided into two groups. Group 1 consisted of patients with urinary albumin excretion (UAE) <300 mg/day and estimated glomerular filtration rate (eGFR) levels >90 ml/min (n = 50); Group 2 had a UAE >300 mg/day and/or eGFR levels between 89 and 60 ml/min (n = 53). The association between RI values obtained with Doppler US of the ophthalmic artery, central retinal artery, posterior ciliary artery and intrarenal arteries were calculated.

RESULTS

Both orbital and intrarenal arterial RI values in Group 1 and Group 2 were higher than the control group (p = 0.001); furthermore, values were higher in Group 2 than in Group 1 (p = 0.0004/0.029/0.036, p = 0.016, respectively). A positive correlation was found between orbital and intrarenal arterial RI values in Group 2 (r = 0.475, 0.285, 0.363, p < 0.01, respectively).

CONCLUSION

Both orbital and renal arterial RI values were shown to be higher than the control group. Further, a trend towards higher RI values was observed with renal disease. RI may be useful as one of the markers for early diagnosis and follow-up of diabetic nephropathy and retinopathy.

Effect of cholecalciferol on parathyroid hormone and vitamin D levels in chronic kidney disease

AIM

We aimed to determine the effect of a monthly oral vitamin D on the serum 25-hydroxyvitamin D levels and iPTH levels in patients with CKD.

METHODS

This was a prospective controlled trial of 48 patients with CKD stage 3-4. Patients were divided into two groups Group1 the cholecalciferol treatment group, Group 2, the control group. One patient in Group 1, and 3 patients in Group2 were excluded after the baseline 25(OH)D levels were determined to be greater than 30ng/ml. Two patients in Group1, and one patient in Group 2 were excluded after the baseline iPTH was determined to be less than 70 pg/ml and greater than 300 pg/ml. Five patients in both groups were lost to follow-up. Thus, a total of 16 patients in Group 1 and 15 patients in Group2 completed the three month study. Group1 patients received 300,000 IU month oral cholecalciferol.

RESULTS

The mean serum 25(OH)D concentration of the group1 was significantly higher at baseline (P=0.039). At the end of the three months; serum 25 (OH) D level increased significantly in Group1 (P=0.001). iPTH level of Group1 was significantly lower at baseline (P=0.034). The values of the group1 before and end of third month was compared, serum Ca (P=0.011), P (P=0.013) level showed significant increase, but no significant increase in the Group 2 (P>0.05). The groups had not a clinically significant change in serum Ca and P level (P>0.05).

CONCLUSION

Oral cholecalciferol supplementation can be used safely and effective in reducing iPTH levels and correcting vitamin D insufficiency/deficiency in patients with CKD.