Assessment of both serum S-100B protein and neuropeptide-Y levels in childhood breath-holding spells.

OBJECTIVE: Breath-holding spells are common paroxysmal events in children. Although the spells have a benign prognosis in the long term, they may be complicated by loss of consciousness, tonic-clonic movements, and occasionally seizures. Hence, this study aimed to measure the levels of serum S-100B proteins and neuropeptide-Y in the blood of children who experience breath-holding spells. METHODS: The study groups consisted of 45 patients (13 females, 32 males) with breath-holding spells and a control group of 32 healthy individuals (12 females, 20 males). The serum S-100B levels were measured using commercially available ELISA kits. The neuropeptide-Y levels in the serum were measured with RayBio® Human/Mouse/Rat Neuropeptide Y ELISA kits. RESULTS: The mean serum S-100B protein level of the breath-holding spells group was 56.38 ± 13.26 pg/mL, and of the control group, 48.53 ± 16.77 pg/mL. The mean neuropeptide-Y level was 62.29 ± 13.89 pg/mL in the breath-holding spells group and 58.24 ± 12.30 pg/mL in the control group. There were significant differences between the groups with respect to serum S-100B protein levels (p = 0.025), while there was no statistically significant difference in neuropeptide-Y levels between the breath-holding spells group and the control group (p = 0.192). CONCLUSIONS: The findings of this study suggest that frequent and lengthy breath-holding may lead to the development of neuronal metabolic dysfunction or neuronal damage which is most likely related to hypoxia. In light of these findings, future studies should be conducted using biochemical and radiological imaging techniques to support these results.

Efficacy of deferasirox in children with ß-thalassemia: single-center 3 year experience.

BACKGROUND: Iron chelation therapy is an important component in the management of patients with ß-thalassemia. METHODS: The study included 87 children with transfusion-dependent ß-thalassemia aged 2-17 years (mean, 8.2 ± 4.1 years), 49 (56%) of whom were male. The patients received deferasirox 9-40 mg/kg per day as a single dose for 36 months. They were clinically and laboratory monitored. RESULTS: The treatment was generally well tolerated. Drug-related adverse events, including abdominal pain (14.9%) and nausea (5.8%), high alanine aminotransferase more than double the upper limit of normal (5.8%), and non-progressive rise in serum creatinine (2.3%), were generally mild to moderate, transient, and reduced in frequency over time. Two patients discontinued treatment due to severe abdominal pain and nausea. Mean deferasirox dose was calculated as 21.2 ± 8.6, 23.7 ± 8.1, 30.7 ± 8.2 and 32.4 ± 7.6 mg/kg per day at 0, 12, 24 and 36 months, respectively. Mean (median) serum ferritin level was found to increase progressively during the first 22 months of treatment, from 3.161 ± 1.683 ng/mL (2.760 ng/mL) to 3.679 ± 1.997 ng/mL (3.071 ng/mL; P < 0.001) and then decreased gradually to 2.907 ± 1.436 ng/mL (2.670 ng/mL; P = 0.023) at 36 months. CONCLUSION: Deferasirox is safe and well tolerated; doses 21-24 mg/kg per day were not able to maintain stable iron balance, but ≥ 30 mg/kg per day was able to reduce iron in regularly transfused pediatric patients.

PD-1 gene polymorphism in children with subacute sclerosing panencephalitis.

Subacute sclerosing panencephalitis (SSPE) is a progressive inflammatory and degenerative disorder of the central nervous system. Several factors influence the risk of chronic brain infection with the mutant measles virus. However, to date, no pathogenic mechanism that may predispose to SSPE has been determined. Studies have indicated that specific polymorphisms in certain host genes are probably involved in impairing the ability of host immune cells to eradicate the measles virus in SSPE patients. Programmed cell death protein 1 (PD-1), a member of the CD28 family, is a negative regulator of the immune system. The purpose of our study was to investigate whether PD-1 gene polymorphisms affect susceptibility to the development of SSPE in Turkish children. In total, 109 subjects (54 SSPE patients and 55 healthy controls) were genotyped for the PD-1.9 C/T (rs2227982) single-nucleotide polymorphism (SNP). The distributions of T alleles in the PD-1.9 polymorphism in SSPE patients and healthy controls were 2.8 and 10.9%, respectively. There was a statistically significant difference between the groups; the 95% confidence interval (CI) was 0.06 to 0.85 and the odds ratio (OR) was 0.23 (χ(2) test). Thus, we identified an association between SSPE and the PD-1 rs2227982 gene polymorphism; the frequency of T alleles was higher in controls than in SSPE patients.

Increased oxidant status in children with breath-holding spells.

BACKGROUND: Breath-holding spells (BHS) are the most common form of non-epileptic paroxysmal events in infancy. The pathophysiology of BHS is not fully understood. Iron-deficiency anemia (IDA) may be a factor contributing to breath-holding spells. Although numerous reports have shown that elevated oxidative stress is implicated in the pathophysiology of neurodegenerative diseases and neurological conditions, such as epileptic seizures, brain damage, and neurotrauma, there are no data regarding the role of oxidative stress in the development of BHS. This study aimed to investigate oxidative stress in children with BHS. METHODS: This case-control study was conducted at the Department of Pediatric Neurology, Harran University School of Medicine, Sanliurfa, in Turkey. Blood samples from 31 patients (14 females, 17 males) with BHS which were taken at least 24 h after the BHS attack, and a control group of 35 healthy individuals (13 females, 22 males) were used for the measurement of the plasma total antioxidant capacity, total oxidant status, and oxidative stress index, hemoglobin concentration, serum iron, transferrin saturation and serum ferritin levels. RESULTS: The plasma total antioxidant capacity values were markedly lower and total oxidant status and oxidative stress index values in the BHS group were significantly higher than that in the controls (P ≤ 0.01). CONCLUSION: Our data suggest that the value of oxidative stress was significantly higher in patients with BHS than in the controls. Conditions associated with increased oxidative stress such as IDA may be a risk factor for the development of BHS.

Clinical and neurological findings of severe vitamin B12 deficiency in infancy and importance of early diagnosis and treatment.

AIM: Nutritional vitamin B12 deficiency among children in developing countries may lead to a severe clinical status. In this article, the clinical manifestations of vitamin B12 deficiency and the consequences of delay in its diagnosis have been evaluated. METHODS: A total of 41 patients who were hospitalised and treated with the diagnosis of severe vitamin B12 deficiency in the paediatric haematology department of the hospital were enrolled in the trial. The diagnosis of severe vitamin B12 deficiency was based on haematological values, a serum vitamin B12 level of <100 pg/mL and a normal level of folic acid. Mental, neuro-motor and social developments of the enrolled patients were assessed by the same physician using the Ankara Developmental Screening Inventory. RESULTS: The mean age of 25 male and 16 female patients was determined as 12 (6-18 months) months. Almost all of the children had been fed with breast milk and a poor nutritional state was found in all of the mothers. Non-specific findings such as growth retardation (78%), hyperpigmentation of the skin (78%), diarrhoea (63.4%), convulsion (14.6%), weakness, reluctance to eat, vomiting, irritability and tremor were found in all the patients, in addition to hypotonia, motor retardation and pallor. Treatment with vitamin B12 provided recovery in all the patients. The mean age of the patients with full recovery was 11.7 months, while the mean age of patients with partial recovery was 12.9 months. CONCLUSION: As a delay in the diagnosis causes irreversible neurological damage, early diagnosis and treatment is highly important.

The oxidative and antioxidative status of simple febrile seizure patients.

OBJECTIVE: To evaluate the oxidative status following a seizure in children experiencing a simple febrile seizure. METHODS: The cross-sectional study was conducted at Harran University, Turkey, between January and September 2011. It comprised 32 paediatric patients who, within the preceding 8 hours, had experienced a seizure due to upper respiratory tract infection and had been diagnosed with simple febrile seizure, and 30 healthy children as the control group. Blood was taken from the patients 8 hours after the seizure. Total oxidant level and Total anti-oxidant level were measured according to the Erel technique and the oxidative stress index was calculated. Data was analysed using SPSS 11.5. RESULTS: The mean values of the total oxidant level and the oxidative stress index of the cases were found to be significantly high compared to the controls and the total anti-oxidant level was found to be significantly low (p < 0.01, p < 0.01, p < 0.03 respectively). CONCLUSION: The increased total oxidant level and decreased total anti-oxidant level resulting in increased oxidative stress associated with febrile seizure patients may increase the risk of experiencing febrile seizures.

Masked subdural empyema secondary to frontal sinusitis.

Intracranial complications of pediatric sinusitis are rare but potentially life threatening. These complications include cavernous sinus thrombosis, orbital infection, meningitis, and subdural empyema. Children with these complications may experience significant morbidity from their infection. In such cases, delay in diagnosis and treatment may lead to severe brain damage or death. Emergency physicians, pediatricians, and otolaryngologists should maintain a high index of suspicion for this complication of disease when treating patients with sinusitis in the emergency department or outpatient clinic. Early and accurate diagnosis of subdural empyema will lead to prompt treatment and a favorable outcome for the patient. We report a case of subdural empyema secondary to frontal sinusitis in an otherwise healthy immunocompetent adolescent boy.

Oxidative status and DNA damage in chidren with marasmic malnutrition.

Malnutrition as a lack of several substances containing antioxidants such as vitamins and micronutrients, while showing a predisposition for lipid peroxidation and DNA damage, is also characterized by a slowing down of the metabolic processes, which may then have protective properties against DNA damage due to a reduction in endogenous free radical production. This study aimed to examine the oxidative status and DNA damage in cases of marasmus. The study comprised 28 infants aged 6-24 months with marasmus only and 28 age-matched healthy infants. DNA damage was examined by the alkali single cell electrophoresis method (Comet assay) on mononuclear leukocytes. The total oxidant status (TOS) and total antioxidant status (TAS) were measured by colormetric auto-analyzer and the oxidative stress index (OSI) was calculated. The TOS, TAS, and OSI levels of the patient group were found to be significantly lower compared to the control group (P < 0.01, P < 0.01, P < 0.01, respectively). No statistically significant difference was found between the two groups in terms of mononuclear leukocyte DNA damage (P > 0.05). The findings of this study showed that in marasmus cases, the oxidative and antioxidative processes, which have a counteractive effect, decreased together. The other results of the study indicate that there is no increase in DNA damage in marasmus cases.

The effect of age on the paraoxonase and arylesterase activity of pregnant mothers and their infants.

AIM: The study aimed to research the effect of maternal age at pregnancy on the paraoxonase (PON) and arylesterase activity levels of mothers and infants. METHOD: The study comprised 30 mothers aged more than 35 years and their infants, and 30 mothers aged under 25 years and their infants. All pregnancies had been of 38-42 weeks with normal spontaneous vaginal birth. PON and arylesterase activities were measured using paraoxon and phenylacetate substrates. RESULTS: When the PON and arylesterase enzyme activities were compared, the PON and arylesterase activity of the mothers aged more than 35 years was found to be statistically significantly lower compared to that of the mothers aged under 25 years (P = 0.006 and P = 0.03, respectively), while there was no statistically significant difference in PON and arylesterase enzyme activity between the two groups of infants (P > 0.05). CONCLUSION: While the PON and arylesterase enzyme activity of the mothers aged more than 35 years was found to be significantly lower compared to that of the mothers aged under 25 years, there was no statistical significance between the infants. This can be explained by the reduced PON and arylesterase enzyme activity during pregnancies at an older age, although this did not affect the PON and arylesterase enzyme activity of the infants.

Evaluation of carotid intima-media thickness, a marker of subclinical atherosclerosis, in children with cerebral palsy.

BACKGROUND: Respiratory and cardiovascular diseases are the most common causes of death in children with cerebral palsy. OBJECTIVE: To evaluate sonographic carotid intima-media thickness, an early marker of atherosclerosis, in children with cerebral palsy and in healthy controls. MATERIALS AND METHODS: One hundred children with cerebral palsy (65 boys), mean age 6.2 (SD, 2.1) years, and 35 age-matched and sex-matched healthy controls were included. Common carotid artery intima-media thickness was measured sonographically. Differences between patients and controls were evaluated with an independent samples t-test. RESULTS: Age, sex distribution and levels of serum lipids were comparable between patients and controls. Average, right and left carotid artery intima-media were thicker in patients compared with controls (mean ± SD, 0.61 ± 0.13 mm vs 0.40 ± 0.03 mm; 0.61 ± 0.14 mm vs 0.40 ± 0.03 mm; 0.61 ± 0.13 mm vs 0.40 ± 0.03 mm, respectively; all P < 0.001). CONCLUSION: Carotid intima-media is sonographically thicker in children with cerebral palsy compared with healthy controls, which may express an increased risk of atherosclerotic diseases.

Evaluation of the glucocorticoid, mineralocorticoid, and adrenal androgen secretion dynamics in a large cohort of patients aged 6-18 years with transfusion-dependent ß-thalassemia major, with an emphasis on the impact of cardiac iron load.

The variable presence of adrenal insufficiency (AI) due to hypocortisolemia (HC) in patients with thalassemia is well established; however, the prevalence of adrenocortical hypofunction (ACH) in the zona glomerulosa and zona reticularis of the adrenal cortex is unknown. To establish the prevalence of ACH, we examined the cortisol response to 1-µg and 250-µg ACTH tests, plasma aldosterone (A)/plasma renin activity (PRA) ratio, and serum dehydroepiandrosterone sulfate (DHEAS) levels in a large cohort of patients with thalassemia, and to investigate the impact of total body iron load (TBIL) on adrenocortical function. The setting used was University hospital and government-based tertiary care center. One hundred twenty-one (52 females) patients with ß-thalassemia major (ß-TM) and 72 healthy peers (38 females) were enrolled. The patients underwent a 250-µg cosyntropin test if their peak cortisol was <500 nmol/L in a 1-µg cosyntropin test. Magnetic resonance imaging (MRI) was performed to assess the MRI-based liver iron content and cardiac MRI T2* iron. The associations between ACH and TBIL were investigated. The patients with thalassemia had lower ACTH, cortisol, DHEAS, and A/PRA values compared with the controls (p < 0.001). Thirty-nine patients (32.2 %) had HC [primary (n = 1), central (n = 36), combined (n = 2)], and 47 (38.8 %) patients had reduced DHEAS levels; 29 (24.0 %) patients had reduced A/PRA ratios. Forty-six (38.0 %) patients had hypofunction in one of the adrenal zones, 26 (21.5 %) had hypofunction in two adrenal zones, and 9 (7.4 %) had hypofunction in all three zones. Patient age and TBIL surrogates were significant independent parameters associated with ACH. Cardiac MRI T2* iron was the only significant parameter that predicted the severity of ACH at a cut-off of 20.6 ms, with 81 % sensitivity and 78 % specificity. Patients with thalassemia have a high prevalence of AI due to HC and zona glomerulosa and zona reticularis hypofunction. TBIL surrogates can predict ACH, but cardiac iron was the only surrogate that was adequately sensitive to predict the severity of ACH.

Visual and brainstem auditory evoked potentials in infants with severe vitamin B12 deficiency.

BACKGROUND/AIM: Vitamin B12 plays an important role in the development of mental, motor, cognitive, and social functions via its role in DNA synthesis and nerve myelination. Its deficiency in infants might cause neuromotor retardation as well as megaloblastic anemia. The objective of this study was to investigate the effects of infantile vitamin B12 deficiency on evoked brain potentials and determine whether improvement could be obtained with vitamin B12 replacement at appropriate dosages. MATERIALS AND METHODS: Thirty patients with vitamin B12 deficiency and 30 age-matched healthy controls were included in the study. Hematological parameters, visual evoked potentials, and brainstem auditory evoked potentials tests were performed prior to treatment, 1 week after treatment, and 3 months after treatment. RESULTS: Visual evoked potentials (VEPs) and brainstem auditory evoked potentials (BAEPs) were found to be prolonged in 16 (53.3%) and 15 (50%) patients, respectively. Statistically significant improvements in VEP and BAEP examinations were determined 3 months after treatment. Three months after treatment, VEP and BAEP examinations returned to normal in 81.3% and 53.3% of subjects with prolonged VEPs and BAEPs, respectively. CONCLUSION: These results demonstrate that vitamin B12 deficiency in infants causes significant impairment in the auditory and visual functioning tests of the brain, such as VEP and BAEP.

Evaluation of Pre-Treatment and Post-Treatment S100B, Oxidant and Antioxidant Capacity in Children with Diabetic Ketoacidosis.

OBJECTIVE: The study aimed to evaluate the pre-treatment and post-treatment oxidant capacity, antioxidant capacity and S100B protein levels in cases of diabetic ketoacidosis (DKA). METHODS: The study included 49 pediatric patients diagnosed with DKA and a control group comprising 49 healthy children. Blood samples were obtained after confirmation of the DKA diagnosis and also after treatment. S100B, total oxidant (TOL) and total antioxidant levels (TAL) were measured and the oxidative stress index (OSI) was calculated. RESULTS: When the pre-treatment and post-treatment values of patients with DKA were compared with those of the healthy control group, the S100B level, TOL, TAL and OSI were found to be significantly higher in the diabetes group (p<0.001). Pre-treatment TOL and TAL were also significantly higher than post-treatment levels (p<0.001), while no statistically significant difference was found in the S100B levels or the OSI (p>0.05). CONCLUSION: We believe that long-term exposure to high blood glucose concentrations leads to an increase in TOL in patients with DKA and that the neurotransmitter changes that develop in response to this exposure lead to an increase in S100B levels, which is an indicator of neuronal damage.

An Evaluation of Oxidative Status in Serum and Breast Milk of Mothers Giving Birth Prematurely and at Full-Term.

BACKGROUND: Burning fat and carbohydrates to provide energy in biological systems causes the formation of free oxygen species. OBJECTIVES: This study aimed to evaluate the oxidative status of serum and breast milk of mothers giving birth prematurely and at full-term. MATERIALS AND METHODS: The study comprised 50 mothers who gave birth at full-term at more than 38 weeks and 43 mothers who gave birth pre-term at below 32 weeks. On the postnatal 5th day, samples of the mother's milk and serum were taken and stored at -80°C until the study day. On the study day, the total oxidant and total antioxidant levels were measured using the Erel method and the oxidative stress index (OSI) was calculated. RESULTS: While the total oxidant level and total antioxidant level values of the milk of the premature birth mothers were found to be significantly high compared to those of the full-term birth mothers (P = 0.001), no statistically significant difference was found in the oxidative stress index values (P > 0.05). No statistically significant difference was found in the total oxidant level and oxidative stress index values of the serum of the premature birth mothers compared to those of the full-term birth mothers, while the total antioxidant level was found to be significantly low (P = 0.04). CONCLUSIONS: The oxidants and antioxidants in the milk of mothers giving birth prematurely were found to be significantly higher than those of full-term birth mothers. This can be evaluated as the milk of the premature birth mothers providing increased antioxidant defense to protect the infant.

Doppler echocardiographic evaluation of pulmonary artery pressure in children with acute pneumonia.

In this prospective study 37 children (ranging 2 months-15 years) with acute pneumonia were evaluated by Doppler echocardiography for the presence of pulmonary hypertension (PH). The goal of this study was to determine the frequency of PH in children with acute pneumonia because the diagnosis of PH influenced the treatment of pneumonia in these patients. The patients who had more than 35 mmHg of systolic pulmonary arterial pressure were considered to have PH. In our study PH was found in 15 (40.5%) of 37 patients. We did not find any significant difference for the parameters including the age, weight, height, clinical symptoms and signs (fever, cough, dyspnea, tachycardia and tachypnea etc.), and laboratory findings such as hemoglobin, PCO2, HCO3 and PO2 between the patients with and without PH (p>0.05). However, there was a significant difference in cyanosis, cardiac failure, blood pH level and O2 saturation measured by pulse oximetry between the patients with and without PH (p<0.05).

Serum paraoxonase/arylesterase activity and oxidative stress status in children with metabolic syndrome.

OBJECTIVE: This study aimed to measure paraoxonase/arylesterase activities and to evaluate the total oxidant and antioxidant capacities in obese children and in children with metabolic syndrome (MetS). METHODS: A total of 151 children of comparable ages (13.23±1.96 years, 13.45±1.85 years and 13.95±1.31 years) were enrolled in the study. Forty of these were children with MetS, 55 were obese and 56 were healthy controls. Diagnosis of the MetS was made according to International Diabetes Federation criteria. Paraoxonase/arylesterase activities were evaluated by using paraoxon and phenylacetate substrates. Total oxidant status (TOS) and total antioxidant status (TAS) were measured and oxidative stress index (OSI) was estimated by calculation. RESULTS: High levels of paraoxonase were detected in the obese group, whereas high levels of arylesterase were detected in both MetS and obese groups. Higher values for TOS, TAS and OSI were found in the MetS group (p<0.05). CONCLUSION: Higher values of mean TOS and OSI in the MetS group than those in the control groups indicate that these parameters may be indicators of future risks such as atherosclerosis in patients with MetS.

Interictal serum S-100B protein levels in intractable epilepsy: a case-control study.

Epilepsy is the most common neurologic disorder of childhood. In approximately 6-14% of all patients with epilepsy, complete seizure control is difficult to achieve with current antiepileptic treatments. Several current studies have shown in both animals and people that the lengthening of epileptic seizures and frequent recurrence increases the likelihood of neuronal damage. S-100B protein is the most analyzed brain derived peripheral biochemical marker in brain damage. This study aimed to evaluate interictal serum S-100B protein levels in children diagnosed with intractable epilepsy. A group of 32 patients with intractable epilepsy and 25 healthy controls were recruited. Serum S-100B protein levels were measured using a commercially available electrochemiluminescence immunoassay (ECLIA kit, as supplied and according to the manufacturer's standards. The serum S-100B protein levels of the patient group in the study were found to be 0.094±0.011 µm/L, and 0.083±0.014 µm/L in the age-matched control group. The difference between the groups was determined to be statistically significant (P=0.004). In conclusions, it can be said that as the serum S-100B protein levels of the patients with focal epilepsy were high compared to those of the control group, this can be reliable peripheral biomarker for neuronal damage in patients with focal intractable epilepsy.

Evaluation of selenium levels and mean platelet volume in patients with simple febrile convulsion.

OBJECTIVE: This study aimed to evaluate serum selenium levels and mean platelet volume in children who experience simple febrile convulsion. METHODS: The study comprised 42 patients diagnosed with simple febrile convulsions and a control group of 30 healthy children. Blood samples were taken following a febrile convulsion. Selenium levels in the serum of both the patients and control subjects were measured with the hydride formation method on an atomic absorption spectrometry device and mean platelet volume was evaluated. FINDINGS: When the mean values of the febrile convulsion patients were compared with those of the control group, the mean selenium levels and thrombocyte count were found to be statistically significantly low (P=0.002, P=0.01 respectively) and the mean platelet volume values were statistically significantly high (P=0.002). CONCLUSION: While low serum selenium levels cause the onset of a febrile seizure in patients with simple febrile convulsion, it is thought that the increased mean platelet volume shows infection activity causing febrile convulsion.

Novel fructose-1,6-bisphosphatase gene mutation in two siblings.

Fructose-1,6-bisphosphatase (FBPase) deficiency is an autosomal, recessively inherited disease that progresses with severe hypoglycemia, and metabolic attacks result in a defect in gluconeogenesis. If not appropriately treated, and if fructose is not excluded from the diet, the outcome could be fatal. Two Turkish children with FBPase deficiency were diagnosed based on mutation of the FBP1 gene. The first, a 2-year-old girl, was referred to our clinic because of lactic acidosis, uncorrectable hypoglycemia, and increased transaminases. FBPase deficiency was suspected in the patient, who recovered dramatically after a high-dose glucose infusion and adequate bicarbonate replacement. The second patient, a five-and-a-half-year-old male sibling of the patient, was also hospitalized, twice, because of hypoglycemic attacks and metabolic acidosis. Different from previous analyses, a homozygous c.658delT mutation was detected at exon 5 of the FBP1 gene in the two siblings. As a result of this mutation, there was a TGA (stop codon) at exon 6. There was first-degree consanguinity between the parents. These two cases were the first FBP1 gene mutations reported in our country.

Oxidative imbalance in child and adolescent patients with obsessive compulsive disorder.

Various psychological, social, genetic and biochemical factors are thought to be involved in etiology of obsessive-compulsive disorder (OCD). To the best of our knowledge there are no studies investigating the effects of free radicals in children and adolescents with OCD. This study evaluated total oxidant and antioxidant status, oxidative stress index, and arylesterase and paraoxonase activity in children and adolescents with OCD. The study included 28 patients diagnosed with OCD and 36 healthy children as an age- and sex-matched control group. Their serum total oxidant status (TOS) and total antioxidant status (TAS) were measured and the oxidative stress index (OSI) was calculated. Although serum TOS and OSI values in the OCD patients were significantly higher than those in the control group (p = 0.008, p < 0.001, respectively), TAS and paraxonase activity were significantly lower ( p < 0.001 for both). However, no statistically significant difference in arylesterase activity was found (p > 0.05). The increase in oxidative status and decrease in antioxidants in patients with OCD demonstrate that oxidative stress may have an important role in the pathophysiology of the disease. It has been suggested that drugs that contain antioxidants should be added to conventional pharmacotherapy during follow-up.