Browsing by Author "Akcura, C"

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    Clinicopathological Reflections of Hashimoto's Thyroiditis and Papillary Thyroid Carcinoma Coexistence
    Akcura, C; Alkan, S; Güney, SC; Çavdar, GG; Senol, E; Tan, AY; Özdemir, N; Aydede, H; Hekimsoy, Z
    Objective: Papillary thyroid carcinoma (PTC) is the most common subtype of thyroid cancer. Hashimoto's thyroiditis (HT), a chronic inflammation of the thyroid gland, is one of the most common autoimmune diseases worldwide. In this study, we aimed to determine the relationship between PTC and HT and the clinicopathological effects of the combination of HT and PTC on the course of PTC. Methods: In this cross-sectional retrospective study, PTC cases who underwent surgery and were followed up at our institution's endocrinology outpatient clinic between 2014 and 2022 were divided into two groups according to the presence of HT. Demographic data of both groups, pathological features of the tumor, and preoperative laboratory findings were examined. Results: A total of 42.4% (n=118) of 278 cases were accompanied by HT. The mean age of the patients was 46.44 +/- 12.2 years. The majority of patients were female (80.6%, n=224). Multifocality was significantly less common in the HT group (p=0.037). Conclusion: Although multifocality was significantly less common in the HT group, no other statistically significant parameter was discovered in other clinicopathological findings. In light of these findings, the effect of HT on the course of PTC cannot be clearly determined. Considering the conflicting results regarding the effect of HT-PTC coexistence on the course of PTC in the literature, a comprehensive prospective study on this subject is necessary.
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    Are Inflammation Markers Derived from Hemogram Parameters Predictive for Papillary Thyroid Carcinoma in Hashimoto's Thyroiditis Patients?
    Akcura, C; Guney, SC; Alkan, S; Cavdar, GG; Tan, AY; Aydede, H; Hekimsoy, Z; Ozdemir, N
    Hashimoto's thyroiditis (HT) and papillary thyroid carcinoma (PTC) are two endocrine disorders, and chronic inflammation plays a key role in their pathogeneses. Recent studies have shown that some inflammation markers derived from hemogram parameters such as neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) are helpful in showing inflammation in many autoimmune diseases and cancers. We aimed to investigate how the coexistence of HT and PTC will affect the inflammation markers derived from hemogram parameters. Eighty PTC patients with coexisting HT (Group 1) and PTC and 80 HT patients without PTC (Group 2) were selected. Hemogram parameters, thyroid function tests, and thyroid autoantibodies of the patients were analyzed. Relevant inflammatory markers were calculated, and the results were statistically analyzed. NLR, PLR, and SII values were found to be significantly higher in Group 1 (p = 0.032, p = 0.005, and p = 0.002, respectively) compared to Group 2. ROC curve analysis revealed the most appropriate cut-off point for NLR to be 495.34, for PLR to be 1.77, and for SII to be 115.99. NLR, PLR, and SII levels have been shown to be sensitive in predicting the development of PTC in HT patients.
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    Severe hypoglycemia due to insulin auto-antibodies of newly diagnosed multiple myeloma: A case report
    Guney, SC; Miskioglu, M; Engurulu, SF; Cavdar, GG; Akcura, C; Alkan, S; Ozdemir, N; Hekimsoy, Z
    ObjectiveInsulin autoimmune syndrome (IAS) is a rare condition that can be overlooked in the differential diagnosis of hypoglycemia. Hematologic malignancies such as multiple myeloma (MM) have been associated with IAS. Very few cases of IAS due to multiple myeloma have been reported in the literature. We wanted to present our case who applied to our clinic with severe hypoglycemia and was diagnosed with multiple myeloma-associated IAS.Case presentationAn 83-year-old male patient was admitted to our clinic with recurrent severe hypoglycemia episodes. When the patient's plasma glucose was 37 mg/dL, insulin level was high (2266 mu IU/ml), C-peptide level was relatively normal (3.44 ng/ml); cortisol and ACTH levels were also normal. No pathologic finding was detected in the abdominal MRI and Ga-68 PET/CT. Anti-insulin antibody (IAA) was tested for IAS, and the antibody level was found to be 95.9%. The patient was evaluated in terms of possible conditions that may lead to IAS. Hematology consultation was made due to the fact that the patient had anemia, chronic renal failure, and albumin/globuline discordance, and he was diagnosed with IgG kappa multiple myeloma. Bortezomib and dexamethasone treatment was initiated. A decrease in hypoglycemic symptoms was observed with chemotherapy.ConclusionIAS should be considered in the differential diagnosis of recurrent hypoglycemia cases of unknown cause. It should be kept in mind that IAS may develop due to multiple myeloma, especially in patients with advanced age and anemia.
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    Should adrenal incidentaloma patients be evaluated for muscle mass, function, and quality? A cross-sectional study
    Alkan, S; Guney, SC; Akcura, C; Ozdemir, N; Hekimsoy, Z
    PurposeOur study evaluated skeletal muscle mass, function and quality among mild autonomous cortisol secretion (MACS) patients and non-functioning adrenal incidentaloma (NFAI) patients in comparison with the control group without adrenal mass.Methods63 NFAI (49 female, 14 male) and 31 MACS (24 female, 7 male) patients were included in the study. As the control group, 44 patients (31 women, 13 men) who were known to have no radiological adrenal pathology on computed tomography or magnetic resonance imaging performed for other reasons were selected. After recording the laboratory parameters of the patients, anthropometric measurements, handgrip strength test with dynamometer, SARC-F survey and bioelectrical impedance analysis (BIA) measurements were performed.ResultsThere was no statistical difference among the groups in terms of age, gender, and BMI parameters. Handgrip strength (HGS), skeletal muscle mass (SMM) index (SMM/BMI), and skeletal muscle quality (HGS/SMM), values used to evaluate muscle strength and quality, were found to be significantly lower in both the MACS and NFAI groups compared to the control group (p = 0.004, p = 0.012 and p = 0.034 respectively). This significance was also present in women subgroup analyses (p = 0.002, p = 0.037 and p = 0.039 respectively), but these parameters lost their statistical significance in men. In the correlation analysis of the female subgroup, 24-h free urine cortisol value was inversely proportional to skeletal muscle quality (rs = -0.417, p = 0.008).ConclusionOur study showed that there is a decrease in muscle mass and function in female AI patients, and this decrease is more severe in MACS patients. These results may suggest that mild cortisol excess also has negative effects on skeletal muscle metabolism.