Browsing by Author "Bilgir, F"

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    Stevens-Johnson syndrome: a case due to hydroxychloroquine
    Özgül Özdemir, RB; Bilgir, F; Pirildar, T; Kirmaz, C
    Stevens-Johnson syndrome is a rare but life-threatening mucocutaneous skin reaction that is often caused by drugs. The most common causes of mortality are sepsis, gastrointestinal bleeding and fluid-electrolyte imbalance. In this article, a patient with Stevens-Johnson syndrome due to hydroxychloroquine is reported.
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    An experience with plasma exhcange treatment of acute lymphoblastic leukemia in a case with fulminant hepatitis related to L-asparaginase
    Bilgir, O; Calan, M; Bilgir, F; Cagliyan, G; Arslan, O
    Acute lymphoblastic leukemia (ALL) is a malignant disorder resulting from the clonal proliferation of lymphoid precursors with arrested maturation. L-asparaginase is commonly used in combination chemotherapy of both pediatric and adult acute lymphoblastic leukemias. The most commonly encountered side effects of L-asparaginase are hypersensitivity reactions like pyrexia, urticaria, skin rash, and respiratory distress. There are also other side effects like anaphylaxis, coagulopathy, pancreatitis, thrombosis, and hepatic toxicity. Plasmapheresis can sometimes be appropriate to manage an overdose of drugs that circulate in the plasma compartment. We have reported plasmapheresis treatment of fulminant hepatitis in a patient with ALL after L-asparaginase treatment. (C) 2013 Elsevier Ltd. All rights reserved.
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    The levels of adhesion molecules in essential thrombocythemia
    Bilgir, F; Bilgir, O; Calan, M; Sari, F
    Aim. It is known that thrombocytosis is closely related to vascular complications and particularly thrombosis in essential thrombocytemia (ET) cases. The aim of this study is to investigate a possible correlation between adhesion molecules and vascular attacks as well as the relation of these molecules to the platelet count. Methods. The study group consisted of 30 ET patients and 30 healthy controls subjects. Serum intracellular adhesion molecule-1 (ICAM-1), serum vascular adhesion molecule-1 (VCAM-1) and serum E-selectin levels were determined by ELISA method according to manufacturer's instructions. Results. There were no significant differences between two groups with respect to levels of sICAM-1 and sE-selectin (P>0.05). The VCAM-1 levels and platelets were significantly higher in patients with ET compared to controls (P=0.000). Spearman's correlation analysis revealed that sVCAM-1 levels were correlated with platelet counts (r=0.574, P<0.001) Conclusion. High VCAM-1 level in ET and its correlation with the platelet count suggest that these may be a factor in vascular complications and thrombocytosis.
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    Changes in the levels of endothelium-derived coagulation parameters in nonalcoholic fatty liver disease
    Bilgir, O; Bilgir, F; Bozkaya, G; Calan, M
    In a majority of patients with nonalcoholic fatty liver disease (NAFLD), cardiovascular risk factors including diabetes mellitus type 2, abdominal obesity, and metabolic syndrome are present. The purpose of this study is to investigate the presence of endothelial injury and the changes in coagulation parameters in NAFLD patients. For this purpose, plasma levels of von Willebrand factor (vWF), thrombomodulin, urokinase plasminogen activator (uPA), plasminogen activator inhibitor-1 (PAI-1), and tissue factor pathway inhibitor (TFPI) in patients with NAFLD were measured. There was a significant difference in vWF and TFPI levels between patient and control groups (P < 0.05). However, no statistically significant difference was obtained in PAI-1, uPA, and thrombomodulin levels between the two groups (P > 0.05). According to our results, an increase in vWF and TFPI levels indicates an endothelial injury in NAFLD cases.
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    Allergic rhinitis and its relationship with autoimmune thyroid diseases
    Degirmenci, PB; Kirmaz, C; Oz, D; Bilgir, F; Ozmen, B; Degirmenci, M; Colak, H; Yilmaz, H; Ozyurt, B
    Background: Autoimmune thyroid diseases are the most common of all autoimmune diseases. In the literature, Hashimoto thyroiditis (HT) is considered to be a T-helper (Th) type 1 dominant condition, and Graves disease is considered a Th2-dominant condition. Objective: The aim of this study was to highlight a new aspect of the relationships among Th cell subgroups by determining the incidence of autoimmune thyroid disease in patients with allergic rhinitis (AR). Methods: Patients were diagnosed with AR based on their medical histories, physical examinations, and skin-prick test results in an outpatient clinic. The levels of free triiodothyronine, free thyroxine, thyroid-stimulating hormone, thyroid peroxidase antibodies, and thyroglobulin antibodies were measured in peripheral blood samples from all study subjects. Results: A total of 1239 patients with AR and 700 consecutive, age- and sex-matched healthy subjects were included in the study. Thyroid function tests showed that 1037 patients with AR (83.7%) had normal thyroid function, 171 (13.8%) had euthyroid HT, and 31 (2.5%) had hypothyroid HT. Among the control subjects, thyroid function test results showed that 688 subjects (98.2%) had normal thyroid function, 10 subjects (1.4%) had euthyroid HT, and 2 subjects(0.4%) had hypothyroid HT. Conclusion: The incidence of HT in the general population is 1.5%; in contrast, it was observed in 16.3% of our patients with AR, which represented a much higher rate than that in the overall population. Graves disease was not detected in our study subjects. A high incidence of HT in patients with AR, in which Th2 responses are dominant, indicates that further studies of the relationships among atopy, autoimmune diseases, and Th cell subgroups are needed.
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    Our results on SF-36 quality of life scale in patients diagnosed with drug allergy
    Bilgir, F; Bayrak Degirmenci, P; Özgül, RB; Dede, B; Kirmaz, C
    Objective: Drug allergies are drug-hypersensitivity reactions that are assumed to be seen frequently in practice and affect quality of life considerably. The aim of this study is to investigate the effect of drug-allergy on quality of life. Materials and Methods: A total of 100 patients, between 18-70 years of age, who referred to our center with drug allergy were evaluated prospectively. During assessment of patients, a questionnaire including socio-demographic characteristics and a Short Form-36 (SF-36) Quality of Life Scale were used. Results: Of our patients 76% were women, 24% were males and mean age was 38.56 +/- 11.03 years. The physical, social and emotional role components of SF-36 were found to be decreased in all areas in women. When the score dispersion of quality of life subscale according to education level was examined, the physical function subscale was found lower only in elementary school and lesser education areas. Conclusion: In present study it was observed that drug allergy had affected the quality of life of both genders; however its influence over women was more prominent.
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    Subclinical hypothyroidism: Comparison of adhesion molecule levels before and after levothyroxine therapy
    Bilgir, F; Bilgir, O; Calan, M; Calan, O; Isikyakar, T
    Objective: Adhesion molecules are involved in inflammation, atherosclerosis and malignancy. This study measured levels of adhesion molecules before and after levothyroxine therapy in patients with subclinical hypothyroidism (SHO). Methods: Levels of soluble (s) intracellular adhesion molecule (ICAM)-1, s vascular cell adhesion molecule (sVCAM) VCAM-1 and sE-selectin were analysed in patients diagnosed with SHO, prior to administration of 50 mg/day levothyroxine orally for 3 months. Subsequently, levels of sICAM-1, sVCAM-1 and sE-selectin were reanalysed then compared with the pretreatment levels. Results: In 30 patients with SHO, levels of sICAM-1 were found to be significantly higher than those in healthy controls, (P = 0.001). Post-treatment sICAM-1 levels were significantly lower than pretreatment levels (P = 0.001). No significant differences were found in sVCAM-1 or sE-selectin levels between healthy controls and patients with SHO before treatment, or between patients with SHO pre- and post-treatment. Conclusions: Patients with SHO had significantly higher levels of sICAM-1 compared with controls. Levels became normal after treatment with levothyroxine. These findings emphasize the need for levothyroxine therapy in cases of SHO to normalize sICAM-1 levels. Such treatment helps to prevent the future development of atherosclerosis or cancer.
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    Allergic Rhinitis and Its Relationship with IL-10, IL-17, TGF-β, IFN-γ, IL 22, and IL-35
    Degirmenci, PB; Aksun, S; Altin, Z; Bilgir, F; Arslan, IB; Colak, H; Ural, B; Kahraman, DS; Diniz, G; Ozdemir, B; Kirmaz, C
    Background. We aimed in our study to research the role of new cytokines such as IL-35, IL-22, and IL-17 that may form a target for novel treatment approaches. Methods. IL-10, IL-17, TGF-beta, IFN-gamma, IL-22, and IL-35 serum levels of allergic rhinitis (AR) patients were measured using ELISA method. Allergic sensitization was demonstrated by the skin prick test. Patients only with olive tree sensitivity were evaluated for seasonal AR (SAR). Patients only with mite sensitivity were included in the study for perennial AR (PAR). AR clinic severity was demonstrated by the nasal symptom scores (NSS). Results. In total, 65 AR patients (patient group), having 31 PAR and 34 SAR patients, and 31 healthy individuals (control group) participated in the study. Cytokine levels between the patient group and the control group were compared; IL-17 (p = 0 038), IL-22 (p = 0 001), and TGF-beta (p = 0 031) were detected as high in the patient group, and IFN-gamma (p < 0 001) was detected as low in the patient group. When correlation analysis was made between age, gender, prick test result, NSS, AR duration, and cytokine levels in the patient group, a negative correlation was detected only between IFN-gamma (p = 0 032/r = -0 266) level and NSS. Conclusions. Accompanied by the literature information, these results made us think that T cell subgroups and cytokines have an important role in AR immunopathogenesis. It is thought that future studies to be conducted relating to this subject will form new targets in treatment.
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    Clinical Features of Patients with Chronic Urticaria and the Results of the Skin Prick Tests
    Bilgir, F; Özdemir, RB; Degirmenci, P; Dede, B; Kirmaz, C
    Objective: Chronic urticaria (CU), which is mostly idiopathic, may also be a sign of an allergic or systemic disease. A variety of diseases and allergens that accompany CU have been reported in various studies. The aim of this study was to investigate the factors that play a role in the etiology of CU. Materials and Methods: The demographic and clinical data from 302 patients-aged over 18 years-who were being monitored for CU were recorded. Several tests were performed to analyze comorbidities such as infection, malignancy, and autoimmune and rheumatic diseases. Skin Prick Test (SPT) results and questionnaires were reviewed. Results: Two hundred and thirteen out of the 302 patients with a mean age of 40.26 +/- 14.3 years were females. The duration of CU was 43.30 +/- 62.60 months and 42.9% of the patients had comorbidities. The most common disease was autoimmune thyroiditis (13.9%). Fifty-five percent of the patients were sensitive to inhalant allergens, and 5% exhibited allergen positivity for food. The most common allergens were house (43.7%) dust mites. Allergen positivity was 37.2% in those with comorbidities, while it was 62.8% in those without any comorbidities and this relationship was statistically significant (p<0.05). Conclusion: This study showed that there was an association between house dust mite and CU dust sensitivity. House dust mite sensitivity may trigger CU.
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    Comparison of high-sensitivity C-reactive protein and fetuin-A levels before and after treatment for subjects with subclinical hyperthyroidism
    Bilgir, O; Bilgir, F; Topcuoglu, T; Calan, M; Calan, O
    This study was designed to show the effect of propylthiouracil treatment on sCD40L, high-sensitivity C-reactive protein, and fetuin-A levels on subjects with subclinical hyperthyroidism. After checking sCD40L, high-sensitivity C-reactive protein, and fetuin-A levels of 35 patients with subclinical hyperthyroidism, each was given 50 mg tablets of propylthiouracil three times daily. After 3 months, sCD40L, high-sensitivity C-reactive protein, and fetuin-A levels were then compared to the levels before treatment. Although high-sensitivity C-reactive protein and sCD40L levels were normal in the subclinical hyperthyroidism patients compared to the healthy controls, fetuin-A levels were statistically significantly higher (*p = 0.022). After treatment, fetuin-A levels of subclinical hyperthyroidism patients decreased statistically significantly compared to the levels before treatment (**p = 0.026). sCD40L and high-sensitivity C-reactive protein levels did not have a statistically significant difference compared to the control group and post-propylthiouracil treatment. In subclinical hyperthyroidism patients, high fetuin-A levels before propylthiouracil treatment and decreases in these levels after treatment in cases with subclinical hyperthyroidism indicated the possibility of preventing long-term cardiac complications with propylthiouracil treatment.