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Öğe Accelerated atherosclerosis in patients with common variable immunodeficiency: Is it overlooked or absent?(Churchill Livingstone, 2015) Ucar, Ramazan; Arslan, Sevket; Turkmen, Kultigin; Caliskaner, Ahmet ZaferCommon variable immunodeficiency (CVID) is a heterogeneous primary deficiency characterized by hypogammaglobulinemia, recurrent infections, and an increased risk of autoimmune disease and malignancy, and so chronic inflammation. Cardiovascular disease is the leading cause of mortality in the general population. Recent studies have suggested that chronic inflammation is an important player in the pathogenesis of CVID. Accelerated atherosclerosis due to ongoing inflammation from recurrent infections and autoimmunity is an expected clinical entity in patients with CVID. However, cardiovascular mortality as a cause of death in CVID series is either absent or minor. We hypothesized that accelerated atherosclerosis and cardiovascular disease are overlooked by clinicians, or atherosclerosis is really lower than that in the general population that may be prevented by some factors such as life-long immunoglobulin replacement treatment. (C) 2015 Elsevier Ltd. All rights reserved.Öğe Common Variable Immunodeficiency and Pulmonary Amyloidosis: A Case Report(Springer/Plenum Publishers, 2015) Arslan, Sevket; Ucar, Ramazan; Yavsan, Dudu Mehmet; Esen, Hasan; Maden, Emin; Reisli, Ismail; Caliskaner, Ahmet ZaferCommon variable immunodeficiency is the most common symptomatic primary immune deficiency characterized by hypogammaglobulinemia, recurrent infections, and increased risk of autoimmune disease and malignancy. Secondary amyloidosis develops from chronic inflammatory conditions. The co-existence of CVID (especially in patients with bronchiectasis) and secondary amyloidosis has been reported rarely. We describe the first case of pulmonary hypertension secondary to pulmonary amyloidosis in a patient with CVID.Öğe Contact dermatitis to cobalt chloride with an unusual mechanism(Sage Publications Ltd, 2015) Arslan, Sevket; Aksan, Serkan; Ucar, Ramazan; Caliskaner, Ahmet ZaferBackground: Contact dermatitis is a frequent inflammatory skin disease. A suspected diagnosis is based on clinical symptoms, a plausible contact to allergens and a suitable history of dermatitis. Therefore, careful diagnosis by patch testing is of great importance because the patch testing is important to find out which allergen/material causes the complaints. Metallic allergens such as cobalt are among the most common causes of allergic contact dermatitis, but frequencies of contact dermatitis to these allergens may vary in different skin areas. Here, we report an unusual case of cobalt allergy on the skin contact with the prosthetic leg of a 30-year-old female patient. Case description and methods: The patient developed maculopapular and vesicular lesions on her contact region of residual limb to prosthetic leg. Findings and outcome: She underwent standard patch testing, which resulted in a strong positive reaction to cobalt chloride. Conclusion: This case report may serve to remind doctors to be aware of potential allergic reactions to prostheses and to enable them to recognize a metal allergy if it appears. Prosthetists should also be reminded of potential allergic reactions. Clinical relevance Cobalt can be used as an accelerator in making a prosthetic socket. Several cases have been reported concerning allergies to components of the prosthetic socket. This is the first report of sensitization to cobalt which is used in making a prosthetic leg.Öğe Could aluminum be a new hidden allergen in type 1 hypersensitivity reactions when used as a drug additive?(Termedia Publishing House Ltd, 2016) Kutlu, Ali; Ucar, Ramazan; Aydin, Ersin; Arslan, Sevket; Caliskaner, Ahmet Zafer[Abstract Not Availabe]Öğe How effective are the 6 European Society of Immunodeficiency warning signs for primary immunodeficiency disease?(Elsevier Science Inc, 2016) Arslan, Sevket; Ucar, Ramazan; Caliskaner, Ahmet Zafer; Reisli, Ismail; Guner, Sukru Nail; Sayar, Esra Hazar; Baloglu, IsmailBackground: The European Society of Immunodeficiency (ESID) developed 6 warning signs to promote the awareness of adult primary immunodeficiency disease (PID). Objective: To screen adult patients for the presence of PID using these 6 warning signs to determine the effectiveness of this protocol. Methods: Questions related to the ESID warning signs for adult PID were added to the standard outpatient clinic file system and asked of 3,510 patients who were admitted to our clinic for any reason. Patients with signs and/or suspicion of PID based on their medical history underwent immunologic investigation. Results: In total, 24 patients were diagnosed as having a PID. The most common reason that patients with PID were admitted was frequent infection (n = 18 [75%]), and the most common PID subgroup was common variable immunodeficiency (n = 12 [50%]). Twenty patients with PID had at least one positive finding according to the ESID warning signs. Two patients with gastrointestinal concerns and 2 with dermatologic symptoms were also diagnosed as having a PID, although they did not have any of the ESID warning signs. Conclusion: The ESID warning signs do not specify the need for symptoms to diagnose a PIDs and do not include a comprehensive list of all signs and symptoms of PIDs. As a result, more than infection-centric questions are needed to identify adult patients with immunodeficiencies. (C) 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.Öğe IgE-Mediated Reaction to Metamizole: Evaluation of a Patient with Severe Anaphylaxis(Aves, 2016) Arslan, Sevket; Ucar, Ramazan; Caliskaner, Ahmet ZaferMetamizole, a non-steroidal anti-inflammatory drug with weak anti-inflammatory and spasmolytic effects, is used as an analgesic and antipyretic agent. Many adverse reactions to metamizole, such as early or late-onset systemic reactions and bone marrow suppression, have been identified. In this report, we present a case of systemic reaction after the application of parenteral metamizole (Novalgin (R) ampoule; Sanofi Aventis, Istanbul, Turkey) and discuss the mechanism underlying the reaction.Öğe Magnetic Resonance Imaging May Be a Valuable Radiation-Free Technique for Lung Pathologies in Patients with Primary Immunodeficiency(Springer/Plenum Publishers, 2016) Arslan, Sevket; Poyraz, Necdet; Ucar, Ramazan; Yesildag, Mihrican; Yesildag, Ahmet; Caliskaner, Ahmet ZaferPurpose In some primary immunodeficiency (PID) patients, especially in the subgroup with common variable immunodeficiency (CVID), radiosensitivity is a concern and avoidance of repeated radiation exposure has been recommended. To investigate the use of lung Magnetic resonance imaging (MRI) instead of Computed Tomography (CT) for the diagnosis and follow-up of various lesions in the lung parenchyma and airways, especially in PID patients in whom x-ray exposure should be limited. Methods The study enrolled 23 patients with PID who underwent thorax CT within the last 3 months and/or who will undergo initial radiological assessment. Lung MRI was performed in all patients to compare the pulmonary findings with CT images. Results MRI performance was weaker at detecting bronchiectasis extension, and a low concordance was found between MRI and CT in the assessment of the number of bronchial generations. CT better identified peripheral airway abnormalities, while CT and MRI gave similar results for detecting the presence and extension of consolidation, bullae, mucus plugging, bronchial wall thickening, bronchiectasis severity and nodules. Conclusions Despite the low spatial resolution, higher cost, and low availability, we suggest MRI as a possible radiation-free alternative to CT in selected patients with PID.
