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Öğe ECTOPIC TSH-SECRETING PITUITARY ADENOMA IN NASOPHARYNGEAL REGION(Editura Acad Romane, 2021) Altay, F. P.; Kulaksizoglu, M.; Fenkci, S. M.; Yalcin, N.; Sagtas, E.Objective. TSH-secreting pituitary adenomas (TSH-omas) are very rare disorders. This report describes the diagnosis and treatment of a thyroid-stimulating hormone-secreting ectopic pituitary adenoma in the nasopharyngeal region. Subjects and Methods. We report a 37-year-old male patient with thyroid-stimulating hormone-secreting ectopic pituitary adenoma in nasopharyngeal region. Results. A patient suffering from sweating, palpitations, dizziness and abnormality in thyroid tests was referred to our clinic. Thyroid function tests showed high basal levels of free thyroxine (FT4), free tri-iodothyronine (FT3), and serum TSH. TRH stimulation test results indicated blunted response. Scintigraphy showed increased radionuclide uptake (iodine-123), and a thyroid ultrasound scan revealed diffuse enlargement of the thyroid gland. A pituitary MRI indicated a normal pituitary. However, MRI showed a mass in the nasopharynx that was confirmed with endoscopy. Endoscopic total endonasal resection was done and the mass was removed. The pathology reported a TSH-secreting pituitary adenoma. Conclusion. In this report, an identified case of thyroid-stimulating hormone-secreting ectopic pituitary adenoma in nasopharyngeal region is reported and it is the only tenth case in the literature indicated in the nasopharyngeal region. Ectopic TSH-omas should be considered during inappropriate secretion of TSH as a candidate cause to enable correct diagnosis and improve the treatment of patients.Öğe Fas/FasL gene polymorphism in patients with Hashimoto's thyroiditis in Turkish population(Springer, 2017) Erdogan, M.; Kulaksizoglu, M.; Ganidagli, S.; Berdeli, A.Objective Hashimoto's disease is a polygenic disorder with complex etiopathogenesis. Apoptosis is proposed as one of its mechanisms. The Fas/Fas ligand cascade represents a major pathway initiating apoptosis. This study aims to evaluate the influence of Fas and FasL gene polymorphism in Hashimoto's thyroiditis in Turkish population. Materials and methods A total of 112 patients with Hashimoto's thyroiditis and 112 cases of healthy control people were included in this study. The evaluation of genotype for Fas -670 A/G and FasL 843 C/T gene polymorphism was performed by using PCR-RFLP method. Results The FAS genotype and gene allele frequency distribution did differ between the control group (AA 36.6 %, AG 50.0 %, GG 13.4 %, A 61.6 %, G 38.4 %) and the Hashimoto's thyroiditis patients (AA 21.4 %, AG 50.9 %, GG 27.7 %, A 46.9 %, G 53.1 %) (p < 0.01). The evaluation of FasL genotype and gene allele frequency did not show statistically significant difference between the patient group (CC 27.7 %, CT 45.5 %, TT 26.8 %, C 50.4 %, T 49.6 %) and control group (CC 33.9 %, CT 44.6 %, TT 21,4 %, C 56.3 %, T 43.8 %) ( p > 0.05). Conclusions Gene polymorphism of Fas and G allele frequency may play a role in the regulation of apoptosis in thyroid autoimmune disorders. There is a need for further studies to clarify the genetic role of apoptosis in HT.Öğe Genetic variations in interleukin 6 rs1800795 polymorphism and the association with susceptibility to Hashimoto's thyroiditis(Elsevier, 2017) Erdogan, M.; Kulaksizoglu, M.; Ganidagli, S.; Berdeli, A.Hashimoto's disease is a polygenic disorder with complex etiopathogenesis. The imbalance between pro- and anti-inflammatory cytokines may play a role in the etiology. We aimed to evaluate the relation between 174 promoter region of the interleukin 6 rs1800795 gene polymorphism in patients with Hashimoto's thyroiditis (HT). We studied 110 HT patients and 110 healthy controls. The evaluation of genotype for interleukin 6 rs1800795 gene polymorphism were performed by using PCR-RFLP method. The genotype of IL6 distribution did differ between the control group (CC 17.3%, GC 78.2%, GG 4.5%) and the HT patients (CC 29.1%, GC 46.4%, GG 24.5%) (p < 0.001). The frequency of the polymorphic G allele was similar for the group with HT patients as the control group with 47.7% and 43.6%, respectively (p > 0.05). Our results indicate that interleukin 6 rs1800795 polymorphism may be associated with susceptibility to HT in Turkish Patients. It is necessary to confirm the results and determine the underlying pathogenic mechanisms in further studies. (C) 2016 Elsevier B.V. All rights reserved.Öğe NORMOCORTISOLEMIA AFTER TEN DAYS OCTREOTIDE TREATMENT IN A PATIENT WITH ECTOPIC CUSHING'S SYNDROME DUE TO BRONCHIAL CARCINOID(Editura Acad Romane, 2013) Kaya, A.; Cakir, M.; Turan, E.; Kulaksizoglu, M.; Tastekin, G.; Altinok, T.Contex. We report the use of subcutaneous somatostatin injection three times a day to decrease hypercortisolism in a patient who had Cushing's syndrome induced by bronchial carcinoid tumour progressive pneumonia due to immune suppression. Subject and Method. A 46-year-old man with 7-month history of DM type-2, hypertension and cerebrovascular-disease, vertebral compression-fracture was admitted to our clinic. Physical examination was consistent with Cushing's syndrome. Laboratory results revealed hyperglycemia (143 mg/dL; reference range, <100 mg/dL) and hypokalemia (2.29 mEq/L; reference range, 3.5-5.1 mEq/L). His morning serum cortisol was 40 mu g/dL (reference range 6.7-22.6 mu g/dL), urine cortisol-excretion was 2245 mu g/24 hours (reference range 58-403 mu g/24 hours), after 1 mg dexamethasone-suppression test serum cortisol was 28 mu g/dL (6.7-22.6 mu g/dL) and ACTH 354 pg/mL (reference range 7.9-66 pg/mL). Adrenal CT and hypophyseal MRI were normal. An ectopic source was searched for Cushing's syndrome. Chest CT scan of the right lung showed 12x9 mm nodule. High fever cough occurred on the follow-up. Chest radiograph revealed diffuse pneumonic infiltration. Despite 3-drug antibiotic combination therapy, infection did not improve. Subcutaneous injection of octreotide 3x100 mu g was initiated to decrease hypercortisolism. The infection improved rapidly after the therapy. The morning serum cortisol, urine cortisol-excretion, ACTH was at the upper normal range (77.1 pg/mL, reference range 7.9-66 pg/mL) on 10th day of treatment. The patient was a consulted for surgery and the nodule was excised. The pathology was consistent carcinoid tumor. Conclusion. Subcutaneous octreotide treatment may be helpful to gain time for exploring the focus in ectopic cushing's syndrome and to control the serious infections due to hypercortisolism.
