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    Evaluation of the effectiveness of anti-IgE treatment in patients with chronic urticaria with an urticarial control test
    (2019) Aytekin, Gokhan; Colkesen, Fatih; Arslan, Sevket; Yildiz, Eray
    Aim: Chronic spontaneous urticaria (CSU) is characterized by recurrent urticaria, angioedema and a combination of both over a period of more than 6 weeks. Anti-immunoglobulin E (IgE) monoclonal antibody (omalizumab) treatment is an effective and safe treatment modality that can be applied in antihistamine-resistant cases in patients with CSU and the urticaria control test is a simple and useful test that evaluates the control level of the disease over the past 4 weeks.Material and Methods: Following appropriate urticaria control tests, 82 test results of 41 patients with CSU (23 females, 18 males) who received subcutaneous anti-IgE treatment at a dose of 300 mg/4 weeks for 6 months were evaluated retrospectively.Results: With each question, there was a statistically significant difference between the mean scores before treatment and at 6 months of treatment (p: 0.001 for question 1, p: 0.001 for question 2, p: 0.001 for question 3, p: 0.001 for question 4). As a result, 95.1% of the patients included in the study achieved a complete and/or partial response to treatment.Conclusion: Omalizumab treatment in patients with chronic spontaneous urticaria (CSU), is an effective and safe treatment modality, independent of the patients’ serum IgE levels, eosinophil counts, thyroid-stimulating hormone levels, C-reactive protein and sedimentation rates, presence or absence of anti-nuclear antibody (ANA) and regardless of whether angioedema is associated with chronic spontaneous urticaria. Furthermore, the urticaria control test is a practical test that can be used to evaluate the efficiency of treatment in CSU patients
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    Kounis syndrome in a patient with secondary mast cell activation syndrome after a bee sting
    (2020) Aytekin, Gokhan; Colkesen, Fatih; Yildiz, Eray; Oltulu, Pembe; Arslan, Sevket
    A 64-year-old male patient was admitted to our clinic with complaints of hot flashes all over the body, fainting and loss of consciousness after a bee sting. The patient who had no history of coronary artery disease was fitted with a stent in the LAD coronary artery with a percutaneous coronary angioplasty by complaints of chest pain and shortness of breath after the bee sting. I3 Vespula spp (yellow jacket) in serum was positive at 0.39 kUA / L-class 1. Tryptase levels were elevated at 19.5/g/L during the asymptomatic period. After the tryptase levels remained elevated at 49.2/g/L during the asymptomatic period after 4 weeks. The bone marrow biopsy revealed a mast cell ratio of 2%. Based on the patient’s history, physical examination and laboratory findings, the patient was considered to have Kounis syndrome, mast cell activation syndrome and a venom allergy
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    Probable “Escitalopram induced” angioedema in a patient with hereditary angioedem
    (2019) Colkesen, Fatih; Aytekin, Gokhan; Yildiz, Eray; Arslan, Sevket; Caliskaner, Ahmet Zafer
    Hereditary angioedema (HAE) is an autosomal dominant disorder. Considerable rate of mortality determines the importance of disease. In this paper, a patient with HAE who developed severe facial angioedema after the first dose of an antidepressant (Escitalopram) prescribed by a psychiatrist because of diagnosis of depression, was presented and discussed. In the presented case, severe facial angioedema was not found to be clearly associated with a particular cause. There were possibilities such as sporadic/idiopathic attack or depression related attack. However, occurrence of an acute attack soon after a newly started drug had to draw attention to Escitalopram. So, in patients with HAE under an antidepressant treatment, antidepressant related angioedema must be kept in mind when the HAE control deteriorated.