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Öğe 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, ErayAim: 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 patientsÖğe 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, SevketA 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 allergyÖğe Probable “Escitalopram induced” angioedema in a patient with hereditary angioedem(2019) Colkesen, Fatih; Aytekin, Gokhan; Yildiz, Eray; Arslan, Sevket; Caliskaner, Ahmet ZaferHereditary 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.Öğe Relationship between T regulatory cell levels (CD4 + CD25 + CD127- T cells) and the presence of autoantibodies in adult patients with selective IgA deficiency(2020) Yaskiran, Osman; Aytekin, Gokhan; Yaskiran, Esra; Celikbilek Celik, Seyma; Colkesen, Fatih; Yildiz, ErayAim: Selective immunoglobulin A (sIgA) deficiency is the most common primary immunodeficiency. Individuals with selective IgA deficiency are generally considered to be asymptomatic. In some patients, autoimmune diseases have been reported. Regulatory T cells (T reg) are a group of cells that play a key role in preventing autoimmunity.Material and Methods: 28 patients with selective IgA deficiency and a control group consisting of 15 individuals of similar age and sex were included in the study.Results: Serum IgA levels were lower in patients with sIgA deficiency (p 0.001). There was no difference between the two groups in term of the rate of Treg cells (p: 0.562 and p: 0.873). There was at least one autoantibody positivity in 19 (67.8%) patients with sIgA deficiency and 4 (26.7%) in the control group. The most common positive autoantibody was ANA in both groups. Serum IgG and IgG1 levels were significantly higher in sIgA deficiency patients with autoantibody than in the other group (p: 0.004 and p: 0.004) The relationship between presence of autoantibodies and Treg cell levels in patients with sIgA deficiency was not statistically significant (p: 0.199). The regression analysis showed that the IgG level (OR: 1.594, 95% CI: 1.096-2.319, p: 0.015) was an independent predictor for the presence of autoantibodies.Conclusion: The findings of our study are important as they are the first evaluation in adult sIgA deficient patients. Further studies are required to shed light on this issue in order to evaluate more patients with sIgA deficiency with autoimmunity.Öğe Single center 10 years’ experience of acute lymphoblastic leukemia in childhood: Retrospective cohort study(2019) Erol Aytekin, Selma; Tokgoz, Huseyin; Caliskan, Umran; Aytekin, GokhanAim: We reviewed the files of 188 patients diagnosed with acute lymphoblastic leukemia at Pediatric Hematology Department, Necmettin Erbakan University Faculty of Medicine, Konya, between April 2006 and April 2016 retrospectively. 167 patients, who had sufficient records and accepting to participate in the study, were included. Patients were classified 3 groups according to their treatment protocols. These protocols were Saint Jude Total Therapy (St. Jude) protocol, Berlin-Frankfurt-Munster 2000 (BFM 2000) protocol and BFM 2009 protocol. Acute lymphoblastic leukemia (ALL) is a malignant disorder characterized with clonal enlargement of lymphoid progenitor cells. It is most common malignancy in childhood. Recent developments in immunologic and genetic methods have significantly altered the diagnostic and classification approaches. Nowadays advanced studies such as immunologic and cytogenetic studies have become more important in prognosis and treatment response. In this study, we aimed to present the clinical and laboratory features of patient with ALL who were followed in our Pediatric Hematology Clinic (Necmettin Erbakan University Faculty of Medicine, Konya) and determine the factors affecting the mortality and morbidity in patients with ALL.Results: When the results of the study were evaluated, we found that uric acid levels, blast ratio on the 15th day bone marrow evaluation, presence of relapse and relapse type were effective on overall survival. Also, we found that blast ratio on 15th day bone marrow evaluation, high levels of uric acid, and lactate dehydrogenase (LDH) were effective for event-free survival. Conclusion: In conclusion, our overall survival and disease-free survival rates are similar to those performed by St. Jude Total therapy XIIIB, BFM 2000 and BFM 2009 protocol.
