Yazar "Kebapcilar, Levent" seçeneğine göre listele

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    Assessment of Evidence for Positive Association and Seroprevalence of Hepatitis B and C in Diabetic Patients in a Developing Country
    (BMJ PUBLISHING GROUP, 2015) Korkmaz, Huseyin; Kesli, Recep; Pamuk, Bans Onder; Ipekci, Suleyman Hilmi; Terzi, Yuksel; Kebapcilar, Levent
    Background and Aim: The data related to the association between hepatitis virus infections and diabetes mellitus (DM) are conflicting. The aim of this study was to investigate the seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) and to determine the risk factors affecting the prevalence in Turkish patients with type 1 DM and type 2 DM. Methods: The study consisted of 736 diabetic and 505 nondiabetic patients. Serological investigation for the hepatitis B surface antigen (HBsAg) and the HCV antibody (anti-HCV) was performed with a third-generation commercial chemiluminescence assay. The presence of HBsAg was considered as indicator of HBV infection. The HCV infection in the patients with positive anti-HCV was confirmed by a real-time polymerase chain reaction assay. The patients were divided according to their HBV and HCV infection status, and their demographic features, diabetes properties, general risk factors, and aminotransferase levels were analyzed. Results: There was no significant difference in the seropositivity rate for the HBsAg (3.8% vs 3.0%, P > 0.43; odds ratio, 1.292; 95% confidence interval, 0.683-2.444). However, anti-HCV seropositivity was significantly increased in the DM group (3.3% vs 1.8%, P < 0.03; odds ratio, 2.398; 95% confidence interval, 1.025-5.609). Increased aminotransferase levels and a history of blood transfusions were positively correlated with both HBV and HCV infection. Moreover, a history of surgical procedures and high glycated hemoglobin A1c levels were positively associated with HBsAg antigen seropositivity. Conclusions: Although no significant difference in the seropositivity of the HBsAg was determined, a high prevalence of HCV infection was detected in the DM patients compared to healthy controls.
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    A CASE OF PAGET'S DISEASE OF THE BONE PRESENTED WITH HEARING LOSS AS THE FIRST SYMPTOM
    (GUNES KITABEVI LTD STI, 2014) Baldane, Suleyman; Ipekci, Suleyman H.; Bulut, Serap; Baldane, Emine Gul; Gedik, Gonca Kara; Kebapcilar, Levent
    A 67-year-old woman presented to the audiology clinic with a complaint of bilateral hearing loss over the past two years. Routine biochemical screening showed an alkaline phosphatase level of 381 U/L, and she was referred to our endocrinology unit. Her vitamin D and parathyroid hormone levels, as well as thyroid, liver and kidney function test results, were within normal ranges. Cranial x-ray radiography showed an increase in the diploe distance and a sclerotic pattern in the calvarium; while whole body bone scintigraphy demonstrated a diffuse increase in radioactive substance involvement of the calvarium. Serum osteocalcin and spot urinary deoxypyridinoline levels were increased. The patient was diagnosed with Paget's disease with hearing loss as the first symptom, and she was started taking zoledronic acid treatment. Three months later, her alkaline phosphatase level had returned to the normal range, and audiologic examination showed a mild improvement in hearing.
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    Central arterial characteristics of gout patients with chronic kidney diseases
    (WILEY, 2017) Celik, Gulperi; Yilmaz, Sema; Kebapcilar, Levent; Gundogdu, Ali
    Background: The aim of this study was to investigate the relationship between central blood pressure, arterial stiffness parameters and renal function parameters in gout patients with chronic kidney disease (CKD) and without CKD. Methods: The study enrolled 48 gout patients and 32 control subjects. Central blood pressure, arterial stiffness parameters and renal function parameters in gout patients were investigated. The vascular measurements were performed with an arteriograph. Results: Of the gout patients, 40.1% had CKD. The 24-h pulse pressure (PP) (P < 0.001), central systolic blood pressure (SBP) (P < 0.001), central diastolic blood pressure (DBP) (P < 0.001), cardiac output (CO) (P < 0.001) and peripheral resistance (P = 0.004) were significantly higher in the all patients with gout compared to healthy control subjects. Moreover, when the gout patients with and without CKD were compared, the gout patients with CKD had higher 24-h PP (P = 0.009), 24-h augmentation index standardized to a heart rate of 75 beats per min (AIx@75) (P < 0.023), daytime PP (P = 0.001), daytime AIx@75 (P = 0.027), and nighttime PP (P = 0.035) than the gout patients without CKD. Conclusions: In our study, gout patients with CKD had worse and more emphasized evidence of arterial stiffness than gout patients without CKD. Further investigations with large sample sizes are needed to evaluate the effect of CKD on the arterial stiffness of gout patients.
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    COMPARISON OF BONE TURNOVER MARKERS BETWEEN MALE SMOKER AND NON-SMOKER
    (CARBONE EDITORE, 2016) Kargin, Nisa Cetin; Marakoglu, Kamile; Unlu, Ali; Kebapcilar, Levent; Korucu, Emine Nedime
    Introduction: Osteoporosis is the most frequently seen metabolic bone disease. Smoking has long been defined as a changeable risk factor in life style for both bone loss and fractures. This study is aimed to compare of the bone turnover markers between smoker and non-smoker male. Materials and methods: In this cross-sectional and descriptive study, 85 smoker males were allocated to the case group, while 85 non-smoker males were allocated to the control group. Osteocalcin (OC) and osteoprotogerin (OPG) analyzed among bone formation parameters, while RANKL (Receptor activator of nuclear factor kappa-B ligand) and CTX (C-terminal telopeptide) were studied among the bone destruction parameters alongside with TSH (Thyroid-Stimulating Hormone), Ca (Calcium), P (Phosphorus), PTH (Parathyroid Hormone), ALP(Alkaline Phosphatase), TT (Total Testosterone), and vitamin D parameters that affect bone mineral density. Results: It was found that the smoker group's CTX level (50.30+/-26.97 ng/ml) was statistically significant lower than that of the non-smoker group (65.10+/-42.41 ng/ml. (p=0.007) The average serum PTH level of the smoker and non-smoker groups were 23.75+/-9.88 pg/ml and 31.35+/-13.15 pg/ml respectively and the related average of the non-smoker group was statistically higher than that of the smoker group (p=0.000). It was found that the smoker group's vitamin D (16.75+/-8.73 ng/ml) was statistically significant lower than that of the non-smoker group (19.50+/-8.97 ng/ml (p=0.044). Conclusions: The study supports the fact that one of the risk factors for osteoporosis is smoking and it negatively affects bone formation as well. It should be noted that osteoporosis is a significant health issue not only for older men but also for middle-aged male smokers and the necessary support for smoking cessation should be offered.
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    Diabetic ketoacidosis occurring in patient on newly started insulin glargine u300
    (AVES, 2018) Kirac, Cem Onur; Ipekci, Suleyman Hilmi; Kebapcilar, Levent
    Insulin glargine U300 is a 3-fold, concentrated, long-acting insulin analog providing a more stable effect compared with insulin glargine U100. However, stable plasma insulin concentration is reached on day 4 of the treatment. Patients with type 1 and type 2 diabetes mellitus with decreased insulin reserve are at an increased risk of diabetic ketoacidosis when there is insufficient exogenous plasma insulin concentration. Herein, we present a case of diabetic ketoacidosis occurring in a patient with insulin glargine U300 and emphasize the pharmacokinetic properties of insulin glargine U300.
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    Efficacy comparison of oral rosuvastatin versus oral progesterone and bevacizumab on regression of surgically endometriotic implants in rats
    (TAYLOR & FRANCIS LTD, 2017) Kebapcilar, Ayse G.; Ilhan, Tolgay T.; Dursunoglu, Duygu; Kebapcilar, Levent; Ipekci, Suleyman H.; Baldane, Suleyman; Ucar, Mustafa G.
    This study hypothesizes that oral rosuvastatin, oral dienogest and intraperitoneal bevacizumab might improve endometriosis in randomly selected female Wistar albino rats with surgically endometriotic implants. Thirty female Wistar albino rats with surgically endometriotic implants were randomized into three treatment groups: oral rosuvastatin (20mg kg/day; oral rosuvastatin group 1; n=10), oral progesterone (dienogest group 2; n=10) and intraperitoneal bevacizumab (2.5mg/kg of single intraperitoneal injection of bevacizumab; bevacizumab group 3; n=10), for 10 days. Post-treatment variables were compared. The oral rosuvastatin group showed higher reduction for the glandular epithelium and uterine vessels of histopathological scores values than the oral progesterone group (both, p<0.017, respectively). The median glandular epithelium and uterine vessels and histopathological scores values did not show a statistically significant difference between group 1 and group 3 (p>0.017). Endometrial thickness values and uterine volume values were more significantly reduced in the oral rosuvastatin group than the oral progesterone group (both, p<0.017, respectively). Moreover, endometrial thickness and uterine volume values were not different in groups wecompared with group 3 (p>0.017). In conclusion, oral rosuvastatin and intraperitoneal injection of bevacizumab may cause more significant regression of surgically endometriotic implants in rats than oral progesterone medications.
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    Examination of Adhesion Molecules, Homocysteine and hs-CRP in Patients with Polygenic Hypercholesterolemia and Isolated Hypertriglyceridemia
    (JAPAN SOC INTERNAL MEDICINE, 2011) Calan, Mehmet; Calan, Ozlem; Gonen, Mustafa Sait; Bilgir, Ferda; Kebapcilar, Levent; Kulac, Esin; Cinali, Turker
    Background Increased levels of selectins, adhesion molecules, hs-CRP and homocysteine are considered important as indicators of atherosclerosis. There is a significant amount of evidence that high LDL-C levels are a risk factor for coronary artery disease, whereas the relevance of isolated triglycerides is controversial. The present study aims to compare the levels of homocysteine, hs-CRP, E-selectin, sP-selectin, VCAM-1, ICAM-1 in patients with isolated hypertriglyceridemia and polygenic hypercholesterolemia. Methods The following three groups were formed: polygenic hypercholesterolemia group (n=30), isolated hypertriglyceridemia group (n=30) and control group (n=30). These three groups were matched in terms of BMI, waist circumference and gender. Plasma high sensitive CRP, homocysteine, sVCAM-1, sICAM-1, sP-selectin, sE-Selectin levels of patients in these three groups were measured. Results In the present study, mean values for sE-selectin, sVCAM-1 and sICAM-1 in the polygenic hypercholesterolemia group were significantly higher than in the other two groups (p<0.001). Homocysteine and hs-CRP levels were higher in the polygenic hypercholesterolemia group, compared to the isolated hypertriglyceridemia group (p=0.019, p<0.001; respectively) and the control group (p<0.001, p<0.001; respectively). Comparison of patients with hypertriglyceridemia to individuals in the control group did not yield a significant difference in terms of sE-selectin, sP-selectin, sVCAM-1, sICAM and homocysteine (p>0.05), where as the hs-CRP value was significantly higher in patients with isolated hypertriglyceridemia compared to the control group (p=0.001). Conclusion The increase of adhesion molecules, homocysteine and hs-CRP in polygenic hypercholesterolemia subjects compared to the isolated hypertriglyceridemia group reflects their high cardiovascular risk.
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    Increased arterial stiffness and its relationship with inflammation, insulin, and insulin resistance in celiac disease
    (LIPPINCOTT WILLIAMS & WILKINS, 2015) Korkmaz, Huseyin; Sozen, Mehmet; Kebapcilar, Levent
    ObjectiveCeliac disease (CD) is a lifelong, chronic, immune-mediated, inflammatory small bowel disorder, precipitated by exposure to dietary gluten and related proteins in genetically predisposed individuals. Recent studies have shed new light on the importance of inflammation in the pathogenesis of arterial stiffness. The aim of this study was to evaluate arterial stiffness using pulse wave velocity (PWV) in adult CD patients without cardiovascular risk factors in comparison with a control group.Patients and methodsA total of 58 patients with CD without cardiovascular risk factors and age-matched and sex-matched healthy controls were enrolled in the study. All patients completed a standard questionnaire form, and various laboratory parameters were assessed. Vascular measurements, including PWV, were carried out using a Mobil-O-Graph 24-h pulse wave analysis monitor, an automatic oscillometric device.ResultsAlthough cardiovascular risk factors, such as low-density lipoprotein cholesterol and triglyceride, were significantly lower (P<0.05) in celiac patients than in controls, the erythrocyte sedimentation rate, C-reactive protein, insulin, homeostasis model assessment of insulin resistance, homocysteine, and 24h, day, and night PWV values were higher in patients with CD than in controls (P<0.05). A multiple linear regression analysis showed that PWV was correlated positively with age and the duration of CD.ConclusionThis study found increased arterial stiffness, homocysteine, erythrocyte sedimentation rate, C-reactive protein, insulin, and homeostasis model assessment of insulin resistance in patients with CD and provides evidence for the potential contribution of these parameters and inflammation toward arterial stiffening, independent of conventional cardiovascular risk factors.
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    Increased pulse wave velocity and relationship with inflammation, insulin, and insulin resistance in inflammatory bowel disease
    (LIPPINCOTT WILLIAMS & WILKINS, 2014) Korkmaz, Huseyin; Sahin, Fatih; Ipekci, Suleyman H.; Temel, Tuncer; Kebapcilar, Levent
    Objective Both ulcerative colitis and Crohn's disease are forms of inflammatory bowel disease (IBD), which is characterized by chronic, progressive inflammation of the gastrointestinal tract. Recent studies have shed new light on the importance of inflammation in the pathogenesis of arterial stiffness. Aim This study aimed to evaluate the relationship between pulse wave velocity (PWV) measurement and biochemical parameters in inactive and active IBD patients without cardiovascular risk factors and perform a comparison with the control group. Materials and methods We enrolled 102 IBD patients without cardiovascular risk factors and 74 matched controls, and evaluated each patient in active and inactive disease periods. All patients completed a standard questionnaire form and we assessed various laboratory parameters. We carried out vascular measurements using a Mobil-O-Graph 24-h pulse wave analysis monitor, an automatic oscillometric device. Results Although cardiovascular risk factors, such as total cholesterol and low-density lipoprotein cholesterol, were significantly lower (P < 0.05) in IBD patients than the controls, 24 h, day and night PWV values, erythrocyte sedimentation rate, C-reactive protein, insulin, homeostasis model assessment of insulin resistance, and homocysteine were higher in patients with active and inactive IBD than the controls (P < 0.05). Multiple linear regression analysis showed that PWV was correlated positively with age and duration of IBD. Conclusion This study showed increased PWV, homocysteine, erythrocyte sedimentation rate, C-reactive protein, insulin, and homeostasis model assessment of insulin resistance in patients with active and inactive IBD and provides evidence of the potential contribution of inflammation and inflammation-related factors toward arterial stiffening independent from conventional cardiovascular risk factors. (C) 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.
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    Influence of Exercise on Leptin, Adiponectin and Quality of Life in Type 2 Diabetics
    (GALENOS YAYINCILIK, 2015) Dede, Nesrin Dogan; Ipekci, Suleyman Hilmi; Kebapcilar, Levent; Arslan, Mihriban; Kurban, Sevil; Yildiz, Mustafa; Gonen, Mustafa Sait
    Purpose: This study aimed to investigate the influence of aerobic exercise on the quality of life and leptin and adiponectin levels in patients with type 2 diabetes mellitus. Material and Method: Patients were randomized into two groups: aerobic exercise-training and control group. Parameters were assessed at baseline and end of the twelve-week follow-up for 60 type 2 diabetic patients who completed the program. The 36-item Short Form Health Survey was administered to the patients. Results: The exercise-training group results showed a decrease in adiponectin and leptin levels, a reduction of waist circumference and percentage of body fat (p=0.007, 0.023, 0.012 and 0.048, respectively). The leptin levels in the aerobic exercise group were positively correlated with body mass index (r=0.303, p=0.021) and percentage of body fat (r=0.371, p=0.005); they were negatively correlated with physical problems (r=-0.482; p=0.009) and pain (r=-0.540; p=0.003). Exercise led to statistically significant improvements in the SF-36 physical functioning and mental health subscales (p=0.020 and 0.023, respectively). Discussion: The association of better HbA1c, waist circumference, and percentage of body fat with improved mental and physical scores may be related to a decrease in leptin levels, despite a significant reduction in serum adiponectin levels.
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    Is the Mean Platelet Volume a Predictive Marker of a Low Apgar Score and Insulin Resistance in Gestational Diabetes Mellitus? A Retrospective Case-Control Study
    (PREMCHAND SHANTIDEVI RESEARCH FOUNDATION, 2016) Kebapcilar, Levent; Kebapcilar, Ayse Gul; Ilhan, Tolgay Tuyan; Ipekci, Suleyman Hilmi; Baldane, Suleyman; Pekin, Aybike; Kulaksizoglu, Mustafa
    Introduction: Gestational diabetes is defined as various degrees of glucose intolerance diagnosed or detected for the first time during pregnancy and is the most common metabolic complication of pregnancy. Early diagnosis and adequate treatment are important to prevent complications. Preeclampsia, polyhydramnios, fetalmacrosomia, and operative delivery are some of the complications seen in pregnant women diagnosed with Gestational Diabetes Mellitus (GDM). Aim: The present study was designed to determine whether there was an association between Mean Platelet Volume (MPV) in predicting poor fetal outcome, insulin resistance, neonatal Apgar scores and gestational age for women with GDM. Materials and Methods: In this retrospective study, we enrolled 101 pregnant women with GDM together with a group of 138 healthy controls. MPV, insulin and homeostatic model assessment (HOMA-IR) values were measured at 24-28 weeks of the pregnancy. An independent samples t-test was used to compare MPV values. Multivariate linear regression models were used to establish relations between MPV values, HOMAIR, insulin levels and Apgar score. Results: There was a significant positive correlation between MPV values, HOMA-IR and Insulin levels and a negative correlation with Apgar score at 1 min and 5 min in the GDM group (r=0.227, p=0.02; r=0.206, p=0.03; r=-0.485, p<0.001; and r=-0.399, p<0.001, respectively). In the multivariate logistic regression analysis, a high MPV value was most consistently associated with a low Apgar 1 min score (beta=-0.387, p=0.003) in the GDM group. An MPV of >8.0 fL had a sensitivity of 82% and a specificity of 75% for the prediction of GDM. Conclusion: We investigated the potential of MPV values in predicting low Apgar scores and insulin resistance in women with GDM.
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    Is there a link between premature ovarian failure and serum concentrations of vitamin D, zinc, and copper?
    (LIPPINCOTT WILLIAMS & WILKINS, 2013) Kebapcilar, Ayse Gul; Kulaksizoglu, Mustafa; Kebapcilar, Levent; Gonen, Mustafa Sait; Unlu, Ali; Topcu, Ali; Demirci, Fatih
    Objective: The risk of primary ovarian insufficiency (POI) increases in association with autoimmune conditions. Adequate intake of vitamin D (vit D) and trace elements is required for the immune system to function efficiently. The aim of this study was to evaluate vit D, zinc, and copper blood levels in women with POI who had given birth to at least one child and in women with normal menstrual cycles. Methods: This was a cross-sectional, case-control study involving 63 participants divided into two groups: the study group, which is composed of 35 women with POI, and the control group, which is composed of 28 women with normal menstrual cycles. Serum concentrations of zinc, vit D, and copper were determined for each participant. Results: Women with POI had significantly higher serum copper levels and copper-to-zinc ratio but significantly lower serum vit D and zinc levels when compared with the healthy control group. Serum follicle-stimulating hormone levels were inversely correlated with zinc and vit D levels and positively correlated with the copper-to-zinc ratio and copper levels. Vit D levels were inversely correlated with follicle-stimulating hormone levels, copper-to-zinc ratio, and copper levels and positively correlated with zinc levels. Conclusions: Most women with POI are deficient in vit D. Zinc, copper, and vit D seem to correlate with hormonal status in the participants. The present study may generate hypotheses for future studies that will investigate the possible mechanisms behind alterations in trace elements and vit D deficiency in women with POI and whether these changes could be used to screen for the risk of developing POI.
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    'Letter to the Editor' of response for arterial stiffness in patients with celiac disease
    (LIPPINCOTT WILLIAMS & WILKINS, 2017) Korkmaz, Huseyin; Kebapcilar, Levent
    [Abstract not Available]
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    Non-Invasive Estimation of Disease Activity and Liver Fibrosis in Non-Alcoholic Fatty Liver Disease Using Anthropometric Biochemical Characteristics, and C-13-Methionine Breath Test
    (WILEY-BLACKWELL, 2015) Korkmaz, Huseyin; Unler, Gulhan K.; Gokturk, Huseyin Savas; Schmidt, Wolfgang E.; Kebapcilar, Levent
    [Abstract not Available]
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    Noninvasive estimation of disease activity and liver fibrosis in nonalcoholic fatty liver disease using anthropometric and biochemical characteristics, including insulin, insulin resistance, and C-13-methionine breath test
    (LIPPINCOTT WILLIAMS & WILKINS, 2015) Korkmaz, Huseyin; Unler, Gulhan K.; Gokturk, Huseyin S.; Schmidt, Wolfgang E.; Kebapcilar, Levent
    ObjectiveThe purpose of this study was to noninvasively estimate disease activity and liver fibrosis in patients with nonalcoholic fatty liver disease (NAFLD) using anthropometric and biochemical characteristics and the C-13-methionine breath test (MeBT).MethodsA total of 164 patients with histologically proven NAFLD and 56 healthy controls were included in the study. Anthropometric and biochemical analyses and the MeBT were performed on all patients and controls.ResultsBMI; waist circumference; waist-hip ratio; transaminase, lipid, -glutamyl transpeptidase (GGT), glucose, and insulin levels; and insulin resistance were significantly higher in patients with NAFLD than in controls. The GGT level and the MeBT were independent predictors of nonalcoholic steatohepatitis (NASH). Fibrosis was correlated with GGT, bilirubin, cholesterol, and insulin levels, and the MeBT, but the test was the only independent predictor of significant fibrosis. Patients with simple steatosis had similar MeBT values as controls. The MeBT values were significantly lower in NASH and NASH-cirrhosis patients (P<0.001) compared with simple steatosis patients and controls. Patients with advanced fibrosis (F2-3) had significantly lower MeBT values than patients with mild fibrosis (F0-1; P<0.001). The area under the receiving operating characteristic curve for NASH and advanced fibrosis was estimated to be 0.95 in the total cohort.ConclusionThis study indicates that anthropometric and biochemical parameters are insufficient for estimating the presence of NASH or the fibrosis stage. However, the MeBT is a suitable noninvasive method for accurately predicting which patients suffer from simple steatosis, NASH, or NASH-cirrhosis.
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    Nonsurgical periodontal therapy with/without diode laser modulates metabolic control of type 2 diabetics with periodontitis: a randomized clinical trial
    (SPRINGER LONDON LTD, 2016) Kocak, Emrah; Saglam, Mehmet; Kayis, Seyit Ali; Dundar, Niyazi; Kebapcilar, Levent; Loos, Bruno G.; Hakki, Sema S.
    In order to evaluate whether nonsurgical periodontal treatment with/without diode laser (DL) decontamination improves clinical parameters, the levels of IL-1 beta, IL-6, IL-8, intercellular adhesion molecule (ICAM), and vascular cell adhesion molecule (VCAM) in gingival crevicular fluid and metabolic control (HbA1c) in chronic periodontitis (CP) patients with diabetes mellitus type 2 (DM2). Sixty patients with DM2 and CP were randomly assigned into two groups to receive scaling and root planing (SRP, n = 30) or SRP followed by diode laser application (SRP + DL, n = 30). Clinical periodontal and gingival crevicular fluid (GCF) parameters were assessed at baseline, 1, and 3 months after periodontal treatment. HbA1c levels were evaluated at baseline and 3 months post-therapy. Total amounts of cytokines and molecules were analyzed by ELISA. Nonsurgical periodontal treatment with/without DL appeared to improve clinical, biochemical parameters, and glycemic control in DM2 patients (BMI < 25 kg/m(2)) with CP. The SRP + DL group provided better reductions in probing depth (PD) and clinical attachment level (CAL) parameters compared to the SRP group (P < 0.05). Significant reductions were found in the total amounts of GCF levels of IL-1, IL-6, IL-8, ICAM, and VCAM after treatment (P < 0.05). HbA1c levels decreased significantly at 3 months after treatment (P < 0.05). SRP + DL reduced HbA1c levels more significantly compared to SRP alone (0.41 vs. 0.22 %, P < 0.05). SRP, especially in combination with DL, shows improvement of glycemic control for DM2 patients with CP.
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    Subclinical Celiac Disease Presented with Postpartum Low Back Pain Case Report
    (BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2015) Baldane, Suleyman; Ipekci, Suleyman; Sahin, Fatih; Gul Baldane, Emine; Karabagli, Pinar; Kebapcilar, Levent
    A 35-year-old woman was admitted with severe low back pain. The patient, who gave birth 5 months ago, was then breastfeeding and presented with postpartum low back pain with increasing severity. Her laboratory results revealed anemia, hypocalcemia, severe vitamin D deficiency, and increase in alkaline phosphatase (ALP) and parathyroid hormone (PTH) levels. Dual energy X-ray absorptiometry (DXA) scan demonstrated lumbar vertebral T and Z scores of -5.1 and -4.4, respectively. The serologic tests for celiac disease (CD) to search underlying malabsorption were positive. Histological analysis of the duodenal biopsy specimen revealed results consistent with the diagnosis of CD. However, because of an absence of gastrointestinal complaints, the diagnosis of subclinical CD could have been made when malabsorption resulted in osteoporosis associated with severe vitamin D deficiency. The initiation of vitamin D therapy showed a significant increase after 6 months at the lumbar vertebra T and Z scores of -0.7 and -0.2, respectively.
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    Successful preoperative treatment by plasmapheresis of hyperthyroidism with hydatidiform mole
    (AVES, 2018) Kirac, Cem Onur; Baldane, Suleyman; Kebapcilar, Ayse Gul; Ipekci, Suleyman Hilmi; Ucar, Mustafa Gazi; Celik, Cetin; Kebapcilar, Levent
    We recently encountered the case of an 18-year-old female complaining of abdominal pain, fatigue, nausea, vomiting, tremor of the hands, and vaginal bleeding. Her blood test revealed highly elevated human chorionic gonadotropin (hCG) levels, suppressed thyroid-stimulating hormone (TSH) levels, and increased free thyroid hormone levels. Molar pregnancy and hyperthyroidism were suspected based on highly elevated hCG levels and suppressed TSH levels with the co-existence of ultrasono-graphic findings of the uterus and thyroid Doppler images. Her symptoms and thyroid hormone levels responded well to plasmapheresis. Subsequently, the patient underwent dilatation and curettage for hydatidiform mole. Histopathology of the products verified the diagnosis of complete hydatidiform mole with no invasion. The patient is currently stable, and her hCG and thyroid hormone levels are within normal reference ranges.
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    Treatment of recurrent hypoglycemia with plasmapheresis and steroid in nondiabetic patient
    (PERGAMON-ELSEVIER SCIENCE LTD, 2013) Kulaksizoglu, Mustafa; Gonen, Mustafa Sait; Kebapcilar, Levent; Sahin, Fatih; Demirci, Fatih; Topcu, Ali
    We recently encountered a 35-year old man who suffered from frequent hypoglycemia. His blood test revealed the presence of high and suppressed level of insulin with supressed C-peptide levels, hypothalamic-pituitary axis was normal response in hypoglycemia and negative for anti-insulin antibody. Endocrinological and imaging data eliminated the possibility of insulinoma. His symptoms responded well to the therapy of prednisolone (60 mg/day) and plasmapheresis. We followed up the patient over the subsequent 6 months without remarkable lesions. He has had no further recurrences of hypoglycemia. We believe that the antiinsulin receptor antibody might have induced hypoglycemia in this patient. (C) 2012 Elsevier Ltd. All rights reserved.