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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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    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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    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.