Renal and suprarenal insufficiency secondary to familial Mediterranean fever associated with amyloidosis: a case report

<p>Abstract</p> <p>Introduction</p> <p>Familial Mediterranean fever is an autosomal recessive disease that predominantly affects people of the Mediterranean coast. One of the most frequent complications of the disease is amyloidosis. This clinical entity is known as secondary (also called AA) amyloidosis.</p> <p>Case presentation</p> <p>In this report, we describe the case of a 33-year-old Turkish man with familial Mediterranean fever and chronic renal insufficiency. He was admitted to our clinic with symptoms of suprarenal insufficiency. The patient died three months later as a result of cardiac arrest.</p> <p>Conclusion</p> <p>Our aim is to make a contribution to the literature by reporting a case of combined insufficiency due to the accumulation of renal and adrenal amyloid in a patient with familial Mediterranean fever, which has very rarely been described in the literature. We hope that adrenal insufficiency, which becomes fatal if not diagnosed and treated rapidly, will come to mind as easily as chronic renal failure in clinical practice.</p

Steinert's syndrome presenting as anal incontinence: a case report

<p>Abstract</p> <p>Introduction</p> <p>Myotonic dystrophy (MD) or Steinert's syndrome is a rare cause of chronic diarrhea and anal incontinence. In the presence of chronic diarrhea and fecal incontinence with muscle weakness, neuromuscular disorders such as myotonic dystrophy should be considered in the differential diagnosis.</p> <p>Case Presentation</p> <p>We present the case of a 45-year-old Turkish man with Steinert's syndrome, who was not diagnosed until the age of 45.</p> <p>Conclusions</p> <p>In clinical practice, the persistence of diarrhea and fecal incontinence with muscle weakness should suggest that the physician perform an anal manometric study and electromyography. Neuromuscular disorders such as myotonic dystrophy should be considered in the differential diagnosis.</p

Central macular thickness in diabetic macular edema

Context. Retinal microvascular dysfunction differs in macular edema lesions in the two eyes of the same patient with diabetic retinopathy. Objective. To evaluate the relationship between central macular thickness (CMT) and metabolic/systemic factors including anthropometric and laboratory findings, in patients with regressed diabetic retinopathy and a history of pars plana vitrectomy (PPV) combined with internal limiting membrane peeling in one eye. Subjects and Methods. Forty-two eyes with PPV and the same patients' fellow 42 eyes (without PPV) included this study. Fasting blood samples of these 42 diabetics were collected to study adiponectin levels and other routine parameters. Results. The average hemoglobinA lc value was 7.3 +/- 1.3%. CMT of the vitrectomized eyes were significantly correlated with atherogenic index of plasma, total cholesterol, low density lipoprotein cholesterol and uric acid (UA). On the other hand, CMT of the nonvitrectomized fellow eyes signifi cantly correlated with glucose levels and diabetes duration. Adiponectin, adiponectin/body mass index, adiponectin/fibrinogen were found significantly higher in the subgroup with CMT >= 300 mu m in the vitrectomized eyes (P= 300 mu m in the fellow (nonvitrectomized) eyes (P<0.05). Conclusions. Although there was no relationship between CMT and hemoglobinA1c values, CMT seemed to be affected by atherogenicity, prooxidant chemical alterations in the course of inflammation, so determination of adiponectin and UA levels may be suggested before surgery to predict the atherosclerotic damage and the postoperative CMT value. Vitrectomy performed at the proper time may be helpful in metabolic remodeling process of the retinal tissue along with life style changes, well control of diabetes, and intraocular treatments

The relationship of inflammatory cytokines with asthma and obesity

Objectives: Obesity is considered a risk factor for asthma. However, the mechanism that connects the two is not well understood. In this study we investigated the relationship between inflammatory cytokines and acute phase reactants in obesity, and asthma. Method: Asthmatic and control subjects were divided into 2 sub-groups: obese and non-obese. Anthropomorphic parameters, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), leptin, tumour necrosis factor-alpha (TNF-&alpha;), and interleukin-6 (IL-6) were compared between obese, asthmatics and control subjects of normal weight. Respiratory function tests and allergy skin tests were also performed in the patients with asthma. Results: ESR, CRP, TNF-&alpha;, IL-6, and leptin levels in obese asthma patients were higher than in the healthy controls (P 0.05). Conclusion: We identified a relationship between acute phase reactants and inflammatory cytokines, and the criteria for obesity in obese asthma patients. Inflammation markers were at their highest levels in obese asthma patients. Leptin levels were considerably higher in obese patients than in normal weight controls. Like obesity, leptin is suggested to play a role in the pathogenesis of asthma

The relationship of inflammatory cytokines with asthma and obesity

Objectives: Obesity is considered a risk factor for asthma. However, the mechanism that connects the two is not well understood. In this study we investigated the relationship between inflammatory cytokines and acute phase reactants in obesity, and asthma

The association of vascular endothelial growth factor, metalloproteinases and their tissue inhibitors with cardiovascular risk factors in the metabolic syndrome

OBJECTIVE: The present study was proposed to examine the matrix metalloproteinases (MMPs), tissue inhibitors of metalloproteinases (TIMPs) and vascular endothelial growth factor (VEGF) in patients with metabolic syndrome (MetS), and to compare these parameters with healthy controls. We also compared the possible association of the circulating levels of MMP-2, MMP-9, TIMP-1, TIMP-2, and VEGF with cardiovascular risk factors in patients with MetS. We also compared the possible association of the circulating levels of MMP-2, MMP-9, TIMP-1, TIMP-2, and VEGF with cardiovascular risk factors in patients with MetS