Atipik Çölyak Hastalığı ve eşlik eden otoimmün hepatit

Burada tedaviye dirençli demir eksikliği, transaminaz yüksekliği ve boy kısalığı ile başvuran, çölyak serolojisi pozitif saptanan ve ince bağırsak biyopsisi ile çölyak hastalığı tanısı alan 10 yaşında olgu sunuldu. Anemi sadece glutensiz diyet ile bir ay içerisinde düzeldi. Başvuru anında hipergamaglobülinemi ve anti-düz kas antikor pozitifliği nedeniyle yapılan karaciğer biyopsisinde portal lenfoplazmositer infiltrasyon saptandı. Histolojik, klinik ve laboratuar bulgular ile otoimmün hepatit tanısı aldı ve immünsüpresif tedavi başlandı. Olgu, atipik prezentasyonun yanında eşlik eden otoimmün hepatitin glutensiz diyet altında immunsüpresif tedaviye alışılagelmişin dışında hızlı yanıt vermesi nedeniyle sunuma değer bulunmuştur.Celiac disease (CD) was diagnosed in a 10-year-old boy who was presented with refractory iron deficiency anemia (IDA), hypertransaminasemia and short stature. Anemia resolved within one month after the institution of gluten-free diet. We performed liver biopsy because of hypergamaglobulinemia and high titers of smooth muscle antibody. On the basis of histologic findings together with clinical and laboratory findings, type 1 autoimmune hepatitis (AIH) was diagnosed. We aimed to report a CD case displaying more than one type of atypical pictures. Concomitant AIH and unusual rapid response of hepatitis to conventional treatment are also emphasized

Association of HLA-DQ polymorphisms with Hepatitis B virus infection in Turkish population

Amaç Konak genetik faktörleri hepatit B virüs (HBV) enfeksiyonunun doğal seyri ve HBV ilişkili karaciğer hastalıklarının gelişme riski ile progresyonu üzerinde etkili olabilmektedir. Bu çalışmada HLA-DQ gen rs9272105, rs2856718 ve rs9275572 polimorfizmlerinin HBV doğal klirensi, viral yük ve HBV ile ilişkili karaciğer hasarı gelişimi ile ilişkisinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem Çalışmaya 150 kronik hepatit B (KHB) hastası ile kontrol grubu olarak 58’i kronik hepatit C (KHC) ve 82’si farklı klinik endikasyonlar nedeniyle karaciğer biyopsi işlemi gerçekleştirilen 140 hasta dâhil edildi. HLA-DQ rs9272105, rs2856718 ve rs9275572 genotip ve polimorfizmlerinin belirlenmesinde TaqMan SNP genotiplendirme yöntemi kullanıldı. Bulgular KHB’li ve kontrol grubundaki hastaların HLA-DQ gen rs9272105, rs2856718 ve rs9275572 genotip ve allel frekansları arasında farklılık tespit edildi (P<0,05). HLA-DQ rs9272105 AA genotip ve A allel varlığı, hepatit B yüzey antijen (Hepatitis B surface antigen; HBSAg) klirensi ve karaciğer hasarı ile ilişkiliydi (p<0,05). HLA-DQ gen rs2856718 ve rs9275572 ise HBV klirensi ve hastaların histolojik sonuçlarıyla ve ayrıca rs9272105 de dâhil hastaların viral yükleriyle ilişkili değildi. Sonuç HLA-DQ rs9272105 AA genotip ve A allel gerek HBV enfeksiyonunun kronikleşmesi gerekse HBV ilişkili karaciğer hasarının gelişmesi için risk faktördür.Objective Host genetic factors can affect the natural course of hepatitis B virus (HBV) infection and the risk of development and progression of HBV-related liver diseases. The aim of this study is to evaluate the role of the HLA-DQ gene polymorphisms rs9272105, rs2856718 and rs9275572 with HBV natural clearance, viral load and the development of HBV associated liver injury. Materials and Methods The study included 150 patients with chronic hepatitis B (CHB) and 140 patients as the control group, 58 of whom had chronic hepatitis C (CHC) and 82 of whom had undergone a liver biopsy due to different clinical indications. The HLA-DQ gene rs9272105, rs2856718 and rs9275572 polymorphisms were genotypes in liver samples using the hybridization probe assay. Results A difference was found between the HLA-DQ gene rs9272105, rs2856718 and rs9275572 genotype and allele frequencies of the patients with CHB and the control group (P<0,05). The HLA-DQ rs9272105 AA genotype and presence of A allele were associated with hepatitis B surface antigen (HBsAg) clearance and liver injury (p<0,05). In contrast, the HLA-DQ genes rs2856718 and rs9275572 were not associated with HBV clearance and patients’ histological outcomes, nor with patients’ viral load, including rs9272105. Conclusions It has been suggested that the HLA-DQ rs9272105 AA genotype and the A allele are risk factors for both the persistence of HBV infection and the development of HBV-related liver damage

TTF-l EXPRESSION IN SMALL CELL NEUROENDOCRINE CARCINOMAS OF THE LARYNX

Small cell neuroendocrine carcinomas of the larynx are uncommon neoplasms-Differential diagnosis includes a limited variety of tumors such as typical carcinoid and atypical carcinoid tumors of the larynx and metastatic small cell lung carcinomas-In this study, 4 cases ol laryngeal small cell carcinoma ol neuroendocrine type were studied for morphological and immunohistochemical features. Three primary laryngeal small cell carcinomas-as well as one metastatic small cell lung carcinoma were detected to be immunopositive for TTF-1. Considering literature data and our findings, the value of TIF-1 expression was found to be questionable in the differential diagnosis between primary and metastatic small cell carcinomas of the larynx

An unusual presentation of an usual lymphoma: A case report

We report a case of seventy-four year-old male with advanced urinary tract obstruction symptoms and a high serum level of prostate specific antigen. In the microscopic examination of the transrectal ultrasound guided prostate needle biopsy specimens, a diffuse infiltration composed of small lymphocytes which were strongly positive for CD20 and CD5 (30%) and negative for CD3, CD10, CD43 and Tdt. After his referral to the hematology clinics for further investigation to verify a possible low grade lymphoproliferative neoplastic disorder, an absolute lymphocytosis in the peripheral blood and generalized lymphadenopathies were detected. In the bone marrow trephine biopsy, we observed a diffuse infiltration of small lymphocytic lymphoid cells having the same morphological and immunohistochemical features with the cells detected in prostate biopsies. With these findings, we made the diagnosis of small lymphocytic lymphoma/chronic lymphocytic leukemia and its prostatic involvement