case report: Werner’s Syndrome

Werner’s syndrome (WS) is an extremely rare and autosomalrecessive premature aging syndrome characterizedby scleroderma-like skin changes, alopecia, legulcers, short stature, cataract, early atherosclerosis, osteoporosis,hypogonadism and increased susceptibilityto malignancies and diabetes mellitus. It can be typicallyrecognized at the third or fourth decades of life. Patientswith WS usually die at the age of 40-50 years due to malignanttumors or atherosclerotic complications. Therefore,early recognition of WS is of great importance forgenetic counseling and for the identification of malignanttumors, atherosclerosis, diabetes, or osteoporosis at anearly stage, since they are the most important factorscausing morbidity and mortality. In this article, growth retardation,premature aging, early cataract, the findings ofhypergonadotropic hypogonadism syndrome was hospitalizedand diagnosed with wermer 19-year-old male patientis presented.Key words: Werner’s syndrome, premature aging, hypogonadis

A case of mediastinitis accompanied with hyperosmolar nonketotic coma

AbstractMediastinitis is a serious infection involving mediastinal spaces after cervical infections spread along the facial planes. A late diagnosis of mediastinitis may result in death. Here we present a diabetic patient suffered from mediastinit accompanied with hyperosmolar nonketotic coma. A 61 years old male patient with type 2 diabetes was admitted to our hospital, with complaint of generalized worsening and fever. A diagnosis of nonketotic hyperosmolar coma was done and proper treatment started immediately. Neck tomography revealed abscess formation in the upper mediastinum. The needle aspirat culture failed to show bacterial growth. After five days of antibiotic treatment the patient's symptoms resolved. The abscess formation and pleural effusion almost disappeared on control tomography. No similar case presentation was seen in the current literature. Apart from this case, mediastinit should be keep in mind when a patient suffered from dysphagia, fever and cervical swelling

Importance and Risk Prediction of ABO Blood Group and Rh Factor in Papillary Thyroid Cancer

Objective: There are limited data in the literature regarding the potentialrelationship between thyroid cancer and ABO blood types and Rh factor.The aim of our study was to investigate whether papillary thyroid cancer(PTC) is associated with blood type.Materials and Methods: The present study included patients who presented to Dicle University Faculty of Medicine between June 2009 andDecember 2020 and were diagnosed with PTC as a result of postoperative(thyroidectomy) histopathological analysis. The control group consisted ofindividuals whose blood type was analyzed at a random blood center.Results: Of the 223 patients diagnosed with PTC, 163 (73.1%) were females and 60 (26.9%) were males. In the comparison of patients based onABO blood types and Rh factor, A Rh positive blood type was found 31%less frequently in the PTC group compared with the control group, and thusit was associated with a lower risk of PTC (OR:0.69; 95% Confidence Interval: 0.50–0.96, p=0.029).Conclusions: In our study, we found A Rh positive blood type to be significantly less frequent among patients with PTC. A Rh positive blood type canbe considered as a protective factor indicating a reduced risk of PTC

Alternative methods for the diagnosis of macroprolactinemia: urine prolactin level and serum / urine prolactin ratio

Objective: The aim of this study was to investigate the urine prolactin and serum/urine prolactin ratio for accuracy diagnosis of macroprolactinemia. Methods: In the retrospective cross-sectional analysis, prolactin levels (high or normal) in the reproductive period of men and women were included in the study. Polyethylene glycol (PEG) precipitation method was used for the detection of macroprolactinemia. Then, patients were divided into three groups as macroprolactinemia, prolactinoma and healthy control group. In patients, prolactin values in spot urine with simultaneous serum prolactin values were calculated. The non-parametric Kruskal-Wallis test was used to compare the groups. The receiver-operating characteristic (ROC) curve was determined to evaluate the predictive power of serum/urine prolactin ratio. Results: A total of 41 patients were included in the study. Female/male:36 (87.8%)/ 5 (12.2%). Urinary prolactin median(minimum-maximum) values were macroprolactinemia, prolactinoma and control group, respectively; 0.06(0.05-0.10), 0.11(0.02-0.95), 0.08(0.05-0.25) ng/ml. Serum/urine ratio median (minium-maximum) values were macroprolactinemia, prolactinoma, and control group, respectively; 633(51-1032), 990(104-9635), 395.5(138-953). When the groups were compared, the patients with prolactinoma had higher urinary prolactin levels(p <0.01). Serum/urine prolactin ratio was found to be the highest in prolactinoma patients and the lowest in the control group and a significant difference was observed in groups (p <0.01). ROC analysis(control-macroprolactin) for serum/urine prolactin ratio (Sensitivity 84.6 specificity 93.7 cut off >549,5 AUC=0.83) p<0.01 Conclusion: Urinary prolactin level and serum/urine prolactin ratio may be used in diagnosis of macroprolactinemia

Erkek hipogonadotropik hipogonadizm tanılı hastaların fertilizasyon oranlarının belirlenmesi ve fertilizasyonu etkileyen faktörlerin değerlendirilmesi

Amaç: Hipogonadotropik hipogonadizm tanısıyla takip edilen hastaları retrospektif olarak tarayıp, bu hastalardaki fertilizasyon oranlarını, hormonal profili ve fertilizasyon düzeyini etkileyen faktörleri araştırmayı amaçladık.Gereç ve Yöntem: 2009-2015 yılları arasında Endokrinoloji polikliniğine başvurmuş olan erkek hipogonadizmi tanılı hastalar retrospektif olarak incelendi. 18 yaşından büyük 55 erkek hasta çalışmaya alındı.Hasta dosyalarından hastaların yaşı, boyu, ağırlığı ve testosteron düzeyleri incelendi. Tedavi öncesi TÖ ve tedavi sonrası TS testosteron,spermiogram parametreleri ve skrotal ultrasonografideki testis volümleri karşılaştırıldı.Bulgular: Ortalama testosteron seviyesiTÖ: 0.88±1,3 ng/ml , TS: 5.98±2.96 ng/ml olup, artış istatistiksel olarak anlamlıydı

The effect of vitamin D deficiency on serum sIL-2R, IL-6 and TNF-alpha levels in adults with Type 1 diabetes

Objective: The aim of this study was to investigate the role of vitamin D deficiency in DMT1 pathogenesis by examining the effects of vitamin D levels on immune modulatory cytokines in patients with DMT1. Methods: Thirty adults with DMT1 from the endocrine clinic and 30 healthy controls were included in the study. Measurements for 25-hydroxyvitamin D (25OHD), soluble interleukin-2 receptor (sIL-2R), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) levels were obtained from serum samples from each study participant. Measurements were compared between the control group and the patient group. Correlations between 25OHD levels and the levels of sIL-2R, IL-6, and TNF-α cytokines were investigated in patients with DMT1. Results: The mean 25OHD value for the DMT1 patients was significantly lower than for the control group (14.9±9.8 ng/ml versus 24.8±9.4 ng/ml, respectively; p<0.01). The mean sIL-2R and TNF-α scores for patients with DMT1 were significantly higher than for the control group (707.3 ± 265 U/mL versus 403.1 ± 128 U/mL, respectively; p<0.01; and 10.2±3.0 pg/mL versus 3.8 ± 1.6 pg/mL, respectively; p<0.01). There was no significant difference between the mean IL-6 scores of the DMT1 patients and the controls (3.7±1.5 pg/mL versus 4.6±1.3 pg/mL, respectively; p=0,202). Negative correlations with varying levels of significance were observed between 25OHD and sIL-2R, IL-6, and TNF-α cytokine levels in patients with DMT1. Conclusion: Vitamin D deficiency in DMT1 patients may contribute to disease pathogenesis by increasing sIL-2R, IL-6, and TNF-α cytokines

A rare cause of acromegaly: McCune-Albright syndrome

McCune-Albright syndrome is characterized by polyostatic fibrous dysplasia, brown spots on the skin (café au lait pigmentation) and autonomous endocrine hyperfunction. Early puberty and other endocrinological manifestations, such as acromegaly, gigantism and hypercortisolism are widely observed in the syndrome. Acromegaly is seen in 20% of patients. We report a case of acromegaly accompanied with this syndrome

Clinical and Demographic Characteristics of 78 Patients with Adrenal Incidentaloma [Adrenal Insidentalomali 78 Hastanin Demografik ve Klinik Ozellikleri]

Adrenal incidentalomas (AIs) are adrenal lesions detected on abdominal imaging procedures or abdominal laparotomy that had been performed for unrelated reasons. AIs have become a common clinical concern as a result of widespread use of abdominal ultrasound, CT and MR imaging in clinical practice. The aim of this study was to evaluate the demographical and clinical data our patients with AI. This study included data from 78 patients (53 female 25 male) with AI those followed at Dicle University School of Medicine, Department of Endocrinology and Metabolism, between 2007 and 2013. Data collected from the records were physical and hormonal evaluation, diameter of the lesion, and the features of the lesion on radiological imaging. Also the results of serum cortisol, aldosterone, renin and 24 hour urinary metanephrine and normetanephrine were recorded. The average age of patients were 48.6 ±14.9 years. There was no significant difference in terms of localization of adenomas. Body mass index of patients were 28.54 ± 5.82. Of the patients, 45 (57.7%) were diagnosed as non-functional AI, 10 (12.8%) as subclinical Cushings syndrome, 11 (14,1%) as pheochromocytoma, 2(2.6%) as primary hyperaldosteronism, and 3(3.8%) as adrenal carcinoma. Ganglioneuroma was stated in 2 patients (2.6%), myelolipoma was stated in 1 patient (1.3%), adrenal adenoma was stated in 1 patient, adrenal cyst was stated in 1 patient, schwannoma was stated in 1 patient and neoplasia with small circular cells was stated in 1 patients. AIs are currently more frequently detected in clinical practice due to increased use of imaging techniques. Although the vast majority of AIs are benign and non-functioning, appropriate hormonal evaluation and imaging procedures must be performed. [Med-Science 2015; 4(2.000): 2181-95