Tip 2 Diyabetli Bir Hastada Linagliptine Bağlı Lokalize Ağrılı Döküntü

The number of patients with type 2 diabetes using dipeptidylpeptidase-4 (DPP-4) inhibitors is increasing across the world.Although this class of antidiabetic medications is generallysafe and associated with less side effects compared to otheroral antidiabetic medications, they could also cause some sideeffects such as skin rashes. Herein we report a case of type 2diabetes patient who developed a painful maculopapular rashinduced by linagliptin, a widely used DPP-4 inhibitor.A localized painful maculopapular rash developed on thepalmar faces of the patient’s hands almost 1 day after theinitiation of the drug. The patient was using intensive insulintherapy before linagliptin was started. There was no eruptionon the other body parts except the palmar faces of the hands.Following the discontinuation of the drug, the rash disappearedin about four days. The patient had no history of urticaria anddid not use an ACE inhibitor. As far as we know, this is the firstcase report of a skin rash induced by linagliptin in the Turkishliterature. This case report highlights a rare and lesser knownside effect of linagliptin, a new member of DPP-4 inhibitors.Dipeptidil peptidaz-4 (DPP-4) inhibitörleri kullanan tip 2 diyabet hastalarının sayısı dünya genelinde artmaktadır. Bu antidiyabetik ilaç sınıfı genelde güvenli olmakla birlikte diğer oral antidiyabetik ilaçlarla karşılaştırıldığında daha az yan etki ile ilişkili olsa da, deri döküntüleri gibi bazı yan etkilerle ilişkili olabilirler. Burada yaygın olarak kullanılan bir DPP-4 inhibitörü olan linagliptin ile indüklenen ağrılı makülopapüler döküntü gelişen tip 2 diyabetli bir hastayı sunuyoruz. Linagliptin başlandıktan 1 gün sonra hastamızın ellerinin palmar yüzünde lokalize ağrılı makülopapüler bir döküntü gelişti. Linagliptin başlanmadan önce hasta intensif insülin tedavisi altındaydı. Vücudun diğer bölgelerinde herhangi bir döküntü yoktu. Linagliptin kesildikten sonra 4 gün içerisinde döküntü kayboldu. Hastanın ürtiker öyküsü yoktu ve Anjiyotensin dönüştürücü enzim inhibitörü kullanmıyordu. Bildiğimiz kadarıyla bu, Türk literatüründe Linagliptine bağlı deri döküntüsü geliştirdiği rapor edilen ilk olgudur. Bu olgu sunumu, DPP-4 inhibitörlerinin nadir görülen ve daha az bilinen bir yan etkisini vurgulamaktadır

Treatment of Recurrent Giant Angiomyolipoma After Nephrectomy with Selective Arterial Embolization: A Case Report

Angiomyolipomas (AMLs) are mesenchymal tumors that typically originate from the kidneys and contain smooth muscle cells, fat cells, and blood vessels. They are usually benign in nature but can be fatal due to complications. AMLs almost always involve the kidneys, and only a few studies have reported the possibility of extrarenal involvement as a rare entity. In this study, we examined a patient who presented to our clinic with left-sided pain and was found to have a large AML measuring approximately 15 cm in size in the left kidney. The patient underwent a simple left nephrectomy, and AML was diagnosed after histopathological examination, with intact surgical margins. During the patient’s routine 6-month follow-up visits, approximately four years after nephrectomy, a mass of approximately 13 cm was observed in the nephrectomy bed and radiologically interpreted as a recurrent AML. A tru-cut biopsy of the mass confirmed AML diagnosis. The patient was treated with selective arterial embolization, which was successful without any complications. We believe that our rare case of recurrent large AML will contribute to the diagnosis and treatment choices for patients with recurrent renal and extrarenal AML in the future and will add to the existing literature

The histopathological evaluation of healing effects of vitamin C administered before methotrexate therapy on testicular injury induced by methotrexate

WOS:000388501500004PubMed ID: 27909615Objective: Methotrexate (MTX) leads to acute toxic side effects in tissues or organs containing rapidly dividing cells such as seminiferous tubules. In this study, we investigated the protective effects of vitamin C against MTX-induced injury in rat testis.Material and methods: A total of 31 rats were divided into 4 groups, including the control group. The study was completed within 4 weeks and the rats received daily doses of 2 mL/kg SF, 100 mg/kg vitamin C and 10 mg/kg/day MTX i.p according to their groups. The mean seminiferous tubular diameter, germinal epithelial cell thickness, and mean testicular biopsy score were determined by histologic examination of each group.Results: The vitamin C MTX group showed more similarity with the control group. Statistically significant results were achieved between groups as for mean seminiferous tubular diameter, germinal epithelial cell thickness, and mean testicular biopsy score. When compared with the group which received vitamin C after MTX therapy, values for mean seminiferous tubular diameter, germinal epithelial cell thickness, and mean testicular biopsy score were significantly higher in the group which received vitamin C before initiation of MTX therapy.Conclusion: Vitamin C decreased MTX-induced testicular histological injuries, especially when used before MTX therap

A Case with Microbiologically Confirmed Lepromatous Leprosy from Mersin, Türkiye

Leprosy, a chronic infectious disease caused by Mycobacterium leprae bacillus, causes damage especially to the skin, upper respiratory tract mucosa and peripheral nerves. In order to prevent the spread of leprosy, which has an effective treatment, it is essential to promptly identify and accurately diagnose cases in the early stages. In this article, we present a patient with lepromatous leprosy who applied to the dermatology outpatient clinic in a non-endemic region. The diagnosis was confirmed through the detection of acid-fast bacilli in the patient’s skin biopsies and the identification of the M. leprae complex using molecular methods. This disease, characterized by non-specific skin lesions in the early stages, should be considered by all clinicians as a potential differential diagnosis. Furthermore, adopting a multidisciplinary approach can greatly facilitate the diagnosis process

Investigation of histopathological effects after intra-arterial sugammadex injection in an experimental animal model

PURPOSE: Intra-arterial injection of medications are related to mortality and morbidity. It was aimed to investigate the histopathological effects caused by two different intra-arterial doses of sugammadex, a new selective relaxant binding agent used to reverse the effects of steroidal systemic muscle relaxants used in surgeries carried out under general anesthesia

The role of COL6A1and PD-1 expressions in renal cell carcinoma

Objective: The COL6A1 is a gene encoding the alpha 1 polypeptide subunit of collagen 6 (COL6A1), an extracellular matrix protein subunit. Programmed cell death receptor-1 (PD-1) and its ligand, programmed cell death receptor ligand-1 (PD-L1) have been shown to have a prognostic significance in clear cell renal cell carcinomas (RCCs). In this study, we evaluated the expressions of COL6A1 and PD-1 in four different RCC subtypes. Materials and methods: A total of 161 radical nephrectomy and nephron-sparing surgery cases with Ra7s from five different health care centers were included in this study. Clinical data of the cases were taken from electronic records of the institutions. The pathological data were collected by an expert uropathologist and re-evaluated with slides obtained from paraffin blocks of the cases. The correlation of COL6A1 and PD-1 expression with sex, age, tumor type, lymphovascular invasion (LVI), World Health Organization/International Society of Urological Pathology (WHO/ISUP) grade, and tumor stage (pT) was analyzed with the Pearson chi-squared test. Results: Patients with sarcomatoid RCC and clear cell RCC had significantly higher COL6A1 scores and intensities than in other types of RCC (p=0.004 and p=0.002, respectively). WHO/ISUP grade and, COL6A1 and PD-1 staining scores also showed positive correlation (r=0.230, p=0.004 and r=0.277, p=0.001, respectively for COL6A1 and r=0.191, p=0.018 and r=0.166, p=0.041, respectively for PD-1). The staining scores and intensities of COL6A1 and PD-1 were not different between the patients with positive and negative LVI (p>0.05). Conclusion: In high-grade RCCs, we found the relationship between immunohistochemical staining scores of COL6A1 and PD-1 proteins and clinical, demographic, and histopathological parameters. Our results proved that COL6A1 and PD-1 are really promising proteins as prognostic parameters and for targeted immunotherapy.Mersin UniversityMersin University [2017-2-AP3-2425]The authors declared that this study has received Mersin University Scientific Research Projects project, AP3; 2017-2-AP3-2425 as financial support