The effects of body ıron stores on metabolic control, ınsulin resistance and microalbuminuria in patients with type 2 diabetes mellitus

Objective: Free iron is involved in processes including oxidative stress, inflammation and insulin resistance which play key roles in the development of type 2 diabetes. The aim of this study is to investigate the role of body iron stores in metabolic control, insulin resistance and microalbuminuria. Materials and Methods: Our study included 50 patients with newly diagnosed type 2 diabetes mellitus and 50 healthy subjects as controls. Groups were compared for sex, age, body mass index, various biochemical and metabolic parameters. Correlation between these parameters with mean ferritin levels of patients was also calculated. Diabetic patients were grouped according to metabolic control, insulin resistance and microalbuminuria and the correlation between these paremeters and ferritin level was analyzed. Results: There was no difference in mean ferritin levels between two groups In the patient group, significant correlation was determined between mean ferritin level and fasting blood glucose, hemoglobin A1c, C-peptide, insulin andHOMAscore. There was no difference in mean ferritin levels between diabetic patients with good or bad metabolic control. The mean ferritin level was significantly higher in diabetic patients with insulin resistance than non-insulin resistant diabetics. Mean ferritin level was significantly higher in microalbuminuric patients. Conclusion: Our findings support that body iron stores are involved in the pathogenesis of type 2 diabetes

A rare cause of non-cirrhotic portal hypertension: primary antiphospholipid syndrome

The antiphospholipid syndrome involves long-term persistence of serum antiphospholipid antibodies and hypercoagulability manifested by venous or arterial thrombosis, recurrent pregnancy loss or thrombocytopenia. Two forms have been described: the “primary syndrome” where there is no evidence of an underlying disease, and the “secondary syndrome”, mainly in the setting of systemic lupus eryhematosus. Classic features of antiphospholipid syndrome include cutaneous signs, such as livedo reticularis, splinter hemorrhages, superficial thrombophlebitis, and leg ulcers; venous thrombotic events, such as cerebral or retinal vein thrombosis; arterial thrombotic events, such as transient attacks or ischemic infarcts, recurrent spontaneous early-term abortions, and thrombocytopenia. Also various hepatic manifestations have been reported with antiphospholipid syndrome in literature, including Budd-Chiari syndrome, hepatic-veno-occlusive disease and occlusion of small hepatic veins, nodular regenerative hyperplasia and portal hypertension. Herein we present a case of non-cirrhotic portal hypertension associated with primary antiphospholipid syndrome which this coexisting is rarely seen in the literature

Musculoskeletal involvement in sarcoidosis: A single center experience

Objective: Sarcoidosis is a chronic inflammatory disease that affects many organs and systems, especially the lungs, lymph nodes and musculoskeletal system. Musculoskeletal system involvement patterns in sarcoidosis are not well defined and literature data are limited in terms of clinical features. This study aimed to investigate the clinical and demographic characteristics of sarcoidosis patients with musculoskeletal system involvement. Methods: One hundred and four patients with sarcoidosis who were followed up in our clinic between June 2020 and January 2024 were evaluated retrospectively. Forty-four sarcoidosis patients aged >18 years with objectively detected musculoskeletal system involvement were included in the study. The musculoskeletal system involvement patterns, clinical and laboratory findings, and demographic characteristics of the patients were analyzed. Results: Musculoskeletal involvement was found in 44 of the 104 sarcoidosis patients (42%). Of the 44 patients with musculoskeletal involvement, 37 (77.3%) were female, the mean age was 46.9±12.2 years, and the mean follow-up time was 14±11.8 months. The most common objective musculoskeletal pathology was chronic arthritis (17%), mostly in the form of chronic oligoarthritis. Wrist (50% vs. 3.8%, p=0.001) and metacarpophalangeal joint involvement (38.9% vs. 0, p=0.001) were significantly higher in patients with chronic arthritis than in patients with acute arthritis. While joint involvement starting as monoarthritis was an independent negative predictor for the development of chronic arthritis [odds ratio (OR): 0.046, 95% confidence interval (CI): 0.003-0.815, p=0.036], the presence of obesity at baseline was a positive predictor for the development of chronic arthritis (OR: 11.968, 95% CI: 1.069-133.960, p=0.044). Conclusion: Sarcoidosis can present with a wide range of musculoskeletal manifestations. The most common musculoskeletal pathologies in sarcoidosis are acute and chronic arthritis. Sarcoidosis patients presenting with monoarthritis do not usually develop chronic arthritis. Patients with chronic sarcoid arthritis initially present more hand-joint involvement. Obesity is a risk factor for the development of chronic arthritis

Hepatosplenomegaly and pernicious anaemia

Sir,Pernicious anaemia (PA) is the end stage of atrophic gastritiswhich results in the loss of parietal cells in the fundus and bodyof the stomach. Loss of parietal cells is associated with the failureof intrinsic factor production and results in vitamin B12 deficiencyand megaloblastic anaemia. Only two cases of splenomegalycoexisting with PA have been reported, but both splenomegaly andhepatomegaly has not been reported yet [1,2]. In this report, weaimed to describe a patient with hepatosplenomegaly due to PA.To the best of our knowledge this is the first documented case ofhepatosplenomegaly due to PA and totally resolved by vitamin B12therapy

Is chills an independent predictor factor for familial mediterranean fever severity score?

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Evaluating of atherosclerosis in rheumatoid arthritis patients with carotid intima media thickness and lipoprotein phospholipase A2 activity

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EMPHYSEMATOUS PYELONEPHRITIS CAUSED BY KLEBSIELLA OXYTOCA IN A PATIENT WITH DIABETIC NEPHROPATHY

WOS: 000281404900020A 50-year-old woman with a 30 years history of diabetes mellitus and has been diagnosed with diabetic nephropathy for the last 4 years presented with abdominal pain, nausea and vomiting. Abdominal ultrasonography revealed a hyperechogenic air image at right kidney and with the aid of subsequently performed abdominal tomography type 2 emphysematous pyelonephritis diagnosis was made. Klebsiella oxytoca was isolated in blood culture and with appropriate antibiotic therapy and subsequent percutenous drainage the patient made a full recover

Thyroid autoimmunity in patients with Familial Mediterranean Fever: preliminary results

Ankarali, Handan Camdeviren/0000-0002-3613-0523; Bugdayci, Guler/0000-0002-4060-3354; SOY, MEHMET/0000-0003-1710-7018WOS: 000328085300008PubMed: 24302182AIM: We investigated whether there was a significant increase in thyroid autoimmunity in patients with Familial Mediterranean fever (FMF). PATIENTS AND METHODS: In total, 220 patients, consisting of 42 with FMF, 75 with rheumatoid arthritis (RA), and 103 healthy controls, were enrolled. Serum thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), and thyroid autoantibodies (anti-thyroid peroxidase and anti-thyroglobulin) were measured in all participants. RESULTS: After adjustment for age, gender, and smoking status, statistically significant differences between serum levels of anti-thyroglobulin antibody, anti-thyroid peroxidase antibody, and fT3 were found between the groups (all p 0.05). The frequency of autoimmune thyroiditis in FMF group is higher than control group. However, this difference did not reached the level of statistical significance (p > 0.05). CONCLUSIONS: Although statistically not significant, thyroid autoimmunity was observed more frequently in patients with FMF than in healthy controls. Thyroid autoantibodies were significantly higher in patients with FMF. Studies with greater number of patients are required for evaluating the frequency of the autoimmune thyroiditis in patients with FMF