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Angioedema is classified into two major groups: mast cell-mediated (histaminergic) and bradykinin-mediated angioedema. Hereditary angioedema and acquired angioedema are well-defined groups of bradykinin-mediated angioedema. Both hereditary angioedema and acquired angioedema demonstrate a similar clinical presentation and can be challenging to differentiate. The prevalence of autoimmune diseases is higher in patients with HAE and lupus is an autoimmune disease associated with HAE. In this case, we aimed to present a male patient who was monitored with the diagnosis of HAE and developed systemic lupus erythematosus (SLE) in the follow-up and to discuss whether the patient had hereditary angioedema and concomitant lupus, or acquired angioedema secondary to SLE. [Med-Science 2020; 9(2.000): 512-4]

Hypersecretion of PTHrP is a relatively common cause of malignancy-related hypercalcemia. However, there is only one case report of letrozole induced hypercalcemia. A 52-year-old female patient was referred to our clinic because of the recent discovery of hypercalcemia (11.0 mg/dL). The patient had a history of left breast carcinoma. She had started a course of letrozole (aromatase inhibitor; 2.5 mg dose/day) ten months earlier. Patient’s parathyroid hormone-related protein levels were normal and a bone scintigram revealed no evidence of skeletal metastasis. Other potential causes of high calcium levels were ruled out. We recognized that, when letrozole was taken at one dose daily (2.5 mg), she had recurrent hypercalcemia. Our experience suggests that letrozole may precipitate hypercalcemia in a patient with breast cancer.

Objective:This study aimed to examine the sleep quality of common variable immunodeficiency (CVID) patients and to investigate the relationship between sleep quality and depression, anxiety, fatigue, excessive daytime sleepiness and naturel killer (NK) cell counts.Materials and Methods:The study included 53 patients followed with CVID diagnosis. To determine sleep quality and conditions associated with sleep quality in CVID patients, Pittsburgh sleep quality index (PSQI), fatigue severity scale (FSS), Hamilton depression scale (HAM-D), Hamilton anxiety scale (HAM-A) and Epworth sleepiness scale (ESS) were used.Results:Fatigue was found in 37 (70%) patients, poor sleep quality in 34 (64%), depression in 20 (38%), anxiety in 16 (30%), and excessive daytime sleepiness in 11 (21%) patients. All patients CVID patients received immunoglobulin replacement therapy: Intravenous immunoglobulin (IVIG) in 37 (72%) and subcutaneous immunoglobulin (SCIG) in 16 (28%) patients. The PSQI, HAM-A, HAM-D and FSS scores of the patients receiving IVIG treatment were higher than those of the patients receiving SCIG treatment (all, p

Background: Despite the worldwide increase in life expectancy and the elderly population, very little is known about the characteristics of anaphylaxis in older adults. Methods: A retrospective scan was made of the files of patients who presented at the Allergy Unit of our clinic between October 2011 and October 2021. The study included 971 patients aged ≥18 years who met the criteria for diagnosis of anaphylaxis. The patients were separated into 2 groups of adults (18–64 years) and older adults (≥65 years). Results: The adult group included 887 (91.3%) patients and the older adult group, 84 (8.7%) patients. Comorbid diseases were seen more frequently in the older adults than in the adult group (p

Purpose: Electrocardiography (ECG) is the first-line diagnostic tool to evaluate cardiac involvement in any disease and COVID-19 patients. The objective of this study is to investigate the ventricular arrhythmia forming effect of COVID-19 and to guide the treatment. Materials and Methods: A total of 74 patients (mean age 52.63±17.85 years) under follow-up for asymptomatic COVID-19 and 74 healthy volunteers (mean age 50.71±6.02 years) were enrolled in the study. Heart rate, QRS duration, QT distance, T-wave morphology (Tp-e interval), Tp-e/QT ratio, and index of cardio-electrophysiological balance (iCEB) were analyzed and compared to both groups. Results: The heart rate was higher, and the QT interval was shorter on ECG in the COVID-19 group. QTc interval, Tp-e intervals, and Tp-e/QT ratio were not different between groups. Furthermore, iCEB and iCEB-c values were not different between groups. A significant positive but weak correlation was observed between CRP and troponin values in patients with COVID-19. Moreover, there was no correlation between troponin levels and Tp-e/QT ratio and iCEB in patients with COVID-19. Conclusion: The chronic cardiac effects of the COVID-19 have not been elucidated. Prospective clinical trials with long-term and a high number of patient populations are needed to reveal this. Notably, patients with significantly elevated troponin values should be followed up for long-term development of cardiomyopathy and arrhythmias.

Aim: In this study, we aimed to determine the epidemiological characteristics of infections detected in a tertiary ICU of our hospital and to evaluate the transmission routes. Materials and Methods: In the period of study, a total of 57 health-care associated infection (HAI) cases were diagnosed. Health-care associated infection diagnoses were evaluated according to the "Centers for Disease Control and Prevention (CDC)" criteria. Results: A total of 1278 patients who were followed up in the ICU for two years were analyzed retrospectively. Health-care associated infections were detected in 57 of these patients. The rate of HAI development among patients hospitalized in the ICU was 5.24%. Pneumonia with specific laboratory findings was the most common infection in patients with HAI (33.3%). Eleven different microorganisms were determined as the pathogens of HAI. The bacteriological profile causing HAI in the study, Gram-negative and Gram-positive pathogens were 87% and 12.9%, respectively. Acinetobacter baumanni was the most common pathogen (51.8%). Conclusion: Each unit should determine its patient profile, flora and resistance patterns by conducting surveillance studies and plan treatment strategies accordingly. Keywords: Health-care associated infection, intensive care unit, surveillance.

Yaygın değişken immün yetmezlik (YDIY), bozulmuş antikor üretimi ve yetersiz B hücresi farklılaşması ile karakterize nadir görülen bir birincil immün yetmezlik tablosudur. Her ne kadar YDIY hastalarında sık tekrarlayan solunum yolu enfeksiyonları en belirgin klinik durum olsa da; YDIY, lenfoid hiperplazi, otoimmün sitopeni, kronik akciğer hastalıkları, granülomatöz hastalıklar ve maligniteye yatkınlık gibi birçok sistem ve organı etkileyen heterojen bir immün sistem bozukluğudur. Bu durum, tanı ve immünoglobulin replasman tedavisinde gecikmeye, uygun dozda ve zamanda antibiyotik alınamamasına, kronik inflamasyona ve dolayısıyla sekonder amiloidoza yol açabilir. Bu vaka sunumunda, otoimmün komplikasyonla seyreden bir YDIY olgusu ve takip sırasında gelişen renal amiloidoz tablosunun sunulması amaçlanmıştır.

Introduction:Common variable immunodeficiency (CVID) is the most heterogeneous group among the antibody deficiency syndromes, but its effects on the cardiovascular system have not yet been clearly identified. Here, we aimed to investigate the arrhythmogenic effects of this disease with electrocardiography.Methods:The study included 30 CVID patients and 30 control subjects matched for age and comorbidities. Electrocardiographic and echocardiographic values of all participants were recorded. QRS, QT, Tp-e were measured manually. QTc was calculated using Bazett’s formula. Then, Tp-e/QT, Tp-e/QTc, QT/QRS, and QTc/QRS ratios were calculated and compared between the groups.Results:PR interval and P-wave dispersion were found to be higher in the CVID group. In addition, the QT interval and corrected QT interval, T peak-to-end interval were higher in the CVID arm, and the index of cardiac electrophysiological balance value obtained with the QT/QRS ratio was also higher in the CVID group. The number of patients with P terminal force was also higher in the CVID group.Conclusion:As a result of this study, it was found that CVID patients have a higher incidence of developing arrhythmia than normal healthy individuals.