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Amaç: Literatürde “büyük taklitçi” olarak anılan inflamatuar bir hastalık olan sarkoidoz olgularında semptomlar ve tutulan organlar açısından cinsiyete göre farklılıklar bildirilmiştir. Bu çalışmada sarkoidoz olgularındaki semptom ve bulguların cinsiyete ve hastalığın evrelerine göre farklılıkları araştırıldı.Gereç ve Yöntemler: Bu retrospektif gözlemsel kohort çalışmamızda sarkoidoz tanılı olgular başvuru semptomlarına göre; asemptomatik, pulmoner semptomlar, ekstrapulmoner semptomlar, pulmoner ve ekstrapulmoner semptom birlikteliği olarak gruplandırıldı. Her iki cinsiyet bulguların sıklığı açısından karşılaştırıldı.Bulgular: Çalışmaya alınan 338 hastanın %71’i kadın olup yaş ortalaması 42,5±11,6 idi. Olguların %86’sı başvuru anında semptomatik olup, semptomların %31’i yalnız pulmoner, %23’ü yalnız ekstrapulmoner, %32’sinde ise hem pulmoner hem de ekstrapulmoner semptomlar birlikte idi. Kadın ve erkeklerde öksürük (sırasıyla %45; %42; p=0,620), balgam çıkarma (sırasıyla %9; %11; p=0,535), hemoptizi (sırasıyla %2; %1; p=0,678), ateş (sırasıyla %4; %4; p=0,999) bulguları açısından cinsiyete göre anlamlı farklılık bulunamadı. Dispne kadınlarda erkek olgulara göre anlamlı olarak daha sık izlendi (sırasıyla %33; %22; p=0,048). Kadın hastalarda erkeklere kıyasla göğüs ağrısı anlamlı olarak daha az görüldü (sırasıyla %7; %20; p=0,001). Aşırı terleme erkeklerde kadınlara göre anlamlı olarak daha fazla görülürken (p=0,004), eritema nodosum kadınlarda erkeklere göre fazla bulundu (p=0,003). Terleme dışındaki konstitüsyonel yakınmalarda cinsiyet farkı izlenmedi.Sonuç: Sarkoidozlu kadınlar daha yaşlıdır ve nefes darlığı ile eritema nodosum, kadınlarda erkeklere göre anlamlı oranda sık bulunmuştur. Erkeklerde ise terleme ve göğüs ağrısı belirgin yüksek tespit edilmiştir.

Aim: Sarcoidosis is a multisystemic disease with typical or atypical pulmonary and extra-pulmonary symptoms or frequently without symptoms. Presence of typical clinical findings and symptoms contribute to rapid diagnosis, whereas asymptomatic progression leads to delays in the diagnosis. The aim of this study was to investigate the delay in diagnosis in between patients with pulmonary and/or extra-pulmonary involvement and related symptoms and those without symptoms. Material and Methods: Patients in the sarcoidosis clinics between 2010-2015, were retrospectively evaluated. The cases were grouped according to the presence or absence of symptoms (pulmonary and/or extra-pulmonary). The groups were compared with regard to the delay in diagnosis. Results: Among the 300 patients, 209 (69%) were female. The mean age was 43±11.68. The disease was stage I in 67.3%, stage II in 23.7%, stage III in 5.7% and stage 0 in 3.3% of the patients. No significant difference was observed between symptomatic and asymptomatic patients with regard to total duration until diagnosis (p=0.78). A statistically significant difference was observed between patients groups with regard to physician-related delayed diagnosis(p=0.026). The mean delay in physician-related diagnosis was observed to be longer in asymptomatic cases (21.44 days) compared to patients with pulmonary symptoms (13.66 days)(p=0.036). In asymptomatic cases, the mean duration of physician-related delayed diagnosis (21.44 days) was observed to be longer in comparison with patients with extra-pulmonary symptoms (12.79 days)(p=0.016). In patient-related delayed diagnosis, no difference was observed between groups with regard to the duration until diagnosis(p=0.78). Conclusion: Comparison of delayed diagnosis between patients with or without pulmonary and/or extra-pulmonary symptoms revealed a longer duration of delay in asymptomatic cases compared to symptomatic cases. The timing of diagnosis is very important in sarcoidosis in order to reduce morbidity and mortality; a suspicious approach to asymptomatic patients will increase the possibility of diagnosis and prevent delayed diagnosis. [ABSTRACT FROM AUTHOR]

The pathogenesis of COVID-19 involves a complex interplay between host factors and the SARS-CoV-2 virus, leading to a multitude of clinical manifestations beyond the respiratory system. This chapter provides an overview of the risk factors, genetic predisposition, and multisystem manifestations of COVID-19, shedding light on the underlying mechanisms that contribute to extrapulmonary manifestations. The chapter discusses the direct invasion of SARS-CoV-2 into various organs as well as the indirect mechanisms such as dysregulation of the renin-angiotensin-aldosterone system (RAAS), immune response dysfunctions within the innate and adaptive immune systems, endothelial damage, and immunothrombosis. Furthermore, the multisystem manifestations of COVID-19 across different organ systems, including the cardiovascular, renal, gastrointestinal, hepatobiliary, nervous, endocrine and metabolic, ophthalmic, ear-nose-throat, reproductive, hematopoietic, and immune systems are discussed in detail. Each system exhibits unique manifestations that contribute to the complexity of the disease., (Copyright © 2024. Published by Elsevier Inc.)

Mycoplasma pneumoniae is a respiratory pathogen responsible for community-acquired atypical pneumonia. Apart from respiratory manifestations, other system involvement has also been reported. We present a case of interstitial pneumonia and a concurrent episode of acute pancreatitis in a young female who presented with fever, cough, vomiting, and epigastric pain. The abdominal evaluation revealed epigastric tenderness with no signs of organomegaly. Her complete metabolic profile was nonsignificant except for elevated serum lipase and amylase. Clinical, serological, and radiological features and detailed investigations confirmed the diagnosis of acute pancreatitis and interstitial pneumonia caused by M .  pneumoniae  in the absence of any other etiology. Her respiratory and gastrointestinal symptoms improved rapidly after commencing clarithromycin, providing a possible link between M .  pneumoniae  and pancreatitis., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Khan et al.)

Objective: Patients seeking treatment for their asthma are most likely motivated by a change in their experience of symptoms, but primary complaints are not always related to the pulmonary system. This study aimed to determine the frequency of such extrapulmonary symptoms in asthma outpatients and their association with psychopathology and asthma outcomes.Methods: This cross-sectional study utilized data collected as part of a nationwide, clinical-epidemiological study. The final sample of 572 asthma patients represented all levels of asthma control and severity. Information on demographics and respiratory function was obtained from physicians' documentation. Symptoms were explored using a standardized checklist.Results: Primary symptoms reported by asthma patients were not necessarily airway-related. Patients reported feeling at least occasionally "tired" (72.1%) and "exhausted" (66.8%) more than any other asthma symptom. Hyperventilation and mood symptoms were experienced by 34.4-42.6% of patients. Anxiety or depression diagnoses indicated higher scores in all symptom domains. Controlling for asthma-related factors and psychopathology, fatigue had a small but significant effect on both asthma-related quality of life (AQLQ) (rsp2 = 0.02, P < .001) and asthma control (rsp2 = 0.01, P = .003). Mood symptoms also showed a small but significant effect on AQLQ (rsp2 = 0.02, P < .001).Conclusion: Findings suggest that extrapulmonary symptoms are endorsed more frequently than previously reported. Symptoms nonspecific to asthma can play a substantial role in clinical presentation and exclusive focus on airway symptoms may miss important information related to patients' well-being. Surveillance of extrapulmonary symptoms alongside pulmonary function is warranted for an integrated medicine approach to asthma management. [ABSTRACT FROM AUTHOR]

Mycoplasma pneumoniae (M. pneumoniae) is an extracellular pathogen that penetrates the ciliated layer of the respiratory mucus and firmly adheres to the surface of the epithelial cells. It differs from other bacteria by not producing peptidoglycan and thereby not forming a firm cell wall. This close contact of cells and mycoplasmas allows for membrane fusion and the exchange of antigens, which explains many extrapulmonary complications from autoimmune reactions (Such as myocarditis, pericarditis, encephalitis, peripheral neuropathy, haemolytic anaemia, Stevens-Johnson syndrome, mucositis, epidermal necrolysis, myelitis, coagulopathy, erythema multi- forme, macular rash, erythema nodosum, hepatocellular jaundice, acute pancreatitis, acute glomerulonephri- tis, renal failure, cholestatic hepatitis, even coma and others). M. pneumoniae is a common cause of upper respiratory tract infections, but it can take the course of atypical bronchopneumonia. Diagnosis can be confir- med with high probability by serological examination of antibody titre of immunoglobulin M (IgM), where an IgM antibody titre of 1:32 is considered highly significant. However, positivity is manifested in only 50--70 % of pati- ents 7--10 days after the outbreak of disease. A negative result, however, does not exclude a possible ongoing infection. [ABSTRACT FROM AUTHOR]