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    A Rare Presentation of Coeliac Disease; Intractable Itching with Recurrent Heart Attack and Dermatitis Herpetiformis
    (Bilimsel Tip Yayinevi, 2021) Alan Yalim, Sümeyra; Dumanoğlu, Betül; Poyraz, Merve; Alpagat, Gülistan; Baççıoğlu, Ayşe; Kalpaklıoğlu, Ayşe Füsun
    Coeliac disease (CD) is a systemic disease of the unwarranted immune reaction to gluten and is associated with a 10% increased risk of cardiovascular disease. Here we present a patient with recurrent myocardial ischemia and intractable itching who was eventually diagnosed with CD. A 53-year-old man presented to the allergy department due to intractable itching that was resistant to antihistamine therapy. In addition, despite successful percutaneous intervention with stent implantation to the right coronary artery, there was an ST segment elevation with myocardial infarction (MI) in the lower wall that had occurred three times. After dermatitis herpetiformis was reported as a result of the biopsy performed from the lesions, duodenal biopsy confirmed the diagnosis of CD. Diagnosis of CD with atypical presentation can be difficult. Cardiovascular risk is increased in patients with celiac disease compared to the normal population. Itching is an important symptom that needs to be evaluated in detail, even without the typical gastrointestinal manifestations of CD.
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    Vitamin D Levels in Patients with Allergic and Non-Allergic Rhinitis
    (Bilimsel Tip Yayinevi, 2022) Kalpaklıoğlu, Ayşe Füsun; Alpagat, Gülistan; Baççıoğlu, Ayşe; Alan Yalim, Sümeyra; Dumanoğlu, Betül; Poyraz, Merve
    Objective: Allergic and non-allergic rhinitis are quite similar from a clinical viewpoint and allergen sensitivity seems to be the important relevant difference between them. However, the role of vitamin-D (vit-D) as an immunomodulator hormone and on rhinitis phenotypes is not clear. We aimed to investigate the relation between vit-D levels and patients with rhinitis as allergic (AR) and non- allergic (NAR). Materials and Methods: This was a retrospective research of 228 patients whom were diagnosed at a tertiary hospital between 2012 and 2016. Rhinitis was diagnosed as AR if nasal symptoms were accompanied with skin prick test (SPT) positivity, and NAR if they were relevant with negative SPT. The clinical history of the patients and the symptoms were recorded. Serum total IgE tests were performed using an allergen detection system (UniCAP, Phadia, Uppsala, Sweden), and vit-D levels were measured with the 25-hydroxy-vit-D (25-OH vit-D) kit in the Elecsys 2010 analyzer (Roche Diagnostics, Germany). Results: A total of 228 patients (AR=170 and NAR=58) with a mean age of 31.06 +/- 11.58 yrs were included. The mean age and ratio of female gender were significantly higher in NAR (p=0.03), whereas obesity was significantly higher in AR patients (p=0.01). Duration of rhinitis in NAR was longer than in AR (p=NS). Serum total IgE levels were significantly higher in AR than NAR, whereas mean levels and ratio of vit-D deficiency were similar between the groups. Levels of vit-D were significantly lower in females than males only in the AR group (p<0.001). Patients with NAR had mostly severe vit-D deficiency (<10 ng/mL), and those with AR had mostly non-severe vit-D deficiency (11-19 ng/mL). There was no relationship between vit-D deficiency and allergen sensitization, but there was a negative correlation of vit-D levels and female gender in the AR group (p<0.001). Conclusion: The present study showed no association between serum vit-D level and allergen sensitization in adult patients with allergic and nonallergic rhinitis.